Equity
Equity calculations are not discussed in any detail here. It is enough
for our purposes to recognize that equity is a derived figure. Equity
must equal total assets less liabilities. In our Williams Convalescent
Center example, this generates values of $2,562 for the constant
dollar method and $2,867 for the current cost method.
SUMMARY
Financial reporting suffers from its current reliance on the HC
valuation concept. Inflation has made many of the reported values in
current financial reports meaningless to decision makers. The
example used in this chapter illustrates this point. The total asset
investment of Williams Convalescent Center is approximately 100%
larger when adjusted for inflation under the current cost or constant
dollar method. Net income, however, decreased. The result is a
dramatic deterioration in return on investment––the single most
important test of business success. Table 10–11 summarizes
(Cleverley 227-237)
Cleverley, William O. Essentials of Health Care Finance, 7th Edition.
Jones & Bartlett Learning, 20101022. VitalBook file..
Chapter 11 Analyzing Financial Position
LEARNING OBJECTIVES
After studying this chapter, you should be able to do the following:
• 1.Describe the balanced scorecard and dashboard
reporting.
• 2.Describe the four key elements of dashboard reporting.
Increase in
specific prices
over general
price level
($3,783 less
$3,791)
($8)
• 3.Explain what is most important in long-term financial
success.
• 4.Explain the primary financial objective of a healthcare
firm.
• 5.Describe the critical drivers of financial performance.
• 6.Discuss the importance and types of performance
measures.
• 7.Introduce the hospital cost index measure.
REAL-WORLD SCENARIO
Michael Dean has been recently appointed to the board of Kenyon
Medical Center, a 300-bed, not-for-profit community hospital. Mike is
an attorney who specializes in labor law and is the firm’s primary
litigation expert in this area. He is reviewing the financial information
that was sent to him this morning in preparation for his first board
meeting this evening. His total financial package includes 28 pages of
financial information consisting of current monthly income statements,
a balance sheet, and other monthly actual-to-budget comparisons of
performance with some selected financial ratios.
Tonight’s meeting is critical because the board’s major item for
discussion is related to a proposed bond issue to finance major
hospital renovation. Mike recognizes that he has a fiduciary
responsibility to protect the assets of the hospital and to ensure its
continued financial viability, but he does not know how to determine
whether the hospital can afford to take on this additional debt. There is
so much information and no apparent pattern as to what really is
important. He is also concerned about assessing how the proposed
financing would impact the hospital’s financial performance and thus
its ability to.
This document provides an overview of brief learning exercises, full exercises, cases, and critical thinking cases covered in Chapter 1 of an accounting textbook. The exercises cover topics such as users of accounting information, components of internal control, accounting standards, and ethics. They are designed to help students develop skills like analysis, judgment, research, and communication. The cases provide real world examples and assessments of topics like reliability of financial statements and codes of ethics. Estimated completion times and difficulty levels are provided for each case.
New Ways To Manage Your Vet Practice With Financialsmjmcgaunn
This document provides an overview of new ways to manage a veterinary practice using financial metrics and key performance indicators. It discusses tools like income statements, dashboards, balanced scorecards, benchmarks and financial strength indexes that can help owners and managers track the financial health and performance of the practice over time. The document emphasizes using visual representations of key data to more easily identify trends, issues, and opportunities for improved decision making.
The document discusses evaluating the financial performance of healthcare organizations. It describes three key steps: 1) selecting performance measures like profitability, liquidity, leverage, and activity from financial statements; 2) setting standards by comparing to past performance, budgets, or industry benchmarks; 3) calculating measures, comparing to standards, and interpreting results. The document provides examples of financial statements and calculates profitability measures like operating margin for a sample hospital.
Healthcare Dashboards: 3 Keys for Creating Effective and Insightful Executive...Health Catalyst
As the use of data-driven Key Performance Indicators (KPIs) increases, healthcare organizations are adopting Executive Dashboards to track organizational performance. While dashboards deliver insight and identify areas for improvement, they fail to make the data actionable and the value is often offset by the unproductive fire drills and churn they create. There are three keys to create and deploy insightful and effective dashboards successfully:
1. Aggregation of underlying dashboards to create the executive dashboard
2. Establishment of clear ownership and accountability
3. Sustainable process
ALL THE DETAILS ARE MENTIONED IN THE DOCUMENT RELATED TO ALL 4 PERSPECTIVES OF BSC.
-REFERRED MAINLY FOR STRATEGIC COST MANAGEMENT.
-INCLUDES ALL THE EXPLANATION WITH APPROPRIATE EXAMPLES & CASE STUDY
This document provides an overview of implementing a balanced scorecard approach for small rural hospitals. It discusses modifying the balanced scorecard to better fit the needs of rural hospitals with limited resources. The key components discussed are conducting a readiness assessment, educating leadership and stakeholders, identifying relevant data and benchmarks, and gaining commitment from hospital administration for long-term use. The goal is to develop a balanced scorecard that translates a rural hospital's strategy into meaningful performance measures across financial, customer, internal process, and learning/growth perspectives.
Response 1:
Part 1
Memo:
Understanding Similarities and Differences between Financial and Managerial Accounting
Attention
: Susan Thompson
Susan-
In an effort to get you up to speed on our expectations, I wanted to provide some details on the differences you can expect to see between managerial and financial accounting and provide you some examples from both areas.
Financial accounting is the backbone of the day-to-day functions of accounting. From payables, to receivables to collections, this area ensures all of the outstanding bills and debts are paid so the organization can operate. The details received from the day to day management of financial accounting are provided to stakeholders’, creditors, vendors and management to ensure the organization is being forthcoming and so management can use the data to further the position of the company(MUSE: Financial and Managerial Accounting). Reports provided within financial accounting include the following:
Income Statement
Statement of Owners Equity
Balance Sheet
Cash Flow Statement
Each of these documents is used by managerial accounting team members to help make decisions about the future of the organization.
Managerial accounting is optional. This is a team of managers who are trying to plan for future business and need to understand the ebbs and flows of the business itself and how any of the business segments or areas can function more productivity. One thing to note is that Financial Accounting is handled by external persons who try to ensure the strength of financial decisions whereas Managerial Accounting is managed by internal managers responsible for the success of the organizations. Financial Accounting Reporting for the IRS is mandatory and GAAP accounting rules must be adhered too. Managerial Accounting has no set rules nor are they bound to any oversight group and are not required to provide any sort of mandatory reporting.
Additional reports used to analyze the health of an organization are horizontal and vertical analyzes.
Horizontal analysis is where we take a series of reports year over year and try to determine what trends were in assets, equity, cash flow, etc. Using these reports allows the management team to better understand the business and what could be coming in the future. Vertical analysis is where we analyze financial statements based on entries for assets, accounts, liabilities and equities. We review each of these as a proportion of the total account and try to understand what led to any inconsistencies.
If you need any further clarification regarding these concepts, reporting or analysis, please reach out to me directly.
Thank You
Part 2
Attn: Board of Directors
MEMO
In an effort to help our team better understand how we can use our current and previous accounting information to help plan and control for future business, I have broken down details on four key financial reports we receive regularly. These reports include the income sta ...
The Happy Marriage of Hospital Finance and Frontline OperationsHealth Catalyst
The hospital finance department typically acts as administrator and controller over hospital operations, at least in the eyes of frontline clinicians. Additionally, finance is burdened with the day-today tasks of balancing the books. And all too often, finance thinks they know what their customers want, but customers think that finance is isolated, secretive, and bureaucratic. The hospital finance department needs a makeover. To transition into the role of valued business partner and financial expert, finance needs to reinvent itself by:
Simplifying the flow of, and expand access to, information
Repositioning financial analysts as experts
Understanding what customers value
Learn how these straightforward business practices can support operations in their outcomes improvement efforts, and ultimately benefit the entire healthcare organization.
This document provides an overview of brief learning exercises, full exercises, cases, and critical thinking cases covered in Chapter 1 of an accounting textbook. The exercises cover topics such as users of accounting information, components of internal control, accounting standards, and ethics. They are designed to help students develop skills like analysis, judgment, research, and communication. The cases provide real world examples and assessments of topics like reliability of financial statements and codes of ethics. Estimated completion times and difficulty levels are provided for each case.
New Ways To Manage Your Vet Practice With Financialsmjmcgaunn
This document provides an overview of new ways to manage a veterinary practice using financial metrics and key performance indicators. It discusses tools like income statements, dashboards, balanced scorecards, benchmarks and financial strength indexes that can help owners and managers track the financial health and performance of the practice over time. The document emphasizes using visual representations of key data to more easily identify trends, issues, and opportunities for improved decision making.
The document discusses evaluating the financial performance of healthcare organizations. It describes three key steps: 1) selecting performance measures like profitability, liquidity, leverage, and activity from financial statements; 2) setting standards by comparing to past performance, budgets, or industry benchmarks; 3) calculating measures, comparing to standards, and interpreting results. The document provides examples of financial statements and calculates profitability measures like operating margin for a sample hospital.
Healthcare Dashboards: 3 Keys for Creating Effective and Insightful Executive...Health Catalyst
As the use of data-driven Key Performance Indicators (KPIs) increases, healthcare organizations are adopting Executive Dashboards to track organizational performance. While dashboards deliver insight and identify areas for improvement, they fail to make the data actionable and the value is often offset by the unproductive fire drills and churn they create. There are three keys to create and deploy insightful and effective dashboards successfully:
1. Aggregation of underlying dashboards to create the executive dashboard
2. Establishment of clear ownership and accountability
3. Sustainable process
ALL THE DETAILS ARE MENTIONED IN THE DOCUMENT RELATED TO ALL 4 PERSPECTIVES OF BSC.
