A nudge toward budgeting
Elizabeth Newman, McKnight's Senior Editor
Whether it's a personal, operating or capital budget, in any industry there is many a manager who has been told “work on the budget” and left to sink or swim. If that's different in your facility — that is, if each nurse manager is giving a course in the budgeting — I congratulate you. Otherwise, I would recommend taking a look at The Nurse Manager's Guide to Budgeting and Finance.
Certainly the title isn't going to set anyone's heart fluttering. But as we read yesterday, if you're new to the budget merry-go-round, looking for overall industry information on budgets might not work. In this pragmatic guide, author Al Rundio, Ph.D., DNP, RN, takes an at-times painstaking approach to the basics, and it's fair to say that many of those reading can skip over sections such as how reimbursement works. Those of you deeply immersed in the complexities of MDS 3.0 coding and its budgetary impact may feel like you can barely get through the day as it is, must less want to learn how to do longer budget analysis.
However, being able to analyze budget variances and producing budget reports, which Rundio explains, lead directly to your bottom line. It's easy to forget how many start in a healthcare field with the clinical skills, but no idea of what bad debt means or why there needs to be a capital budget, or have a formula for calculating employee costs.
That's a problem when those same people have to make decisions about staffing, software or service delivery. On the list of my many grievances —not writing thank-you notes, turning a 13-year-old dog or cat over to a shelter, wearing jeans to the symphony or theater – perhaps the biggest is when business decisions are based on emotion rather than data. Clearly, long-term care leaders would be lost if they didn't understand how to interact with families and act with passion in promoting their facilities. There's many a business leader who relies on his (or her, but mostly his) gut. Sometimes that works out, but how many of you have gotten the knee-jerk “we can't afford it” when you ask about purchasing a new piece of equipment or hiring an extra staff member? Instead of nursing your bitterness, Rundio gives you the tools to make a case, without emotion, about defending your budget proposals. It's not revolutionary, but it may be the ticket to a revolution in getting what you want and need for your residents.
Do you have thoughts on how you learned to budget, or feel like you don't know where to begin? If so, please note something about it in the comments below and be eligible to win a copy of Rundio's guide.