Final Project Guidelines and Rubric

Overview The final project for this course is the creation of a capital budget proposal in which you will analyze a specific healthcare organization, identify areas of need and/or improvement within the organization, research various options to address these needs, and create a presentation in which you propose your options to decision makers. This will require close analysis of historical budgetary information for the organization, research regarding healthcare trends, and careful alignment of your proposal to the organization’s mission, vision, and values. The final product represents an authentic demonstration of competency because, while healthcare organizations differ greatly, managers in various departments in various organizations must present changes to processes, the purchase of new equipment, the addition of employees, and many other changes to executives and boards to obtain approval. A specific example of the necessary presentations department managers often perform is a capital budget proposal, whereby managers identify the various needs or areas of improvement in their department and prepare proposals for decision makers. In addition to the analysis and presentation needs discussed, this assessment will provide you with the opportunity to apply the financial budgetary knowledge you have gained throughout this course to a healthcare organization, as you would in the real world. While you will not be building the organization’s entire budget yourself, you will be discussing how your proposal impacts the current budget and what impact your proposal will have on future financial statements if implemented through the creation of a projected departmental budget that implements your proposal in the upcoming year. To complete this project, you will utilize one of two provided case studies, which will include the financial statements and information necessary for you to analyze while preparing your budget request. Your final submission will be a presentation (either PowerPoint or an equivalent tool) with speaker notes, along with a projected departmental budget for the next year. You will not have to record your presentation. The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules Two, Five, and Six. The final product will be submitted in Module Seven. In this assignment, you will demonstrate your mastery of the following course outcomes:

x Analyze healthcare trends to inform effective decision making and financial planning within healthcare management x Integrate effective communication and leadership principles into financial proposal presentations x Articulate the purpose and importance of financial statements and principles for healthcare decision making x Create realistic departmental budgets based on financial statements, healthcare trends, and strategic plans x Create proposals that incorporate missions, visions, and values and align to strategic plans

Prompt Your capital budget proposal presentation should use 12–20 PowerPoint slides (or similar presentation software) to answer the following prompt and it should include an accompanying projected departmental budget: Select one of the following two organizations and accompanying financial information to create a

reasonable capital budget proposal that addresses the needs of the organization while aligning to the organization’s mission, vision, and values. Note that while you will submit a single proposal, your proposal might include multiple items. For example, you might propose that the organization acquire a new piece of equipment. Implementation of that item (the equipment) might require additional items such as software, spare parts, etc. In order to utilize real-world financial statements, you must choose one of the following organizations to provide the context, background information and organizational information for your proposal: Organization #1: Venice Family Clinic ● 2018 Annual Report (most current Annual Report available) ● Consolidated Financial Statements for the Year Ended June 30, 2018 Organization #2: Joslin Diabetes Center ● Consolidated Financial Statements and Supplemental Information – 2013 and 2012 (most current Consolidated Financial Statement available) ● Consolidated Financial Statements and Supplemental Information – 2012 and 2011 Specifically, the following critical elements must be addressed; however, the following order is not necessarily the order in which you will present:

I. Introduction A. Financial Condition: Describe the overall financial condition of the organization based on financial statements and explain your reasoning. B. Healthcare Trends: Describe what current healthcare trends influenced your proposal. Could any of these trends impact the organization

financially? C. Proposal Items: List your proposal items and indicate how each one is linked to the organizational mission, vision, and values. You might need to

infer the vision or values based on the information provided in the organization’s annual reports, website, etc. D. Organizational Strategic Goals: How will your proposal further the strategic goals of your department and/or organization as a whole? You

might need to infer the strategic goals based on the information provided in the organization’s annual reports, website, etc.

II. Proposal A. Options: What options are available for each item in your budget proposal? You will want to have various options ready that will meet your

needs because one option may not be approved by your supervisor or board, but another option may better fit their needs. B. Financial Research: Describe the cost-benefit of each option based on relevant information and research. Information and research can include

research on the items or vendors, organizational numbers, price quotes, and more. Be sure to provide relevant documentation in an appendix or reference slide (e.g., sources for the cost of the items in your proposal, company resources, and financial calculations) to show the depth of your research and the various options available.

C. Organizational Resources: Identify what resources would be needed to implement one of the options in your proposal (e.g., support from information technology, accounting, janitorial, volunteers).

D. Communication: What method of communication would be used to notify departments across the organization and what methods would be used throughout proposal implementation? Justify the appropriateness of your suggestions.