-REFERRED MAINLY FOR STRATEGIC COST MANAGEMENT.
-INCLUDES ALL THE EXPLANATION WITH APPROPRIATE EXAMPLES & CASE STUDY
This document provides an overview of implementing a balanced scorecard approach for small rural hospitals. It discusses modifying the balanced scorecard to better fit the needs of rural hospitals with limited resources. The key components discussed are conducting a readiness assessment, educating leadership and stakeholders, identifying relevant data and benchmarks, and gaining commitment from hospital administration for long-term use. The goal is to develop a balanced scorecard that translates a rural hospital's strategy into meaningful performance measures across financial, customer, internal process, and learning/growth perspectives.
Response 1:
Part 1
Memo:
Understanding Similarities and Differences between Financial and Managerial Accounting
Attention
: Susan Thompson
Susan-
In an effort to get you up to speed on our expectations, I wanted to provide some details on the differences you can expect to see between managerial and financial accounting and provide you some examples from both areas.
Financial accounting is the backbone of the day-to-day functions of accounting. From payables, to receivables to collections, this area ensures all of the outstanding bills and debts are paid so the organization can operate. The details received from the day to day management of financial accounting are provided to stakeholders’, creditors, vendors and management to ensure the organization is being forthcoming and so management can use the data to further the position of the company(MUSE: Financial and Managerial Accounting). Reports provided within financial accounting include the following:
Income Statement
Statement of Owners Equity
Balance Sheet
Cash Flow Statement
Each of these documents is used by managerial accounting team members to help make decisions about the future of the organization.
Managerial accounting is optional. This is a team of managers who are trying to plan for future business and need to understand the ebbs and flows of the business itself and how any of the business segments or areas can function more productivity. One thing to note is that Financial Accounting is handled by external persons who try to ensure the strength of financial decisions whereas Managerial Accounting is managed by internal managers responsible for the success of the organizations. Financial Accounting Reporting for the IRS is mandatory and GAAP accounting rules must be adhered too. Managerial Accounting has no set rules nor are they bound to any oversight group and are not required to provide any sort of mandatory reporting.
Additional reports used to analyze the health of an organization are horizontal and vertical analyzes.
Horizontal analysis is where we take a series of reports year over year and try to determine what trends were in assets, equity, cash flow, etc. Using these reports allows the management team to better understand the business and what could be coming in the future. Vertical analysis is where we analyze financial statements based on entries for assets, accounts, liabilities and equities. We review each of these as a proportion of the total account and try to understand what led to any inconsistencies.
If you need any further clarification regarding these concepts, reporting or analysis, please reach out to me directly.
Thank You
Part 2
Attn: Board of Directors
MEMO
In an effort to help our team better understand how we can use our current and previous accounting information to help plan and control for future business, I have broken down details on four key financial reports we receive regularly. These reports include the income sta ...
The Happy Marriage of Hospital Finance and Frontline OperationsHealth Catalyst
The hospital finance department typically acts as administrator and controller over hospital operations, at least in the eyes of frontline clinicians. Additionally, finance is burdened with the day-today tasks of balancing the books. And all too often, finance thinks they know what their customers want, but customers think that finance is isolated, secretive, and bureaucratic. The hospital finance department needs a makeover. To transition into the role of valued business partner and financial expert, finance needs to reinvent itself by:
Simplifying the flow of, and expand access to, information
Repositioning financial analysts as experts
Understanding what customers value
Learn how these straightforward business practices can support operations in their outcomes improvement efforts, and ultimately benefit the entire healthcare organization.
Budgets translate organizational goals into operational terms and provide standards for control and evaluation. Control involves setting standards, monitoring actual performance, and taking corrective action. Budgeting benefits all organizations by facilitating planning and control. A master budget combines all individual budgets, while operating budgets concern income generation and financial budgets concern cash flows and capital expenditures. Flexible budgets are superior to static budgets for performance reporting because they allow comparison of actual costs to budgeted costs at the actual level of activity.
Please write a response to each discussion post. 4.1 Winterstien.docxjolleybendicty
Please write a response to each discussion post.
4.1 Winterstien
Top of Form
As a nurse in the acute care hospital setting, I can see how contribution margins can help manage units within a large organization, especially if the units have separate budgets. Fiscal performance in healthcare organizations is evident by profit, liquidity and debt structure (Broyles, Khaliq & Mattachione, 2009). In recent years, the dependence of healthcare organizations on the prospective payment method that Obamacare enforces makes it even more important to reduce financial liabilities and risks and promote healthy budgets (Broyles et al., 2009). It is important for managers to understand how to analyze and understand contribution margins as they help with planning and control of operations (Baker & Baker, 2014).
According to Broyles et al. (2009) contribution margin is the difference between revenue and total variable costs. The formula is recognized as contribution margin= revenue - variable costs (Baker & Baker, 2014). The contribution margin allows a manager to visualize the break even point in which there is an excess of revenue over costs and a profit is realized (Baker & Baker, 2014). In contrast, if the expenses are more excessive than revenues, then a loss will be realized (Baker & Baker, 2014). The advantage of determining the contribution margin is that it allows management to allocate the excess funds to areas that need more funding after fixed costs are covered or using that revenue other areas that benefit the unit (AllBusiness, nd).
4.1 Franks
Top of Form
A contribution margin refers to a per unit measure of a product's gross operating margin calculated as the product's price minus its total variable costs (Iles, 2005). In my current role as a clinical liaison, Contribution Margins would not help me manage my present work, however, my LTACH facility is a for-profit facility and I'm sure Contribution Margins come into play when speaking of our corporate level. Understanding the concept of a contribution margin is important because it is what allows a health care organization to cover their fixed costs and generate a profit (Iles, 2005). If the contribution margin does not exceed a company's fixed expenses, it does not make a profit. A company that has a contribution margin that is less than its fixed expenses incurs a loss. Health care facility managers/owners who assume that a higher gross margin is better for their business may find themselves in financial difficulty because they aren't considering the additional costs to complete "the sale" (Iles, 2005). It is important for health care organizations to compare various sales channels and choose the best option for their facility.
Bottom of Form
4.1 Kelly
Top of Form
According to Baker and Baker (2006), contribution margins are computed as net revenues less variable costs. Contribution margins help me in my present work by determining if new vendors and workflows that we are impl.
The document provides background information on Apple Inc.'s founding and history. It was established in 1976 by Steve Jobs, Steve Wozniak and Ronald Wayne to sell the Apple I computer kit. In 2007, Apple Computer Inc. changed its name to Apple Inc. The document also discusses research methodology, objectives, limitations and definitions of ratio analysis as it relates to analyzing financial statements. Ratios simplify and summarize accounting figures to assess a company's performance, financial position, and efficiency.
This document analyzes the cash flow statement of Bega Company over three years from 2014 to 2016. It examines cash flows from operating, investing, and financing activities. Operating cash flow indicates profits from daily business activities, with negative cash flow meaning the company collects money from customers slower than it pays suppliers. The document aims to understand where the company's cash comes from and how it is spent.
Finance is the lifeblood and lifeline of any business entity either commercial or non-commercial. The
Survival, Stability and Sustainability of a firm is highly associated with its financial wellness. It can be observed through its ability to pay(re) short-term as well as long term liabilities, meeting the regular financial obligations, to increase the value of firm and ability to generate profit. Financial analysis, evaluation, and assessment help in determines the financial position and financial strength of a firm. Among the plenty of methods and tolls available for financial performance, ratio analysis is more useful and meaningful. These ratios make it possible to analyze the evolution of the financial situation of a firm (trend analysis), cross-sectional analysis and comparative analysis.
Earnings management involves using accounting techniques to alter financial results within GAAP, while fraud intentionally misleads through financial statements in violation of law. While the two can be similar in distorting financial reports, earnings management does not necessarily constitute fraud if performed within the boundaries of accepted accounting standards. However, abusive earnings management could lead firms into committing accounting fraud.
This document discusses key concepts related to budgeting including:
1. Budgets translate organizational goals and strategies into operational terms and are used for planning and control by setting standards and comparing actual performance.
2. Master budgets combine all individual area and activity budgets, while operating budgets concern income generation and financial budgets concern cash flows and capital expenditures.
3. Flexible budgets are superior to static budgets for performance reporting because they allow comparison of actual costs to budgeted costs at the actual level of activity.
IntroductionThe budgeting process is an attempt to estab.docxmariuse18nolet
Introduction
The budgeting process is an attempt to establish a set of realistic standards for operating a health care organization. The budget is a set of specific objectives for the year ahead. The finance system provides the cost and revenue data and sometimes assists with other measures.
Formulating a budget is the beginning of the process. Every budgeting system must contain provisions for preparing the budget and implementing a system. This system must include coordination, control, follow-up, and maintenance. An effective budget must be tailored to the organization’s specific needs. The budget must be comprehensible and attainable. There should be innovation and flexibility to meet unexpected occurrences.
A health care organization’s budget provides a fully detailed description of expected financial transactions, by accounting period, for at least an entire year. The review of future expectations is useful in making smooth progress toward financial goals.
The major parts of an annual budget address operational and financial planning needs. The operating budgets are made up of the following:
· Expenditure or cost budgets anticipated by reporting period and responsibility center: Costs are often identified as fixed, semi-variable, or variable. Anticipated volumes of demand or output are incorporated into cost budgets.
