Part III: Tools to Analyze Financial Operations

CHAPTER 8:

STAFFING: THE MANAGER’S RESPONSIBILITY

Staffing Requirements

In Health Care, many positions

Must be filled, or covered, 7 days a week, and

Must also be filled, or covered, 24 hours a day.

Productive and Non-Productive Time

Why analyzed?

Employees are paid for more hours than the hours they are on duty (vacation days, etc.), soAnnualizing allows the full cost of the position to be computed through a “burden” approach.

FTEs for Annualizing Staff Positions

Productive Time — Represents the employee’s net hours on duty.

Non-Productive Time — Represents the paid-for time when the employee is not on duty (such as vacation time).

FTE Definition for purposes of understanding annualizing positions:

FTEs for Annualizing Staff Positions

Two employees working half-time for one year would be the same as one FTE.

The equivalent of one full-time employee paid for one year, including both productive and non-productive time.

FTEs for Annualizing Staff Positions

The calculations to annualize staff positions is a two-step process:

1. Compute the net days worked.

2. Convert the net paid days worked to a factor.

See Exhibit 8-2 as an example.

Number of Employees Required to Fill a Position

You will also find scheduling software using this method.

The scheduled position method is often used when forecasting new programs and services.

Why calculate by position? Because computing by position is used in controlling, planning and decision-making.

Number of Employees Required to Fill a Position

A factor expressing the number of employees required measured against, or the equivalent of, one full-time employee’s standard work week.

FTE definition for purposes of filling a scheduled position:

Number of Employees Required to Fill a Position

The calculation to fill scheduled positions is as follows:

Compute the number of hours for a full-time position filled for one year. This measure is the baseline.

Compute a factor representing the position to be filled for the required number of days (a required seven-day week to cover, for example, versus a five-day work week equals a factor of 1.4).

See the cast room example in the chapter.

Tying Cost to Staffing

In the case of the annualizing method the cost of nonproductive days is already in the formula.

So, multiply the factor times the base hourly rate to compute cost.

Study the example in the chapter.

Tying Cost to StaffingIn the case of the scheduled position method the base rate must be

increased, or burdened, by the nonproductive time.

First, increase the hourly base rate by a percent or factor that represents the nonproductive time. Then multiply the burdened based rate by the factor to compute the cost.

Then, multiply the factor times the base hourly rate to compute the cost.

Examine the examples in the chapter.

Tying Cost to Staffing

The actual cost is attached to staffing in the books and records, though.

A subsidiary journal and a basic transaction record (both of which are described in the previous chapter).

Study the examples shown in the chapter.

Subacute Unit Master Staffing Plan

Shift 1

Day +

Shift 2

Evening +

Shift 3

Night =

24-Hour

Staff Total

RN

LPN

NA

2

1

5

2

1

4

1

1

2

5

3

11

Staffing for Eight-Hour Nursing Shift

Calculation for AnnualizingMaster Staffing Plan Example

Total Days in Business Year

Less two days off per Week

Number of Paid Days per Year

RN

364

104

260

LPN

364

104

260

NA

364

104

260

Less Paid Days Not Worked:

Holidays

Sick Days

Vacation Days

Education Days

Net Paid Days Worked

9

7

15

3

226

9

7

15

2

227

9

7

15

1

226

Step 1: Compute Net Paid Days Worked

Calculation for AnnualizingMaster Staffing Plan: Example

Step 2: Converting Net Paid Days Worked to a Factor

RN

LPN

NA

364226

= 1.6106192

364227

364228

=

=

1.6035242

1.5964912

FTEs to Annualize Staffing: Practice

2. Convert Net Paid Days Worked to a Factor.

Total days in business year divided by net paid days worked

equals factor 364/241 = 1.510373

364

104

260

241

8

5

1

5

19

1. Compute Net Paid Days Worked

Total days in business year

Less two days off per week

Number paid days per year

Less paid days not worked

Holidays

Sick days

Education days

Vacation days

Net paid days worked

1. Compute Net Paid Days Worked

Total days in business year

Less two days off per week

Number paid days per year

Less paid days not worked

Holidays

Sick days

Education days

Vacation days

Net paid days worked

_______

_______

_______

_______

_________

_________

_________

2. Convert Net Paid Days Worked to a Factor.

Total days in business year divided by net paid days worked

equals factor ____________________

FTEs to Annualize Staffing: Assignment

Compute Net Paid Days Worked Laboratory Medical Records

Total Days in Business Year

Less Two Days off Per Week

Number of Paid Days Per Year

_________

_________

_________

________

________

________

Less Paid days Not Worked

Holidays

Sick Days

Education Days

Vacation Days

Personal Leave Days

_________

_________

_________

_________

_________

________

________

________

________

________

Net Paid Days Worked

________

________

_______

_______

Covert Net Paid Days Worked to a Factor:

For the Lab.