III. Budget

A. Statements: What statements were utilized for formulating your proposal? Why? Select the appropriate statements for analysis and defend your choices.

B. Expenses: What major expenses are associated with your proposal items and what budgetary accounts are impacted? C. Reasoning: Based on the previous year’s budget data, why did you select these budget items for adjustment over other options? D. Ratios: Research the various ratio options (including ROI) used for reviewing financial statements. Determine what ratios you will use for your

proposal items and explain why. E. Ratio Calculations: Using budget statements, formulate calculations that support each recommendation. F. Projected Departmental Budget: Create a projected departmental budget for the upcoming year that incorporates the costs of the proposed

changes.

IV. Impacts and Justification A. Short-Term Impact: What short-term impact will this request have on the overall financial statements used for decision making and on financial

planning? B. Long-Term Impact: What long-term impact will this request have on the overall financial statements used for decision making and on financial

planning? C. Cost-Benefit: What is the percentage increase in financial need? How does this balance with the potential value added by your requests? What

is the cost-benefit of these requests? D. Strategic Planning: Provide an explanation for each budget request in your proposal, taking into consideration strategic plans. How do your

budget requests show strategic planning and forethought? E. Conflicts: Describe the strategic impact and any potential ways in which your recommendations might conflict with the overall strategic vision.

Milestones Milestone One: Major Trends In Module Two, you will submit a short paper analyzing the potential impact of healthcare trends on the finances and mission of healthcare organizations. This milestone will be graded with the Milestone One Rubric. Milestone Two: Departmental Budget and Presentation Outline In Module Five, you will create a budget for a healthcare department and outline your capital proposal presentation. This milestone will be graded with the Milestone Two Rubric. Milestone Three: Implementation Options and Cost-Benefit In Module Six, you will submit a short paper describing options for implementing your capital budget item(s), their cost-benefit, and their anticipated impact on key healthcare operating indicators. This milestone will be graded with the Milestone Three Rubric.

Final Submission: Capital Budget Proposal In Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Project Rubric (below).

Deliverables Milestone Deliverable Module Due Grading

One Major Trends Two Graded separately; Milestone One Rubric

Two Departmental Budget and Presentation Outline

Five Graded separately; Milestone Two Rubric

Three Implementation Options and Cost-Benefit Six Graded separately; Milestone Three Rubric

Final Submission: Capital Budget Proposal, including Projected Departmental Budget

Seven Graded separately; Final Project Rubric

Final Project Rubric Guidelines for Submission: A comprehensive proposal presentation will be between 12–20 slides; however, the content and quality of those slides are more important than the quantity. All resources must be appropriately cited in APA format. All speaker notes must be written in the “notes” section of each PowerPoint. In addition to your presentation, you must submit a final draft of your proposed departmental budget, which you drafted in Milestone Three using the Departmental Budget Sample as a base.

Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Introduction: Financial

Condition

Meets “Proficient” criteria and evidences keen ability to interpret financial statements to gain understanding of financial conditions

Accurately describes the overall financial condition of the organization based on the financial statements

Describes the overall financial conditions of the organization, but with gaps in accuracy or detail based on the financial statements

Does not describe the overall financial conditions of the organization

2.74

Introduction: Healthcare Trends

Meets “Proficient” criteria and evidences keen insight into application of current healthcare trends to organizations

Accurately describes the current healthcare trends that influence the proposal and how they impact the organization financially

Describes the current healthcare trends that the proposal was based on and how they impact the organization financially, but with gaps in detail or accuracy

Does not describe the current healthcare trends that the proposal was based on and how they impact the organization financially

6.4

Introduction: Proposal Items

Meets “Proficient” criteria and evidences keen understanding of how to further missions, visions, and values in organizations

Links each proposal item to the organization’s mission, vision, and values, comprehensively explaining each connection

Links each proposal item to the organization’s mission, vision, and values, explaining each connection, but lacks detail

Does not link each proposal item to the organization’s mission, vision, and values, explaining each connection

6.4

Introduction: Strategic Goals

Meets “Proficient” criteria and evidences keen insight into the methods for further strategic goals

Clearly details how the proposal will further the strategic goals of the organization

Explains how the proposal will further the strategic goals of the organization, but with gaps in clarity or detail

Does not explain how the proposal will further the strategic goals of the organization

6.4

Proposal: Options

Meets “Proficient” criteria and evidences keen analysis of potential options for proposal implementation

Provides reasonable implementation options for each proposal item

Provides implementation options for each proposal item, but options are not reasonable