· Revenue budgets reflect the receipt of income from services rendered. Standard gross revenue accounting reports a profit increase to the responsibility center, creating an incentive for productive activity.
· Income and expense budgets consist of expected net income and expenses incurred by the organization.
· Financial budgets embrace the effects of the organization’s financial decisions. These plans include a budgeted balance sheet that shows the effects of planned operations and capital investments on assets, liabilities, and equities. The plans also include a cash budget that forecasts the flow of cash and other funds in the business.
· Cash budget is for cash planning and control, presenting expected cash inflow and outflow for a designated time period. The cash budget helps management keep cash balances in a reasonable relationship to needs. You must know how much cash will flow in and out of the organization. You must also have an idea when these will take place. The cash budget is primarily used to spotlight periods of too little or too much cash rather than for continual control.
· Capital budgets are lists of proposed capital expenditures and new or significantly revised programs, with the implications for the operating and cash budgets by period and responsibility center. The capital budgets include all anticipated expenditures for facilities and equipment and for sources of funds.
Cost accounting is the process of determining the full and incremental costs of providing services and goods to patients and customers. To determine the full cost of providing a service, you must ensure that all costs are in.
This document summarizes a paper on approaching revenue cycle management. The paper introduced the issue of poor performing accounts receivable revenue cycles, defined the problem as being caused by improperly structured securitization, a lack of process improvement methods, varying metrics and poor leadership. It reviewed literature on improving cash flow through benchmarking receivables and redesigning revenue cycles. Recommendations included benchmarking exemplary organizations, implementing a multidisciplinary recovery program, updating financial policies to include patient financing, and properly structuring securitization. An implementation plan with monitoring and control was also outlined.
An it manager’s new best friend the company balance sheet it-toolkitsIT-Toolkits.org
Hey IT manager, how is that company that you are working for currently doing? Yeah, yeah – I know that all of the press releases that your management keeps putting out say that things have never been better and the internal emails that you get from the big guy say the same thing. However, how are things really going? It turns out that you can answer this question if you know how to read your company’s balance sheet…
Analyzing The Functions Of A Business, Many Relies On...Jasmine Culbreth
Financial statement analysis and ratio analysis are useful tools for evaluating a company's financial health and performance over time. Ratio analysis examines various financial metrics to identify strengths, weaknesses, and trends. Some key ratios analyzed include liquidity ratios, which measure a company's ability to meet short-term obligations, and profitability ratios, which indicate how effectively a company generates profits from its resources and sales. Ratio analysis is an important part of the financial statement analysis process for managers, investors, and other stakeholders.
Paying attention to outcomes pays off in big ways. Yet many companies fail to take the time to systematically figure out how to measure performance. As a result, the business doesn't flourish as it should. Instead, it stagnates. This presentation highlights the nine success factors of a balanced performance scorecard.
1 1. Describe key methodologies for the practical applicat.docxhoney725342
1
1. Describe key methodologies for the practical application of financial management in healthcare
organizations.
Reading Assignment
Chapter 15:
Financial Statement Analysis
Chapter 16:
Financial Condition Analysis
Unit Lesson
The focus of Unit VIII is on providing a general framework for financial statement analysis to gain insight into
the financial status of an organization. The basic framework provided is to:
Carefully review the financial statements in detail, including reading the auditor’s opinion letter and
considering the information in that letter.
Examine the notes that accompany the financial statements.
Calculate a series of ratios and compare them with the organization over time, other specific similar
organizations, and the industry as a whole.
Make a final assessment of the financial situation of the organization, taking all of the available
information into account.
This unit will address the notes that accompany the financial statements. This includes significant accounting
policies that you need to understand and apply. There will be a review of the summary of the notes provided.
The unit will also explore ratio analysis and making comparisons within the major classes of ratios.
Key Learning
This is a good time to look back and reflect on your key learning from this course. Hopefully, you have a
better understanding now in terms of how healthcare finance actually works, how it gets reported, and how it
gets audited. As we conclude this unit, let’s look back at your key learning from this course.
Healthcare spending: Earlier in this course, we talked about healthcare spending; where does the money
come from, and where does it go? That is definitely a key concept from the course. You learned that private
insurance is the number one source of funding for healthcare in America, representing 32% of total healthcare
dollars. Even with so many Americans currently uninsured, health insurance is the number one source of
funding. Next comes Medicare at 20% and then Medicaid at 15%. Government programs overall make up
35% of spending. That may shed some light on why government has so much influence in our field. In terms
of out-of-pocket expenditures, they truly make up a small portion of healthcare spending in America, just 12%
of total healthcare spending (Finkler, Purtell, Calabrese, & Smith, 2013).
Where does the money go? Well, hospitals clearly get the largest piece of the healthcare dollar, receiving
31% of total medical spending each year. Doctors and clinics come next at 20%, and prescription medications
are next at 10%. Several other areas receive smaller amounts, about 5-7% each. Such areas include dental
services, health insurance administration cost, and nursing care (Finkler et al., 2013).
2
UNIT x STUDY GUIDE
Title
The big problem, as you likely recall, is that in America, we spend two to three times as much on healthcare
as any other developed nation aroun ...
Ratio Analysis in Management Accounting.pdfmanishco.com
Ratio analysis in administration accounting is like a magnifying glass for businesses. It’s a device that helps them look at their monetary health, apprehend their strengths and weaknesses, and make knowledgeable decisions. In this complete guide, we are going to discover the world of ratio analysis, breaking down complicated economic jargon into simple, easy-to-understand terms. We’ll exhibit to you how organizations use ratios to measure performance, control resources, and design for the future. Whether you are a commercial enterprise owner, student, or simply curious about the monetary world, this information will demystify ratio analysis and disclose its significance in the realm of administration accounting.
This document discusses various tools for analyzing financial performance, including ratio analysis, working capital analysis, and funds flow statement analysis. It provides details on each tool and how they are used to evaluate a firm's financial position, operating efficiency, and creditworthiness. Specifically, it explains that ratio analysis involves determining and interpreting numerical relationships between financial statement items, funds flow statement analysis highlights changes in financial position over time and how the business financed those changes, and working capital analysis examines a firm's ability to meet current obligations. The document emphasizes that these tools help management evaluate financial strengths and weaknesses and make informed decisions.
Get to budgeting in 4 easy stages it-toolkitsIT-Toolkits.org
Realistic project budgets can be achieved in four (4) steps designed to ensure that your budgets are sufficiently defined and aligned to existing project needs and capabilities.
Stage 1: Set a justifiable basis for your budget projection by answering the following questions….
What is the source of the cost projection?
How was the projection derived?
How was the projection validated?
How confident are you in the accuracy of each projection?
The document discusses the objective and methodology of analyzing the financial statements of SDG Software Pvt Ltd. It aims to understand the profitability, solvency, liquidity, and financial position of the company. Secondary data sources like annual reports and interactions with finance employees will be used. The analysis will involve comparing financial statements over multiple years and applying analytical tools and ratios. Key financial statements like the income statement, balance sheet, cash flows will be examined to derive useful measurements and relationships.
This document provides an overview of finance processes and legal considerations for an organization. It discusses budgeting, invoices, and legal compliance. The key aspects covered are:
1. Finance is crucial to provide a sustainable financial platform and realize long-term activities. Legal compliance supports safe and responsible operations.
2. Financial management involves planning, organizing, controlling, monitoring, and reporting to effectively manage resources and fulfill commitments.
3. Main finance processes include financial planning and forecasting, controlling and monitoring, risk management, revenue generation, and financial reporting. Budgets, reserves, pricing, grants, and reporting are discussed.
accounting information and decision makingfarhana rahman
This chapter provides an overview of the exercises, cases, and internet assignments in the textbook. It includes:
1) Descriptions of 15 exercises that cover topics such as users of accounting information, financial reporting, accounting principles, and accounting terminology.
2) Descriptions of 5 cases that explore topics like the reliability of financial statements and accounting systems. The estimated completion times and difficulty levels are provided.
3) A description of an internet assignment directing students to access accounting information on the Rutgers University website.
The document concludes with sample answers to 40 discussion questions that correspond to the chapter material. The questions cover accounting concepts and help students develop communication skills.
Essay for ENG 213 21st century and e.docxrusselldayna
Essay for ENG 213: 21st century and everything before
Source Material:
Reading resources in Units 1
through 5 Viewing resources in
Units 1 through 5
Background:
You have read, viewed, and discussed resources on different genres and eras of
poems and poets as well as resources on how compare and contrast topics
effectively. Now, it is time to combine those two subjects into one assignment.
Prompt:
Choose a poet from the 21st century and compare his/her poems and writing
styles to a poet that was presented in Units 1 through 4.
Task:
Choose a poet that is presented in Unit 5 (Miranda, Angelou, Heaney, Collins).
Choose a poet in that is presented in Units 1 through 4.
Use the resources available in all the units on writing styles, devices,
imagery, and history to create a plan for similarities and differences in your
chosen authors’ poems and in their writing styles.
You will be writing a 2-3 page essay that analyzes these similarities and
differences. Be sure to include a supporting section that addresses similarities
and differences in the poems (theme, subjects, structure, rhyme scheme) as
well as a section that addresses the writing styles (use of imagery and poetic
devices).
Instructions:
Analyze the two poets and their poems for similarities and differences in the
poems and in the authors’ writing styles.
