6 Line item budgets specialized knowledge and control City Hospital is a city

6 line item budgets specialized knowledge and control

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6. Line item budgets, specialized knowledge, and control City Hospital is a city government-owned and -operated hospital providing basic health care to lowincome people. Most of the hospital’s revenues are from federal, state, county, and city governments. Some patients covered by private insurance are also admitted, but most of the patients are covered by government assistance programs (Medicare and Medicaid). Maxine Jones is the director of nursing for the 40-bed pediatrics unit at City Hospital. She is responsible for recruiting nurses, scheduling when they work (days, evenings, weekends), and preparing the nursing budget for the pediatrics unit. A variety of different nursing skills is needed to staff the unit: There are nursing aides, nurse practitioners, registered nurses, nursing supervisors, and clinical nurses. Each type of nurse provides different patient care services (care and feeding, drawing blood samples, giving injections, changing dressings, supervising, etc.). Not all types of nurses can provide all services, and each type of nurse has a different wage rate. Minimum nurse staffing levels per patient must be maintained. If the minimums are violated, new patients cannot be admitted. Over 45 full-time nurses are required to staff the pediatrics unit. The number of each type of nurse is set in the budget (8 nurses aides, 12 nurse practitioners, 14
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