Does not provide implementation options for each proposal item

6.4

Proposal: Financial Research

Meets “Proficient” criteria and evidences keen insight into the research and information requirements of financially sound proposals

Describes the cost-benefit of the listed options based on relevant research and information

Describes the cost-benefit of the listed options, but with gaps in relevant research and information

Does not describe the cost-benefit of the listed options

6.4

Proposal: Organizational

Resources

Meets “Proficient” criteria and evidences keen insight into the organizational needs for proposal implementation

Accurately and clearly identifies the organizational resources that will be needed for proposal implementation

Identifies the organizational resources that will be needed for proposal implementation, but lacks accuracy or clarity

Does not identify the organizational resources that will be needed for proposal implementation

6.4

Proposal: Communication

Meets “Proficient” criteria and evidences keen insight into the communication needs across departments for successful implementation

Proposes methods for communicating budgetary changes and communicating throughout proposal implementation to departments across the organization, and justifies the appropriateness of these methods

Proposes methods for communicating budgetary changes and communicating throughout proposal implementation to departments across the organization, but does not justify the appropriateness of these methods

Does not propose methods of communication for notifying departments across the organization and for proposal implementation

6.4

Budget: Statements

Meets “Proficient” criteria and evidences keen understanding of the use of financial statements for proposal creation

Selects and comprehensively defends the appropriate financial statements for use in the proposal

Selects and defends financial statements for use in the proposal, but statements are not appropriate or not comprehensively defended

Does not select and defend financial statements for use in the proposal

6.4

Budget: Expenses

Meets “Proficient” criteria and evidences keen understanding of the breakdown of budgets and expenses

Accurately identifies the major expenses associated with the proposal and the budgetary accounts that would be impacted

Identifies the major expenses associated with the proposal and the budgetary accounts that would be impacted, but identification is not accurate

Does not identify the major expenses associated with the proposal and the budgetary accounts that would be impacted

2.74

Budget: Reasoning

Meets “Proficient” criteria and evidences keen understanding of the use of budgetary information for informing future budgets

Justifies why the selected budgetary accounts were chosen for adjustment based on analysis of previous year’s budget

Justifies why the selected budgetary accounts were chosen for adjustment, but not based on previous year’s budget

Does not justify why the selected budgetary accounts were chosen for adjustment

2.74

Budget: Ratios

Meets “Proficient” criteria and evidences keen insight into the use of ratios for financial analysis and budget support

Selects appropriate ratios to use for support of the proposal and justifies logically

Selects and justifies ratios to use for support of the proposal, but does not select appropriate ratios or justification is not logical

Does not select and justify ratios to use for support of the proposal

6.4

Budget: Ratio Calculations

Meets “Proficient” criteria and calculations are performed correctly, resulting in accurate and applicable results

Calculates the selected ratios based on the budget statement analysis

Calculates the selected ratios, but not based on the budgetary statement analysis

Does not calculate the selected ratios

2.74

Budget: Projected Departmental Budget

Meets “Proficient” criteria and demonstrates keen insights into the specific needs of the department

Creates a projected budget that applies the proposed changes to the specific department

Creates a projected budget but is missing key elements of a departmental budget

Does not create a departmental budget applying the proposed changes to a specific department

2.74

Impacts and Justification: Short-

Term Impact

Meets “Proficient” criteria and evidences keen insight informing decision making and planning in healthcare

Logically determines the short- term impact of the proposal on the financial statements and organizational financial planning

Determines the short-term impact of the proposal on the financial statements and organizational financial planning, but with gaps in logic

Does not determine the short-term impact of the proposal on the financial statements and organizational financial planning

6.4

Impacts and Justification: Long-Term

Impact

Meets “Proficient” criteria and evidences keen insight into informing long-term financial planning

Logically determines the long- term impact of the proposal on the financial statements and organizational financial planning

Determines the long-term impact of the proposal on the financial statements and organizational financial planning, but with gaps in logic

Does not determine the long-term impact of the proposal on the financial statements and organizational financial planning

6.34

Impacts and Justification: Cost-

Benefit

Meets “Proficient” criteria and cost-benefit is accurate given the financial information and potential value

Determines the cost-benefit of the proposal based on detailed analysis of financial information and potential value added

Determines the cost-benefit of the proposal, but not based on analysis, or analysis of financial information and potential value added is not detailed

Does not determine the cost- benefit of the proposal

2.74

Impacts and Justification: Strategic

Planning

Meets “Proficient” criteria and reflection evidences keen insight into strategic financial and management planning in healthcare