Write a 2-3 page essay with a thesis statement that asserts your main
answer to the prompt.
Use ideas, paraphrases, and quotes from both stories to support your own
ideas. Be sure to format these citations according to APA formatting
guidelines.
Your audience for this response will be people who have read the poems but
not compared and contrasted the elements. This will eliminate the need to
summarize or add plot-heavy detail.
Compare & Contrast: 21st Century and Everything Before
ENG213—Poetry
Requirements:
Your response should be 2-3 pages.
Your response should have a properly APA formatted title page.
Your response should have properly formatted in-text citations.
Your response should have a properly formatted reference page
It should also be double spaced, written in Times New Roman, in 12 point font
and with 1 inch margins.
Use the third-person, objective voice, avoiding personal pronouns such as
“I,” “you,” “we,” etc.
Please be cautious about plagiarism. Make sure to use internal citations
for direct quotes, paraphrases, and new information.
Students: Be sure to read before you write, and again after you write.
Rubric for Compare and Contrast of Poets and Poems
Does Not
Meet
Expectatio
ns 0-11
Below
Expectatio
ns 12-13
Needs
Improveme
nt 14-15
Satisfactory
16-17
Meets
Expectatio
ns 18-20
Thesis
Statement
(Controlling
Idea)
Thesis is
not
present.
Thesis is
confusing,
vague or
unclear.
Thesis is
loosely
related to the
paper or not
present.
Thesis is
attempted with
little .
Essay for ENG Unit 3 Breaking out Poe.docxrusselldayna
Essay for ENG Unit 3: Breaking out Poet Study
Source Material:
Resources in Unit
3 Research
sources
Background:
In Unit 3, you have read, viewed, and discussed resources on authors who have
broken out of their traditional styles and formats.
Prompt:
Choose one of the authors from Unit 3 and research how your author “broke
away” from his/her previously accepted norms of poetry writing.
You will need to have at least two outside sources (in addition to the poetry
sources) that you will incorporate into your response. These sources must be
valuable and reliable.
Task:
Choose a poet that is presented in Unit 3 (Whitman, Emerson, Thoreau, or Dickenson)
Use the resources available and at least two research resources and analyze
how your chosen author’s writing style and poems break away from the norms
that were followed prior to his/her break out poetry
You will be writing a 2-3 page essay that analyzes this prompt. Be sure to
include information on
o The structures, themes, and writing styles that were the norm prior
to your author.
o How your chosen author broke away from this norm. Use both your
resources and text examples from the poems to support your
response.
Instructions:
Write a 2-3 page essay with a thesis statement that asserts your main
answer to the prompt.
Use ideas, paraphrases, and quotes from researched sources and poetry
sources to support your own ideas. Be sure to format these citations according
to APA formatting guidelines. Remember that these sources need to be valid
and reliable.
Your audience for this response will be people who are familiar with the
author and his/her poems, but have not researched how the author broke
away from the prior norms. This will eliminate the need to summarize or
add plot-heavy detail.
Literary Analysis Essay: Breaking out Poet Study
ENG213—Poetry
Requirements:
Your response should be 2-3 pages.
Your response should have a properly APA formatted title page.
Your response should have properly formatted in-text citations.
Your response should have a properly formatted reference page
It should also be double spaced, written in Times New Roman, in 12 point font
and with 1 inch margins.
Use the third-person, objective voice, avoiding personal pronouns such as
“I,” “you,” “we,” etc.
Please be cautious about plagiarism. Make sure to use internal citations
for direct quotes, paraphrases, and new information.
Students: Be sure to read before you write, and again after you write.
Rubric for the Literary Analysis Essay: Breaking Out Poet Study
Does Not
Meet
Expectation
s 0-11
Meet
Expectation
s 12-13
Needs
Improveme
nt 14-15
Satisfactor
y
16-17
Meets
Expectation
s 18-20
Approach/Struct
ure
The essay
does not have
a clear
approach and
the structure is
varied so that
the essay
information
cannot be
understood.
The essay’s
approach is
confu.
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Essay for ENG 213: 21st century and everything before
Source Material:
Reading resources in Units 1
through 5 Viewing resources in
Units 1 through 5
Background:
You have read, viewed, and discussed resources on different genres and eras of
poems and poets as well as resources on how compare and contrast topics
effectively. Now, it is time to combine those two subjects into one assignment.
Prompt:
Choose a poet from the 21st century and compare his/her poems and writing
styles to a poet that was presented in Units 1 through 4.
Task:
Choose a poet that is presented in Unit 5 (Miranda, Angelou, Heaney, Collins).
Choose a poet in that is presented in Units 1 through 4.
Use the resources available in all the units on writing styles, devices,
imagery, and history to create a plan for similarities and differences in your
chosen authors’ poems and in their writing styles.
You will be writing a 2-3 page essay that analyzes these similarities and
differences. Be sure to include a supporting section that addresses similarities
and differences in the poems (theme, subjects, structure, rhyme scheme) as
well as a section that addresses the writing styles (use of imagery and poetic
devices).
Instructions:
Analyze the two poets and their poems for similarities and differences in the
poems and in the authors’ writing styles.
Write a 2-3 page essay with a thesis statement that asserts your main
answer to the prompt.
Use ideas, paraphrases, and quotes from both stories to support your own
ideas. Be sure to format these citations according to APA formatting
guidelines.
Your audience for this response will be people who have read the poems but
not compared and contrasted the elements. This will eliminate the need to
summarize or add plot-heavy detail.
Compare & Contrast: 21st Century and Everything Before
ENG213—Poetry
Requirements:
Your response should be 2-3 pages.
Your response should have a properly APA formatted title page.
Your response should have properly formatted in-text citations.
Your response should have a properly formatted reference page
It should also be double spaced, written in Times New Roman, in 12 point font
and with 1 inch margins.
Use the third-person, objective voice, avoiding personal pronouns such as
“I,” “you,” “we,” etc.
Please be cautious about plagiarism. Make sure to use internal citations
for direct quotes, paraphrases, and new information.
Students: Be sure to read before you write, and again after you write.
Rubric for Compare and Contrast of Poets and Poems
Does Not
Meet
Expectatio
ns 0-11
Below
Expectatio
ns 12-13
Needs
Improveme
nt 14-15
Satisfactory
16-17
Meets
Expectatio
ns 18-20
Thesis
Statement
(Controlling
Idea)
Thesis is
not
present.
Thesis is
confusing,
vague or
unclear.
Thesis is
loosely
related to the
paper or not
present.
Thesis is
attempted with
little .
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Essay for ENG Unit 3: Breaking out Poet Study
Source Material:
Resources in Unit
3 Research
sources
Background:
In Unit 3, you have read, viewed, and discussed resources on authors who have
broken out of their traditional styles and formats.
Prompt:
Choose one of the authors from Unit 3 and research how your author “broke
away” from his/her previously accepted norms of poetry writing.
You will need to have at least two outside sources (in addition to the poetry
sources) that you will incorporate into your response. These sources must be
valuable and reliable.
Task:
Choose a poet that is presented in Unit 3 (Whitman, Emerson, Thoreau, or Dickenson)
Use the resources available and at least two research resources and analyze
how your chosen author’s writing style and poems break away from the norms
that were followed prior to his/her break out poetry
You will be writing a 2-3 page essay that analyzes this prompt. Be sure to
include information on
o The structures, themes, and writing styles that were the norm prior
to your author.
o How your chosen author broke away from this norm. Use both your
resources and text examples from the poems to support your
response.
Instructions:
Write a 2-3 page essay with a thesis statement that asserts your main
answer to the prompt.
Use ideas, paraphrases, and quotes from researched sources and poetry
sources to support your own ideas. Be sure to format these citations according
to APA formatting guidelines. Remember that these sources need to be valid
and reliable.
Your audience for this response will be people who are familiar with the
author and his/her poems, but have not researched how the author broke
away from the prior norms. This will eliminate the need to summarize or
add plot-heavy detail.
Literary Analysis Essay: Breaking out Poet Study
ENG213—Poetry
Requirements:
Your response should be 2-3 pages.
Your response should have a properly APA formatted title page.
Your response should have properly formatted in-text citations.
Your response should have a properly formatted reference page
It should also be double spaced, written in Times New Roman, in 12 point font
and with 1 inch margins.
Use the third-person, objective voice, avoiding personal pronouns such as
“I,” “you,” “we,” etc.
Please be cautious about plagiarism. Make sure to use internal citations
for direct quotes, paraphrases, and new information.
Students: Be sure to read before you write, and again after you write.
Rubric for the Literary Analysis Essay: Breaking Out Poet Study
Does Not
Meet
Expectation
s 0-11
Meet
Expectation
s 12-13
Needs
Improveme
nt 14-15
Satisfactor
y
16-17
Meets
Expectation
s 18-20
Approach/Struct
ure
The essay
does not have
a clear
approach and
the structure is
varied so that
the essay
information
cannot be
understood.
The essay’s
approach is
confu.
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*Demonstrate a fundamental knowledge of world geography within specific global issues.
*Demonstrate knowledge of major historical and contemporary events affecting ones’ culture
and other cultures.
*Compare beliefs, belief systems, and ideologies that may be different from their own.
*Develop insight into the nature of language and culture.
*Investigate the variety of human cultures and demonstrate an understanding of the ways in
which cultures have changed.
*Analyze global and cultural arguments, identifying the underlying premises.
Choose one of the following questions and answer using your book/notes. Do not use outside
sources.
