Question

Elmo Clinic has identified three activities for daily maternity care: Occupancy and feeding, nursing, and nursing supervision. The nursing supervision oversees 150 nurses, 25 of whom are maternity nurses (the other nurses are located in other care areas such as emergency room and intensive care). The nursing supervisor has three assistants, a secretary, several offices, computers, phones, and furniture. The three assistants spend 75% of their time on the supervising activity and 25% of their time as surgical nurses. They each receive a salary of $60,000. The nursing supervisor has a salary of $80,000. She spends 100% of her time supervising. The secretary receives the salary of $35,000 per year. Other costs directly traceable to the supervisory activity (depreciation, utilities, phone, etc.) average $170,000 per year. Daily care output is measured as "patient days." The clinic has traditionally assigned the cost of daily care by using a daily rate (a rate per patient day). Daily rates can differ between units, but within units the daily rates are the same for all patients. Under the traditional approach, the daily rate is computed by dividing the annual costs of occupancy and feeding nursing, and a share of supervision by the unit's capacity expressed in patient days. The cost of supervision is assigned to each care area based on the number of nurses. A single driver patient days) is used to assign the costs of daily care to each patient. A pilot study has revealed that the demands for nursing care vary within the maternity unit, depending on the severity of a patient's case. Assume that the maternity unit has three levels of increasing severity: normal patients, cesarean patients, and patients with complications. The pilot study provided the following activity and cost information: Activity Annual Cost Activity Driver Annual Quantity Occupancy and Feeding Nursing Care (maternity) Nursing Supervision $1,500,000 $1,200,000 Patient days Hours of nursing care Number of nurses 10,000 50,000 150 The pilot study also revealed the following information concerning the three types of patients and their annual demands: Patient Type Patient Days Demanded Nursing Hours Demanded Normal Cesarean Complications Total 7 000 2.000 1.000 17.500 12,500 20.000 50.000 Required: 1. Calculate the maternity cost per patient day by using a functional-based approach. This is a traditional approach that costs maternity cases by patient day as a whole based on the total cost of maternity care

Answer 1

Total Cost of Nursing Supervision :
	No.	%	Expense	Calculation	Total
Supervisor	1	100%	80000	80000*1*100%	80000
Assistants	3	75%	60000	60000*3*75%	135000
Secretary	1	100%	35000	35000*1*100%	35000
Other			170000		170000
Total Supervision Expense for 150 Nurses					420000
Therefore, Supervision Expense for 25 Maternity Nurses=420000/150*25							70000

Calculation of Maternity cost per Patient Day :
	Normal	Cesearean	Complications	Total
Occupancy & Feeding	1050000	300000	150000	1500000
	(1500000/10000*7000)	(1500000/10000*2000)	(1500000/10000*1000)
Nursing Care	420000	300000	480000	1200000
	(1200000/50000*17500)	(1200000/50000*12500)	(1200000/50000*20000)
Nursing Supervision	23333.33	23333.33	23333.33	70000.00
(Assumed Equally)	(70000/3)	(70000/3)	(70000/3)
Total Maternity Cost	1493333.33	623333.33	653333.33	2770000.00
Total Patient Days	7000.00	2000.00	1000.00
Total Maternity Cost per Patient Day	213.33	311.67	653.33