With the recent changes in healthcare, hospitals have been under increasing pressure to reduce costs. You have been hired by Best Care Hospital to assist in negotiating the 2016 contract with the nurses. Based on the terms of the nursing contract, the hospital may need to change the way they charge the various hospital departments. Your job is to advise the hospital on whether they insist on a contract that allows the hospital to continue with the existing two-level fixed cost system for charging nursing services to the various hospital departments or to accept a contract that would cause them to switch to a variable cost system. You are provided with the following information:

In 2015, the nurses received an average annual salary of $45,000. The hospital holds each department accountable for its financial performance, and it records revenues and expense by departments. Consider the expenses of the pediatrics department in 2015.

Variable expenses (based on 2015 patient days) are as follows:

Variable expenses:

Meals $ 610,000

Laundry $260,000

Laboratory $900,000

Pharmacy $850,000

Maintenance $150,000

Other $530,000

Total $ 3,300,000

Fixed expenses (based on number of beds) are as follows:

Rent $ 3,000,000

General administrative services $2,200,000

Janitorial $200,000

Maintenance $150,000

Other $350,000

Total $ 5,900,000

Management assigns nurses to department on the basis on annual patient-days as follows:

Volume Level in Patient-Days # of nurses

10,000-12,000 30

12,001-16,000 35

Total patient-days are the number of patients multiplied by the number of days they are hospitalized. The hospital charges each department for the salaries of the nurses assigned to it. During 2015, the pediatrics department had a capacity of 60 beds, billed each patient an average of $810 per day, and had revenues of $12.15 million.

1) Compute the 2015 volume of activity in patient-days.

2) Compute the 2015 patient days that would have been necessary for the pediatrics dept to recoup all fixed expenses except nursing expenses.

3) Compute the 2015 patient-days that would have been necessary for pediatrics to break-even including nurses salaries as a fixed cost. Do this for both relevant ranges. Provide a written conclusion based on your analysis.

4) Suppose pediatrics must pay $175 per patient-day for nursing services. This plan would replace the two-level, fixed cost system employed in 2015. Compute what the break-even point in patient-days would have been in 2015 under this plan.

5) Using the calculations from questions 3 & 4, provide a written memo to the board explaining either to stay with the current two-level fixed system or switch to a variable cost system.