4. In Tayeb Salih’s “The Doum Tree of Wad Hamid,” Salih draws on Sudanese oral culture
and the Western literary tradition to write about the experiences of the Arab world in the
wake of colonialism. How does Salih use folklore to represent the conflict between
modernity and tradition?
.
Essay ElectionVoting ReformWrite a 4 page essay in which y.docxrusselldayna
Essay: Election/Voting Reform
Write a 4 page essay in which you explore and critically assess the topic of election reform in the
United States and/or California. The essay must address at least one proposed or alternative electoral
reform that would change current election and/or voting practices.
In deciding what reform you choose to write on, you should explore the websites of various policy
think tanks, organizations, political parties, interest groups, and/or news sources that address the
topic of election/voting reform. Select at least one proposed electoral reform policy and write a 3-4
page paper analyzing the main points of the policy (or policies). Compare the proposed policy to
current US or state election policy. Critically analyze and discuss how the new policy will change
current election practices. Provide arguments as to whether the new policies will enhance or hinder
current election/voting practices, such as the level of democracy or citizen representation.
Assignment Requirements
1. The essay must be between three to four pages, but no more than four.
2. The essay must analyze at least one election/voting reform and include an argument supporting or
opposing the reform(s).
3. The argument of the essay must be based upon research and evidence. The essay must include
references to at least four sources in its analysis.
4. All secondary sources must be cited, including the proper formatting for website sources.
5. The essay must follow the “Essay Requirements” below.
Possible Topics
• Changes in redistricting practices (gerrymandering)
• Same Day Voter Registration or automatic voter registration.
• Changes in FCC (Federal Communications Commission) policy
• Instant Runoff Voting (IRV) or Ranked Choice Voting
• Proportional representation
• Electoral college reform
• Campaign finance reform
• No-fault absentee voting
• Early voting
• Mail-in voting
• Election Day as a holiday or time off for voting
• Voter's Bill of Rights
• Changes in Presidential Debates to allow third parties.
• Increase the size of the U.S. Senate or the House of Representatives
Possible points to include in your analysis.
• How will such electoral reforms improve the level of democracy, representation or citizen
participation?
• What issues will such reforms resolve?
• How will such reforms be put into practice?
• What laws need to change? Will it be necessary to change either the California Constitution or the
U.S. Constitution?
• Compare U.S. voting practices with the practices of other countries.
• Will the implementation of a particular reform lively improve voter turnout? (compare with other
countries or voting systems)
• Will such electoral reforms provide more or less democracy, equality, justice, freedom, and/or
representation? (provide reasons why this would be the case)
• What politicians support and/or oppose the election reforms and why?
• What political parties support and/or oppose election ref.
Essay contentWhere did your storypoetry come from What specif.docxrusselldayna
Essay content:
Where did your story/poetry come from? What specific things did you use from your Alien Anthropology, Creator’s Subject, or other course writing to generate the idea or subject of your story/poetry? How did you move from those original snippets of writing to a story/poetry idea to the story/poetry itself?
What discourse community does your work speak to, or for? What subject, issue, or conversation might your work contribute to within that discourse community? What might your work add to that conversation? Be as specific as possible, here; I’m looking for detail and insight into how your work fits into a larger, already ongoing conversation within an established discourse community.
Describe the most significant revisions you made in your work, and the thinking behind those revisions (why you made the craft choices that you did, what you were experimenting with, or what you hoped to accomplish through your revisions). One thing you could do for this subtopic is look back at the workshop responses you received, and describe how/why you did/did not use those responses.
Describe the craft elements in your work that give it the most impact, and what you were trying to accomplish by using those craft elements the way you did. (Suggestion: This is where you show off your knowledge of writing craft, so use vocabulary terms you’ve learned, and be detailed with them. I encourage you to look at the discussion posts on craft elements to examine and reflect on how your knowledge and skills with writing craft have evolved, and how your knowledge/skills of craft elements are illustrated in your creative work. You might also cite any reading assignments that helped you learn about specific craft elements in your own work.)
In general, how did the writing process work for you? What challenges did you face as you wrote and revised? What risks did you take? What did you learn from any “mistakes” you made? What worked well for you? (Suggestion: This is where you might use vocabulary terms and concepts about creativity that we covered in this course, going all the way back to the beginning of the course.)
Explain the specific revisions you would/will make to your final draft in order to complete it, and why you think these revisions would make your story/poetry complete and effective.
Can you imagine situations where skills in creative thinking/innovation might be useful or necessary in your academic discipline or career field? What concepts or skills from ENG 226 might you apply in those situations to help you solve a problem, answer a complicated question, or innovate a new idea or solution? (Suggestion: look through the readings, etc., from our first unit to find specific ideas, skills, activities, etc., that can help you address this question.)
Final revision poem (add 500 words)
“Life as a teen”
Every chance I get,
I use it to look at the trends,
I do not pay attention to issues that are political,
Neither do I associate myself wit.
Essay contains at least six pages and includes an introduction, bo.docxrusselldayna
The essay is at least six pages long and follows a standard essay format including an introduction, body paragraphs, and conclusion. It properly cites sources within the text and lists them in a references section using APA style. Though there may be minor errors, the overall meaning is clear.
Essay at least 1 page each paper, APA, with references. 1). Clif.docxrusselldayna
Essay at least 1 page each paper, APA, with references.
1). Clifford Stoll — lecturer, computer security expert, and author of
Silicon Snake Oil: Second Thoughts on the Information Superhighway
— notes a wide gap between data and information. “The Internet has great gobs of data,” Stoll maintains, “and little, little information.”
2).
A debate is raging at the IT consulting firm where you work. Some staff members believe that it is harder for experienced analysts to learn object-modeling techniques, because the analysts are accustomed to thinking about data and processes as separate entities. Others believe that solid analytical skills are easily transferable and do not see a problem in crossing over to the newer approach.
.
ESSAY CHOICE 1Develop a communication strategy to resolve confli.docxrusselldayna
The document provides instructions for a communication strategy essay assignment. It asks students to develop a communication strategy to resolve conflict in a workplace by analyzing the structural, cultural, and relationship issues contributing to the conflict. Students must select a large organization they have investigated and focus on developing a communication strategy to improve staff morale. The analysis should demonstrate understanding of organizational structure and culture, as well as interpersonal communication issues. At least six scholarly sources must be cited using APA or Harvard referencing style. The essay should be double-spaced with a completed cover sheet.
Essay Assignments Topic (How Should I be Governed d.docxrusselldayna
Essay Assignments
Topic: (How Should I be Governed during Ancient Greek Era)
ERA/Civilization:
The Classical Greek Period (Greek Political Thought: Plato and Aristotle)
"Great Question" to be answered and analyzed in the essay:
How should I be governed?
- The paper will argue how the people of the era/civilization (Ancient Greek)
answered the particular great question (How should I be governed?).
- All papers must carry a working thesis. This is not simply a report of different
historical perspectives, but a careful analysis and synthesis of the research you
conduct.
- Your final essay will include a title page and bibliography. The essay itself should
be no less than 2400 words and no more than 10 pages.
Note: introduction and Bibliography is already written, please see
attached file. Please continue writing the paper using this file.
ALL WRITTEN WORK TURNED IN FOR CORE HISTORY MUST FOLLOW THESE
BASIC RUBRICS:
• Typed work (word processor), neat and legible, 81/2” x 11” paper 1” margins
all sides
• Times New Roman font, 12 pt.
• Use Footnotes as opposed to endnotes
• All citations must conform to the Chicago Manual of Style
• Use only permitted sources.
- Papers must cite no fewer than FIVE scholarly sources, including at least THREE
primary sources approved by the instructor.
- Permitted secondary sources: Printed works that are scholarly (that is, peer-
reviewed) are the only permitted secondary sources. Peer-reviewed print journals
that are available electronically through library databases are included among
permitted sources. NO OTHER ELECTRONIC SOURCES are permitted Your
instructor may, at his/her discretion, reject or fail any paper that has used one or
more non-permitted sources.
Evidence of academic dishonesty or plagiarism on any part of the assignments will
result in failure of the course and referral to the dean for expulsion.
Essay Grading Rubric
1. Strong Thesis Statement - Is argued coherently and forcefully throughout
the paper. Includes appropriate introductory and concluding paragraphs. The
entire body of the paper is argument driven.
2. Use of Appropriate Scholarly Secondary Sources and Primary Sources -
There is depth and breadth to the research. No false citations. N0 fluff added
to bibliography.
3. Correct use of historical facts and examples to further the argument -
Paper does not give incorrect information, all facts serve the argument and
are not used as mere filler, historical context is maintained.
4. Mechanics and Grammar - No grammatical or spelling errors, proper
formatting, formality of language.
5. Adheres to assignment instructions - Chicago Manual of Style, Word
Count, etc.
Complex Regional Pain Disorder
White Male With Hip Pain
BACKGROUND
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the b.
Essay Assignment Students are tasked with completing an e.docxrusselldayna
Essay Assignment
:
Students are tasked with completing an essay assignment from a list of 3 potential topics.
- Topic #1:
Culture
– Over the past couple of months, people all over the world have had to undertake ‘social distancing’ which has seen contact even between close family members seriously curtailed, if not prohibited, outside of their homes. This has meant that many of the cultural rituals that have historically punctuated and gave meaning to our lives have had to be delayed, modified or cancelled altogether. This has included birthdays, graduations, weddings and funerals in addition to various religious celebrations that happen daily, weekly, annually or otherwise. How have you had to modify, delay or cancel cultural activities over this time and what, if anything, have you learned about the meaning/significance of these events as a result? How might have ‘social distancing’ practices affected other groups or cultures differently from what you have experienced? To what extent do you feel virtual participation can replace physical presence at cultural events?