Total days in business year divided by net paid days worked = factor _______________

For Medical Records

Total days in business year divided by net paid days worked = factor _______________

Compute Net Paid Days Worked Laboratory Medical Records

Total Days in Business Year

Less Two Days off Per Week

Number of Paid Days Per Year

364

104

260

364

104

260

Less Paid days Not Worked

Holidays

Sick Days

Education Days

Vacation Days

Personal Leave Days

9

7

3

15

0

9

0

0

0

21

Net Paid Days Worked

34

226

30

230

Covert Net Paid Days Worked to a Factor:

For the Lab.

Total days in business year divided by net paid days worked = factor 364/226 = 1.610619

For Medical Records

Total days in business year divided by net paid days worked = factor 364/230 = 1.582609

FTEs to Fill Position: Example 8 Hour

Emergency Department Scheduling for Eight-Hour Shifts:

Shift

One

Day

Shift

Two

Evening

Shift

Three

Night=

24-Hour

Scheduling

Total

Position:

Emergency Room Intake 1 1 1 =

Three

Eight

Hour

Shifts

Staff needed to cover position 7/24 1.4 1.4 1.4 = 4.2 FTEs

One full time employee works 40 hours per week. One eight-hour shift per day times seven days per week equals 56 hours on duty. Therefore, to cover seven days or 56 hours requires 1.4 times a 40 hour employee.

FTEs to Fill a Position: Practice 8 Hour

Scheduling for Eight-Hour Shifts:

Shift

One

Day

Shift

Two

Evening

Shift

Three

Night=

24-Hour

Scheduling

Total

Position:

Admissions Officer 2 1 1 =

Four Eight

Hour Shifts

FTEs to cover position equals 2.8 1.4 1.4 = 5.6

Position

Clerical

1 0 0 = One Eight

Hour Shift

FTEs to cover position equals 1.4 0 0 = 1.4

Scheduling for Eight-Hour Shifts:

Shift

One

Day

Shift

Two

Evening

Shift

Three

Night=

24-Hour

Scheduling

Total

Position:

Admissions Officer =

Four Eight

Hour Shifts

FTEs to cover position equals =

Position

Clerical= One Eight

Hour Shift

FTEs to cover position equals =

FTEs to Fill a Position: Assignment 8 Hour

Scheduling for Eight-Hour Shifts:

Shift

One

Day

Shift

Two

Evening

Shift

Three

Night=

FTEs

Seven Day

Week

Position:

Nursing Supervisor

Technician

Nurses

Clerical

Aides

2.8

2.8

4.2

1.4

1.4

1.4

2.8

2.8

0

0

1.4

1.4

2.8

0

0

= 5.6

7.0

9.8

1.4

1.4

Total FTEs needed to cover all shifts 25.2

FTEs to Fill a Position: Example 12 Hour

Emergency Department Scheduling for Twelve-Hour Shifts: 36 Hour Week

Shift

One

Shift

Two =

24-Hour

Scheduling

Total

Position:

Emergency Room Intake 1 1 =

Two

Twelve

Hour

Shifts

Staff needed to cover position 7/24 2.33 2.33 = 4.66 FTEs

One full time employee works 36 hours per week. One twelve-hour shift per day times seven days per week equals 84 hours on duty. Therefore, to cover seven days or 84 hours requires 2.33 times a 36 hour employee.

FTEs to Fill a Position: Assignment 12 Hour

Scheduling for Twelve-Hour Shifts: 36 Hour Week

Shift

One

Shift

Two =

FTEs

Seven Day

Week

Position:

Nursing Supervisor

Technician

Nurses

Clerical

Aides

4.66

2.66

7

1.4

2.33

2.33

4.66

4.66

0

0

= 7

9.33

11.66

1.4

2.33

Total FTEs needed to cover all shifts 31.75

FTEs to Fill a Position: Example 12 Hour

Emergency Department Scheduling for Twelve-Hour Shifts: 48 Hour Week

Shift

One

Shift

Two =

24-Hour

Scheduling

Total

Position:

Emergency Room Intake 1 1 =

Two

Twelve

Hour

Shifts

Staff needed to cover position 7/24 1.75 1.75 = 3.5 FTEs

One full time employee works 48 hours per week. One twelve-hour shift per day times seven days per week equals 84 hours on duty. Therefore, to cover seven days or 84 hours requires 1.75 times a 48 hour employee.

FTEs to Fill a Position: Assignment 12 Hour

Scheduling for Twelve-Hour Shifts: 36 Hour Week

Shift

One

Shift

Two =

FTEs

Seven Day

Week

Position:

Nursing Supervisor

Technician

Nurses

Clerical

Aides

3.50

3.50

5.25

1.4

2.33

1.75

3.50

3.50

0

0

= 5.25

7

8.75

1.4

2.33

Total FTEs needed to cover all shifts 24.73