review the 2 files attached one is instructions and extra information.

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review the 2 files attached one is instructions and info and the second one is the assignment‘s content.

review the 2 files attached one is instructions and extra information.
If you need any clarification WhatsApp 314-844-1006 CASE STUDY-CHISOS MOUNTAINS MEDICAL CENTER Description One real – world case with questions has been included for student analysis. This will provide the student the opportunity to apply many of the concepts discussed in the text and from our weekly discussions. It will be the expectation for the student to prepare a response to each question and submit by Sunday of Unit 7. Points will be assigned based on the quality and completeness of each response. I attached a separate pdf file with the case that contains 13 questions that need to be answered, please read all the instructions. Below, I copied and pasted the announcements that the professor posted and clarified some of the questions. We are using this book please use it as reference and for citation. Also this case is located in this book Pg 463: Introduction to the Financial Management of Healthcare Organizations, Eighth Edition         by Michael Nowicki (Author)   Class, I hope you have all had a chance to read the Case Study and reviewed the 13 questions that are asked. Also, you can see the reference the case makes to the chapters in the text. For instance, question number 2 relates to the material from chapter 4 on community benefits and tax exempt status. Your final preparation of the case will be much easier by making yourself notes on the questions and preparing responses as the material is presented in the text Announcement that the Professor made related to the 13 questions: Class, In preparing the response on the Statement of Operations you will need to compute both Gross Revenue and the Net Revenue. To complete the Gross revenue prepare a schedule for the Services:Med/Surg…ICU…Ob/Gyn…Swing…SNF…Emergency (Links to an external site.)The payors would be down the left hand side:MedicareGrossNetMedicaidGrossNetSelf PayManaged Care DiscountManaged Care CapBad DebtCharity CareImplicit Price Concession Gross Revenue is the Volume times the Charges. Both of these are schedules found in the case. To compute the Net Revenue you will need to understand how each of the payors reimburses the hospital. For instance Medicare and Medicaid are both COST reimbursed. Take the percentage of each times the Operating Expenses and that would equal the Net Revenue of Medicare and MedicaidThen begin to complete the schedule with the information from the case…Your target Net Revenue is $40,511,208 The key point in preparing the Balance Sheet is to remember that Assets are equal to Liabilities plus Equity. In preparing the Balance Sheet remember the comment from Mr. Operator, to carry forward format and numbers from the 2019 balance sheet and only adjust for the profit or loss from your statement of operations. Questions 2, 3, 4 and 5 should reflect your understanding from the material in the text and recommendation on how to proceed. This can become confusing so please let me know if questions. Don’t spend too much time and get frustrated. Hope this will help, John Additional explanation for Questions 6, 8, 9 and 13 Class, Some of you have asked for additional information for one or more of these questions: Question 6… This is the agreement where the Net Revenue is $96000…The volume is also 1% of Total Costs…Identify the Fixed and Variable expenses and compare to the net revenue to determine the increase necessary to cover Full Costs and then Differential Costs… Question 8… Review page 223 in relation to Table IV, Table VA  and Table VII from the case… Compute the Labor Expense and use the Supply expense from the Table… Question 9… Review Table VII and divide each of the expense categories by the volume for a expense per procedure… Identify which of the categories are Fixed and Variable and what the change (reduction) would need to be to breakeven… Question 13… Prepare your response to the situation requested as you have been doing in the mini cases… There is no right or wrong answer… Hope this helps, John Extra explanation for Question 1 Question 1:   To compute Gross Revenue. Identify the Patient Care Days by Service Table III-C. Multiply the days times Charges Table III-D. This will give you the Gross Revenue for Medical/Surgical, ICU, OB/Gyn and Swing Beds. Multiply the Volumes for SNF and Emergency times the Charges table III-C. This will give you the Gross Revenue for SNF and Emergency. Multiply the Gross Revenue for each of those services times the Volumes by percentage, by Payor. This will give you the Gross Revenue by Service and by payor.   To compute Net Revenue. Identify the Operating Expense 2020 Table VII. Multiply the Total expense by the percentage of Medicare and Medicaid Table III-B. This will give you the Net Revenue for Medicare and Medicaid since they are Cost reimbursed. The Gross Revenue for Self Pay/Commercial is also the Net, since they pay charges. Take the Managed Care with Discount times 50% for Net Revenue. Take the $400 times 20 families times 12 for the Managed Care with Capitations. There is not any Net Revenue for Bad Debt and Charity Care.    You have then computed for your Income Statement Gross Revenue and Net Revenue. The difference between the 2 would be Explicit Price Concessions. The Operating Expense comes from the case. The difference between Net Revenue and Operating Expense is then carried over to the Balance Sheet Table I. All numbers stay the same from 2019 except the Unrestricted net Assets. Some additional explanation for Question Number 1 on the Case Study. For question Number 1On Table III-A you will see Volumes…On Table III-B you will see Payer percentages…Medicare = 25%, etcOn Table III-D you will see Average Charges per Day…So you need to start a schedule and build the Revenue:Acute Care Days by Service = Medical/Surgical = 2843Average Charges/Day = Medical/Surgical = $10000Gross Medical/Surgical Revenue = $28,430,000Times Medicare Gross = 25% times $28,430,000 = $7,107,500Read carefully the comments from Ms. Controller…She indicates that they have opted for cost based reimbursement from Medicare and Medicaid. so they will only be reimbursed their cost for these two payors.Once you complete the Cost portion of your analysis you should compute that Medicare costs are $10, 143,137…The Total revenue they will receive from Medicare is roughly $10, 143,137…The difference is the Contractual Deduction or the Explicit Price Concession…You will develop the same type of calculation for each payor and each service.You will need to read carefully the interviews for each of the executives and follow each of the schedules that are provided.The Income Statement and Balance Sheet will require the most detail of explanations.John This explanation will help with Question No. 8 dealing with developing a RVU schedule: The greatest common factor (GCF or GCD or HCF) of a set of whole numbers is the largest positive integer that divides evenly into all numbers with zero remainder. For example, for the set of numbers 18, 30 and 42 the GCF = 6. Let me know if any questions, John

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