Topic #2:
political Economy
– The Covid-19 pandemic has forced governments around the world, including Canada’s, to make interventions into their economies in ways which may have never seemed possible just a few months ago. This has included paying most of the wages of workers in private enterprises, curtailing the legal rights of landlords to evict or punish their renters, and closing large parts of their economies altogether. This has happened in countries who perceive themselves to be in favour of a limited role of government, such as the United States, and others which are officially socialist, such as China. What have these actions taught you about the differences in the political and economic ideologies of countries? Have your opinions on what the role of the ‘state’ should be in the economies of countries?
Topic #3:
Trade
– The Covid-19 pandemic has illustrated how interconnected the world is with respect to the trade in goods and the flow of people. While countries, such as Canada, have closed their borders to all but essential travel by people, they have remained open to trade. While people have been required to ‘stay home’ and even ‘shelter in place’, Amazon has had to hire 100,000 workers to keep the flow of goods moving internationally. How has international trade assisted in the international response to the pandemic? Has this strengthened the arguments in favour of international trade? What, if any, weaknesses in the global trading system has the pandemic identified?
Marks for the essay assignment are awarded as followed:
Use of Course Materials and Additional Research - 5 marks
Students are required to support their arguments by referencing materials from both within and outside of the course
3500-3600 words (7 pages long single spaced with 1” margins and 12 point font) Students are expected to conduct a significant amount of research Per.
essay assignmentTechnology and Education”How have new tec.docxrusselldayna
essay assignment
“Technology and Education”
How have new technologies had an impact on education? What impact might they have the future? While change can always have both positive and negative effects, has the impact of specific technologies on education been
mostly
positive or
mostly
negative, and for whom? To have a more specific and focused paper, choose a specific type of technology
and
a specific level of education (primary, high school, college).
Sample Topics/Ideas for the Technology and Education Option:
Should more assistive/adaptive technology for people with disabilities be incorporated into schools? What schools would most benefit from greater assistive technologies? Why are these technologies important?
Should teachers incorporate social media/cell phones/computers into the classrooms? Are these new methods of communication a neglected and vital resource that most teachers are simply too old-fashioned to take advantage of? Or are they mostly a dangerous distraction?
How important is it for students to have technology in the classroom? Is it
essential
to a modern student’s education, or are there more important things on which we should spend our education budget?
Essay Structure:
Introduction: includes background and context—makes the reader interested in your topic
Thesis: your main claim
Body Paragraphs (as many as you need, but at least 3 or 4): research and support for each of your claims and reasons, explanation and support for your assumptions, answers to possible objections (counterarguments).
Conclusion: review major points, a summary of what you learned, and/or a call to action and possible solutions.
Essay Requirements:
4-5 pages in length, and at 1200 words (minimum). MLA format, 12 pt. Times New Roman font.
At least 3 different outside sources, all sources MUST be quoted and cited. No individual quotes may be longer than 4 lines. No block quotations are permitted.
.
Essay Assignment – A Textual Analysis of the Royal Proclamation of 1.docxrusselldayna
Essay Assignment – A Textual Analysis of the Royal Proclamation of 1763
Introduction
:
With the conclusion of the Seven Years War, Great Britain became the dominant power in North America. However, having taken over French colonial possessions, the British were not welcomed by many of the First Nations who had been allied with the French (review Pontiac’s War). In order to establish peaceful relationships with the First Nations (and the French settlers), the British negotiated with the First Nations that resulted in the Royal Proclamation of 1763 – which ended the hostilities, for the most part, between the British and the First Nations. This document, the Proclamation, is an enormously important document in Canadian history and its significance reverberates into modern days as First Nations continue to rely on the document when making legal claims about land ownership.
For this assignment, the Learning Objectives are:
• The Reading of excerpts of a primary document/historical document (the Proclamation)• The Contextualizing of said document, taking a British and First Nations’ perspective of the time and formulating your own stance/viewpoint• The Researching and incorporating of one secondary source related to this topic
Prompt Questions:
Write an essay that incorporates and answers the following questions:
Who benefited most from the issuance of the Royal Proclamation? European settlers or First Nations?
Why did the Proclamation of 1763 contribute to a “souring of the relationship” between Great Britain and her subjects (British settlers) in the thirteen colonies?
The document appears to show great concern for the welfare of First Nations. To what extent was this document designed with the intention of supporting and protecting the interests of the indigenous peoples?
Context
:
At the end of the Seven Years’ War in 1763, France surrendered Canada and much of the Ohio and Mississippi valleys—two-thirds of eastern North America—to England. The British Proclamation of 1763 "preserved to the said Indians" the lands west of the Appalachian Mountains and ordered white settlers "there forthwith to remove themselves from such Settlements," forbade white settlement, and restricted commerce with the American Indians to traders licensed by the British government, requiring settlers to "take out a License for carrying on such Trade from the Governor or Commander in Chief of any of Our Colonies respectively." Power over westward expansion was in the hands of British officials, outside the colonists’ control. By preventing the colonial population from moving inland the British ministry hoped to avoid costly wars, protect the western fur trade, and keep western land speculation under the control of the crown. To enforce the proclamation, Britain authorized positioning 10,000 troops along the frontier, with the costs of 250,000 pounds sterling per year to be paid by the colonists. The British settlers, who looked at the new land as an opportunit.
Essay Arugment on Julius Caesar play. essay question is 2In.docxrusselldayna
Essay Arugment on Julius Caesar play. essay question is:
2
In
Julius Caesar
, there are no moral absolutes: no character is entirely good or entirely bad.
Throughout the play, Julius Caesar, it is evident that Marcus Brutus is entirely good proving the statement there are no moral absolutes in the play to be false. The only action that Brutus does that is perceived as “bad” is justifiable, rendering it as “good.” With no other bad action or thing done by Brutus in the rest of the play, Brutus is irrefragably entirely good. The only action that Brutus does that was perceived as bad was the assassination of Julius Caesar. This action, however, is actually not bad and is a good action as it was justifiable. The reason that Brutus killed Julius Caesar was not for personal gain and was for the benefit of Rome. Brutus clearly exhibits that he did not kill Caesar for personal reasons in the line, “It must be by his death And for my part I know no personal cause to spurn at him…” Due to Brutus having a justifiable reason for killing Caesar that is “good” and is of benefit to others and not just Brutus, then the action of killing Caesar is a good one. The argument could be brought up that murder is never justifiable, and therefore Brutus is not entirely good. The argument that murder is never justifiable does not apply to more ancient times when the play is set and is thus not relevant to the play. This is to killing being more acceptable in ancient times than in modern times of which this notion originates from particularly due to a very violent 20
th
century. Therefore, as Brutus’ only action that is perceived as “bad” is actually good, and he has no other bad actions in the play, then Brutus is entirely good. Thus, the statement that there are no moral absolutes in Julius Caesar is incorrect as exhibited by Marcus Brutus.
.
Essay Assignment #3Required length 5-7 pages, not including th.docxrusselldayna
Essay Assignment #3
Required length: 5-7 pages, not including the Works Cited
This assignment requires students to use the ideas from our readings to develop a research project on the experiences of the children of immigrants and college in the United States. Your purpose in Assignment #3 is to devise your own argument about your chosen subject and to support your argument using various sources (and your own ethnographic research if you would like to). This assignment requires you to identify a specific topic on your own and to do library research (and ethnographic research) in developing your argument: you must include direct citations from at least one (1) course reading and at least three (3) sources from the library databases. It is optional to use your own ethnographic research. In your essay, you should formulate a clear and focused thesis and provide a detailed account of your evidence.
As mentioned earlier, this assignment is to be driven largely by your own research and thinking. You should be doing library research as you write, not after you’ve completed a first draft. Research and writing are thoroughly connected. Your research process will involve reading, thinking, taking notes, and perusing the databases and other sources until you have figured out what you want to write. Then, as you continue writing, you should go back into the research process again to get new ideas or to find additional sources. Sometimes your argument shifts or changes as you find new sources, and this is a good sign that you are doing research-based writing correctly. Don’t be afraid to change direction in writing the first draft—you can always improve or clarify your draft in your revision process.
Remember that, in a short paper like this, you cannot write something meaningful about all aspects of the experiences of the children of immigrants and college in the United States, but you can make a significant argument about one or two issues in connection with this topic.
In Essay 3, you need to develop your own argument in connection with the experiences of the children of immigrants and college in the United States. You may pursue any argumentative angle that you would like. You may want to consider some of the topics raised by the authors that we read:
· Parental expectations/influence regarding education, college major, career choice
· Other influences on students’ pursuit of a college degree, choice of major/career
· Connection between parents’ work situation/financial status/work ethic and the choice to pursue a college education Comment by Zahraa Alquraini: I choose this topic
· Differences in educational attainment among different second-generation immigrant populations
· Reasons for a particular second-generation immigrant population’s high (or low) educational attainment
· Obstacles some second-generation individuals experience regarding going to college (such as poor high school education, lack of parental educational attainment, lack of .
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
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Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
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How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
EquityEquity calculations are not discussed in any detail he.docx
1. Equity
Equity calculations are not discussed in any detail here. It is
enough
for our purposes to recognize that equity is a derived figure.