Reflects thoroughly upon and explains in detail how the budget proposal evidences strategic planning and forethought

Reflects upon and explains how the budget proposal evidences strategic planning and forethought, but reflection lacks comprehensive attention or explanation lacks detail

Does not reflect upon and explain how the budget proposal evidences strategic planning and forethought

2.74

Impacts and Justification: Conflicts

Meets “Proficient” criteria and evidences keen insight or intuition regarding potential conflicts with healthcare organizations’ strategic visions

Accurately describes the strategic impact of the proposal and identifies logical, potential conflicts with the overall strategic vision of the organization

Describes the strategic impact of the proposal and identifies potential conflicts with the overall strategic vision of the organization, but with gaps in accuracy or logic

Does not describe the strategic impact of the proposal nor identify potential conflicts with the overall strategic vision of the organization

6.4

Articulation of Response

Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy-to-read format

Submission has no major errors related to citations, grammar, spelling, syntax, or organization

Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas

Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas

4.08

Earned Total 100%

DEPARTMENTAL BUDGET AND PROPOSAL OUTLINE 2

Departmental Budget and Proposal Outline

PART 1

Options:

I believe Venice Family Clinic (VFC) need to implement a major asset of Electronic Health Record (EHR) Systems that would be beneficial for both the population it will serve and the hospital as well (Grain, Martin-Sanchez & Schaper, 2014). Using AHIMA along with Webinars, a certified coder will be chosen that will serve both the inpatient and outpatient, as an alternative option for providing coding updates services. Outpatient coders will meet with certified outpatient coders within the facility while, inpatient coders meet with certified inpatient coders. This exercise will need a trainer who will train the facility’s coding experts once every 3 weeks in a session of 2 hours. I estimate this exercise to cost an approximate of $2000 per year to cater for the two employees who will be teaching the coders. Through webinars, AHIMA lasts 1 hour, starting at noon Eastern Time and their charges start at $98.9 for members and $118 for non-members (Venice Family Clinic, 2018).

Financial Research:

These opportunities come with low or fee charges, though they bring a huge impact to the facility and also improving patient care delivery. According to VFC (2018), various factors determine the types of health care used in a facility, the timing of care and how much health care people use. Cash flow statements are indicated in a separate financial statement as cash flows (VFC, 2018). This implies the company’s health status is indicated by cash flow statements; because a cash flow statement serves as an important organizational asset that assists in determining the facility’s capacity to pay its existing expenses.

Communication:

Support from information technology

Organizational Resources

VFC has an opportunity of using a multitude of resources when organizing its annual financial status. For example, when the organization wants to draft its budget, it can hire an outsider professional consultant. Also, an excel system can be used as an alternative electronic method.

PART 2

Statements 

It is important for an organization to do regular statements when doing financial budgeting. The regular statements will help VFC to be accountable for every coin spent and ensure that it is not losing a huge amount of money through unnecessary budgets. I would recommend brief quarterly review statements and a comprehensive annual statement.

Expenses

I estimated my budget for VFC salaries to remain the same; however, there was a slight decrease in RN and staffing salaries. I did this projection for a short period of the term to allow the facility to settle other medical supplies expenditure. Subsequently, the facility will not purchase other equipment in the year to come; this has reduced our equipment’s financial budget by $100,000. Though in case of an emergency purchase, we are allowing for some cushion room. Equipment leases went down slightly, to give room for more insurance coverage.

Reasoning

My budget estimation was a lower end to allow VFC to save a considerable amount of $ 55, 591, thus gaining more on profit generation. This is a more significant understanding that the clinic, unluckily, closed the year of 2017 with a loss of $1.5 million. It is significant for VFC to break even at best because it is a non-profit organization, which is the reason I budgeted conservatively.

Ratios and Ratio Calculations

Total Net Patient Revenue was budgeted to equal $19,340,000, and the Total Net Expenses was budgeted to equal $8,689,000. The Total Net Profit would then be calculated using the equation:

Net profit= (net revenue)/ (net expenses)

Net profit= ($19,340,000)/ ($8,689,000)

Net profit= 2.226

References

Grain, H., Martin-Sanchez, F., & Schaper, L. K. (Eds.). (2014). Investing in E-Health: People, Knowledge and Technology for a Healthy Future: Selected Papers from the 22nd Australian National Health Informatics Conference (HIC 2014) (Vol. 204). IOS Press.

Venice Family Clinic (2018). Retrieved from

https://venicefamilyclinic.org/index.php?view=vfc_about&action=clinic_brief

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