Equity
must equal total assets less liabilities. In our Williams
Convalescent
Center example, this generates values of $2,562 for the constant
dollar method and $2,867 for the current cost method.
SUMMARY
Financial reporting suffers from its current reliance on the HC
valuation concept. Inflation has made many of the reported
values in
current financial reports meaningless to decision makers. The
example used in this chapter illustrates this point. The total
asset
investment of Williams Convalescent Center is approximately
100%
larger when adjusted for inflation under the current cost or
constant
dollar method. Net income, however, decreased. The result is a
dramatic deterioration in return on investment––the single most
important test of business success. Table 10–11 summarizes
(Cleverley 227-237)
Cleverley, William O. Essentials of Health Care Finance, 7th
Edition.
Jones & Bartlett Learning, 20101022. VitalBook file..
Chapter 11 Analyzing Financial Position
LEARNING OBJECTIVES
After studying this chapter, you should be able to do the
2. following:
• 1.Describe the balanced scorecard and dashboard
reporting.
• 2.Describe the four key elements of dashboard reporting.
Increase in
specific prices
over general
price level
($3,783 less
$3,791)
($8)
• 3.Explain what is most important in long-term financial
success.
• 4.Explain the primary financial objective of a healthcare
firm.
• 5.Describe the critical drivers of financial performance.
• 6.Discuss the importance and types of performance
measures.
• 7.Introduce the hospital cost index measure.
REAL-WORLD SCENARIO
Michael Dean has been recently appointed to the board of
Kenyon
Medical Center, a 300-bed, not-for-profit community hospital.
Mike is
an attorney who specializes in labor law and is the firm’s
3. primary
litigation expert in this area. He is reviewing the financial
information
that was sent to him this morning in preparation for his first
board
meeting this evening. His total financial package includes 28
pages of
financial information consisting of current monthly income
statements,
a balance sheet, and other monthly actual-to-budget
comparisons of
performance with some selected financial ratios.
Tonight’s meeting is critical because the board’s major item for
discussion is related to a proposed bond issue to finance major
hospital renovation. Mike recognizes that he has a fiduciary
responsibility to protect the assets of the hospital and to ensure
its
continued financial viability, but he does not know how to
determine
whether the hospital can afford to take on this additional debt.
There is
so much information and no apparent pattern as to what really is
important. He is also concerned about assessing how the
proposed
financing would impact the hospital’s financial performance and
thus
its ability to repay both interest and principal on the debt. He
recently
read a report on “dashboard reporting” and wonders if some
structure
like this would help him and other board members to get a
better
appreciation for the financial performance of the hospital.
The major purpose of this chapter is to introduce some
analytical tools
4. for evaluating the financial condition of healthcare entities.
Think for a
moment how confusing and difficult it would be without a key
to reach
any conclusions about financial position from any of the
financial
statements presented in Chapter 9. Unless your training is in
business
or finance, the statements may look like a mass of endless
numbers
with little meaning. In short, there may be too much information
in
most financial statements to be digested easily by a general-
purpose
user.
During the last 30 years there has been an explosion in the
adoption
and integration of information technology to financial reporting.
Financial data are collected, analyzed, and distributed to
decision
makers in a more accurate and timely manner and in greater
quantity
than ever before. However, many people believe the technology
has
not had a positive impact on performance. Although we have
made
important strides in the technology of information collection
and
distribution, we have failed to realize significant improvements
in the
decision-making value of that information.
What accounts for the failure to take advantage of information
technology advances? We believe the answer is very clear and is
5. one
that most executives would readily acknowledge. We have been
using
the technology to deliver data, and more of it, to decision
makers more
rapidly, but we have ignored the issue of information relevance.
As a
result we have in many cases simply used technology to deliver
irrelevant or inappropriate data more quickly. Bad data
delivered more
quickly are not likely to improve performance in either the short
run or
the long run.
LEARNING OBJECTIVE 1
Describe the balanced scorecard and dashboard reporting.
To improve the collection and communication of financial and
operating information, “balanced scorecards” and “dashboards”
were
created. Essentially, these tools are neatly formatted reports that
provide information on the organization’s performance in a
limited
number of areas. The reports help focus attention to key
performance
indicators (also referred to as key metrics or measures) that are
typically defined by senior leadership.
The concept of balanced scorecards developed by Robert Kaplan
and
David Norton represents an attempt to enhance the value of
information and exploit the capability of information
technology to
deliver true value to decision makers. Balanced scorecards, in
their
stripped-down version, simply state that reporting should be
6. available
on those key attributes affecting performance. More data are of
little
value if they do not provide information to a decision maker
that can
be used to improve the performance of the firm. Dashboard
reporting
is a natural subset of balanced scorecards and is increasingly
used in
almost all sectors of the economy to keep managers focused on
critical areas that affect overall firm performance.
In 1988, a major company won a Vision Award issued by
Business
Finance for its dashboard reporting system. The company’s
present
dashboard system is intranet based and replaced the company’s
monthly 200-page binder system that was sent to managers. The
mix
of 16 financial, operating, and human resource measures is
available
online in a drill-down format into which managers can dig
deeper if
they desire. The system is extremely easy to use and focuses on
critical performance drivers.
DEVELOPING AN EFFECTIVE FINANCIAL
REPORTING SYSTEM
LEARNING OBJECTIVE 2
Describe the four key elements of dashboard reporting.
Assuming that many healthcare providers are interested in
developing
a dashboard reporting system for key executives and board
members,
what needs to be done? In general, four critical questions must
be
answered:
7. • 1.What is most important to the firm’s success?
• 2.What are the critical drivers that influence performance
attainment?
• 3.What are the most relevant measures that reflect critical
driver relationships?
• 4.What relevant benchmarking data are available to assess
performance?
In the remainder of this chapter we answer these four questions
with
respect to financial performance. We then examine a specific
hospital
example to illustrate the definition and utilization of financial
indicators
to assess financial performance and to identify critical
opportunities for
management intervention.
Question One: What is Most Important for
Success?
Understanding financial performance in any business requires
some
global or summary measure of financial success. For many
healthcare
organization executives, this measure is often the operating
margin
(operating income divided by revenues). Although operating
margin is
important, we believe that relying on this as a measure of
success can
be misleading in many situations. For example, low operating
margins
8. may not always be bad and high operating margins may not
always be
good.
LEARNING OBJECTIVE 3
Explain what is most important in long-term financial success.
What should be the primary criterion for financial success in
healthcare organizations? We believe that a financially
successful
organization is capable of generating the resources needed to
meet its
mission. This creates two immediate questions. First, what are
resources? Second, what level of resources is needed to fulfill
the
mission? Economic resources that are owned or controlled by a
business firm are referred to as assets and include such items as
supplies, equipment, buildings, and other factors of production
that
must be present to produce health services. Human resources are
not
usually shown as assets because the firm does not own an
individual,
but human resources also are required in the production of
products
or services. Resources or assets owned by a healthcare
organization
are shown in its balance sheet, which provides a listing of its
assets
and the pattern of financing used to acquire those assets. The
level of
resources required by a healthcare organization depends largely
on
the range and quantity of health services envisioned in the
mission
statement. In situations when there is no scientific standard for
9. resource requirements, benchmarking against other healthcare
organizations may be used to partially address the issue of
resource
need. A hospital or healthcare firm can find itself in a situation
when it
may have too little investment in assets to meet the production
needs
for services, or it may have excessive investment in assets of a
certain
category.
Resources can be financed with either debt or equity funds, as
any
balance sheet clearly shows. A financially successful
organization
must therefore be capable of generating the amount of funds
through
debt and/or equity that is needed to finance the required level of
resources. Figure 11–1 depicts a simple balance sheet that
illustrates
these concepts. In this example our healthcare organization
needs to
increase its investment in assets, or resources, by $100 million
(to a
total of $200 million) over the next 7 years to fulfill its mission.
This
level of future investment should be a byproduct of the firm’s
strategic
plan. A strategic plan should provide some information about
projected
service levels, which in turn should drive expected investment.
Strategic financial planning is the topic of Chapter 13. The rate
of
annual compounded asset growth for the example in Figure 11–
1s
approximately 10% per year. This rate equals the average rate
10. of
asset growth in many voluntary not-for-profit hospitals during
the last 5
years. Although this growth rate may seem high, remember that
this
rate incorporates replacement of assets at higher prices, new
technology, entry into new product lines requiring new
investment, and
increases in working capital such as accounts receivable. The
healthcare organization depicted in Figure 11–1 has chosen a
financing mix of 50% equity and 50% debt.
Figure 11-1 Sustainable Growth
This means that 7 years later, the target financing mix will be
$100
million of debt and $100 million of equity to finance the $200
million
investment in assets.
If an organization must grow to meet its mission, then, given
our
discussion, it must be sensitive to how quickly it grows (the
asset
growth rate) and how it grows (the mix of debt and equity
financing).
The principle of sustainable growth states that no business
entity can
generate a growth rate in assets (10% in our example) that is
greater
than its growth rate in equity (also 10% in our example) for a
prolonged period. It may be possible to generate new asset
growth of
15% for several years when equity growth is only 5% by
changing the
percentages of equity and debt financing. There is no mystery in
11. the
principle of sustainable growth, and it is not some esoteric
finance
concept that bears no relationship to reality. Any business will
have its
asset growth rates limited by its ability to generate new equity
growth.
To not believe in the validity of this concept implies that a firm
could
always increase its percentage of debt financing to any level.
There
are no exceptions to this theorem. It is not something that
represents
a nice target; it is a fundamental principle of business from
which no
one is exempt. Some governmental healthcare organizations
may
argue that they always generate growth rates in equity less than
their
asset growth because they get capital funds directly from their
governmental sponsors. Those transfers represent a transfer of
equity
and are a part of equity growth. To be clear, the most important
aspect
of long-term financial success is sustainable growth.
LEARNING OBJECTIVE 4
Explain the primary financial objective of a healthcare firm.
If sustainable growth (equity growth that meets or exceeds asset
growth) is an organization’s long-term financial goal, then there
is no
other financial objective that is more important than equity
growth.
Healthcare organizations that expect low rates of equity growth
12. in the
future most likely will not be able to provide the level of
resources
sufficient to meet their mission. If your healthcare organization
anticipates growth rates in equity of only 5% over the next
decade, it is
almost certain that your asset growth potential will be no
greater than
5%. Although the objective is not to add assets or investments
for the
sake of growth, health-care organizations that remain viable
must add
new investments. Healthcare organizations with low rates of
growth in
equity most likely will experience most of their asset growth in
working
capital areas such as accounts receivable and supplies. These
firms
will invest very little in renovation and replacement of existing
equipment and plant and very little in new capital required for
entry
into new markets. If they are surrounded by firms that are not
experiencing low equity growth rates, their market share will
decrease
as their relative delivery capability deteriorates.
Growth rate in equity can be expressed as follows:
Change in equity
Equity
=
Net income
Equity
13. ×
Change in equity
Net income
Most voluntary not-for-profit healthcare organizations do not
have a
source of equity other than net income. This means that no
transfers
of funds from government or large restricted endowments exist
to
increase the firm’s change in equity from the level of reported
net
income. In these situations the term change in equity/net income
equals one; therefore, growth rate in equity can be defined as
net
income divided by equity, or return on equity (ROE). ROE is
therefore
the primary financial criterion that should be used to evaluate
and
target financial performance for voluntary not-for-profit
healthcare
organizations when transfers of new equity are not likely. ROE
is also
the primary financial criterion that should be used to evaluate
and
target financial performance for taxable for-profit firms.
In sum, to answer our first question of “what is most important”
in
dashboard creation, we believe that organizations must focus on
sustainable growth to be viable long term. Sustainable growth,
and
equity growth in particular, can be measured by ROE.
Therefore, the
most important long-term financial metric that can be included
14. on a
financial dashboard is ROE. In the remaining portions of this
chapter,
we explore how the relationships that drive ROE impact the rest
of the
financial dashboard.
LEARNING OBJECTIVE 5
Describe the critical drivers of financial performance.
Question Two: What Are the Critical Drivers
of Performance?
At present, we only have one measure on our financial
dashboard:
ROE. If improving ROE is our goal, it is important to
understand the
underlying performance relationships that impact that growth.
ROE is
simply defined as follows:
ROE
=
Net Income
Equity
(
or Net Assets
)
However, ROE can be factored into a number of components
that help
executives analyze and improve their ROE values. The
following
15. equation also defines ROE:
R
O
E
=
Operating income
+
Nonoperating income
Revenue
×
Revenue
Assets
×
Assets
Equity
This alternative formula tells us that an organization can
improve its
ROE in a variety of ways. First, it can improve its operating
margins
(operating income divided by revenue). Second, it can increase
its
nonoper-ating gain ratio (nonoperating income divided by
revenue).
Third, it can increase its total asset turnover (revenue divided
by
assets). Fourth, it can reduce its equity financing ratio (equity
divided
by assets). Operating margin improvement is an important
strategy for
improving ROE, but it is not the only way that ROE can be
increased
16. and sustainable growth achieved. Figure 11–2 depicts the
critical
relationships affecting financial performance in most healthcare
firms.
If we assume that ROE, or business unit value, is the primary
measure of financial performance success, the schematic in
Figure
11–2 provides a roadmap of the critical drivers of performance.
The
schematic shows that the three primary determinants of value
are
profit, investment, and cost of capital. These three primary
determinants of value can be related to a set of macro drivers,
and
then ultimately to a number of micro value drivers that enable
measurement and modeling for effective dashboard reporting.
It is important for every healthcare firm interested in
developing a set
of measures to monitor and evaluate performance to start with a
model similar to the one defined in Figure 11–2. Without this
type of
framework, many executives simply try to define a set of
measures
from those that currently exist or could be created. Defining
measures
without understanding key relationships can be dangerous. For
example, reporting man-hours per discharge without adjusting
for
case-mix intensity can lead to erroneous conclusions and
potentially
bad decisions. Know your business before you determine how
best to
capture the essence of its performance.
17. LEARNING OBJECTIVE 6
Discuss the importance and types of performance measures.
Question Three: What Are the Most
Relevant Metrics?
Understanding the relationships that drive performance permits
one to
define performance measures that should focus management
attention on areas that need to be corrected. There is always a
dilemma encountered in the definition of the measures used for
reporting. First, the absolute number of measures used must be
limited. The used measures should have a high probability of
problem/
opportunity detection. For example, in our sample hospital’s
dashboard report, we assess the probability of a supply or drug
cost
problem by examining costs for four high-profile diagnosis-
related
groups (DRGs). Second, the measures should be naturally
related to
the key driver map developed earlier (Figure 11–2). In the case
of our
dashboard report we identify 13 critical performance driver
categories:
Figure 11-2 Micro and Macro Drivers
• 1.Market factors
• 2.Pricing
• 3.Coding
• 4.Contract negotiation
• 5.Overall cost
18. • 6.Labor costs
• 7.Departmental costs
• 8.Supply and drug costs
• 9.Service intensity
• 10.Nonoperating income
• 11.Investment efficiency
• 12.Plant obsolescence
• 13.Capital position
Third, the measures used should be capable of external
validation or
benchmarking. Measuring current performance with past
performance
may be helpful in some cases, but ideally comparative industry
benchmarks should be available.
Our “hospital dashboard” report contains 49 measures that are
related
to the 13 critical performance driver categories. Each of these
measures can be related to external comparative data as well as
comparisons with individual market area competitors.
Benchmarking
data from competitors are extremely valuable. We discuss the
measures used for each of the 13 performance drivers when we
begin
our case discussion.
Question Four: What Benchmarking Data
Should Be Used?
Comparative benchmarking data are crucial ingredients to the
success
of any dashboard reporting system. Ideally, a business would
like
some comparative reference points. How am I doing with
respect to
similar firms in my industry? How am I doing relative to my
primary
19. competitors?
Identifying measures that are able to capture the nuances of
revenue
or cost drivers is nice but may be of
little value if no external comparative benchmarks can be found.
For
example, most hospitals would like to measure and compare
nursing
cost on an acuity-adjusted basis, but uniform benchmarks are
not
currently available. In this situation direct nursing cost per
patient day
may be the best that one can do.
The measures used in this chapter for our case hospital allow
external
comparisons and competitor comparisons because the databases
used in measure definition are publicly available in the
following
sources:
• •Medicare Cost Reports
• •Standard analytical outpatient file
• •MedPAR file
CASE EXAMPLE: HARRIS MEMORIAL
HOSPITAL
For the remainder of this chapter we illustrate the use of
financial
analysis techniques through a case example: Harris Memorial
Hospital
and Harris Community Foundation (HCF), which we also used
in
20. Chapter 9. We use the audit for HCF in Appendix 9–A to
calculate
many of the financial ratios in our dashboard. HCF has one
primary
competitor in its market: Eastside Healthcare. The primary
hospital for
HCF is Harris Memorial Hospital, a 430-bed facility. The
primary
hospital for Eastside Healthcare is Eastside Medical Center, a
170-
bed facility. Many of the metrics on our dashboard relate only
to the
primary hospitals. These metrics are calculated from the public
data
sources (cost reports, standard analytical outpatient file,
MedPAR)
and do not directly tie to the audit in Appendix 9–A. In sum,
when
examining our sample dashboard you can practice calculating
the
metrics when the data source is listed as “Audit” but cannot
practice
calculations for the other data sources. In the end, it is most
important
to understand how to interpret the metrics, not simply how they
are
calculated. Our dashboard can be found in Table 11–1.
Table 11-1 Dashboard for Harris Memorial
Hospital
Data Element Data
Sour
ce
22. average age of plant/9]
1.4 0.1 –1.0
Total margin Audit Excess of revenues
over expenses/
operatingrevenue
nonoperating gains
7.0 6.9 1.9
Market factors
Inpatient
revenue %
Publi
c
Gross inpatient
revenue/gross patient
revenue
30.5 61.9 54.0
Surgical cases
%
Publi
c
Medicare surgical
discharges/Medicare
total discharges
35.6 38.3 23.3
23. Market share % Publi
c
Net patient revenue/
sum of net patient
revenue in county
87.0 57.8 32.6
Medicaid days
%**
Publi
c
Medicaid patient days/
total patient days
23.2 12.4 14.7
Medicare days
%**
Publi
c
Medicare patient days/
total patient days
42.3 59.7 49.5
Revenue growth
(last year) %
24. Audit (Operating revenue
current year –
operating revenue prior
year)/operating
revenue prior year
6.5 10.5 4.6
Pricing
Average charge
perMedicare
discharge (CMI
= 1.0)*
Publi
c
All Medicare inpatient
charges/(number
ofdischarges × CMI)
14,421 14,73414,977
Average charge
per visit (RW =
1.0)*
Publi
c
Average Medicare visit
charge/average relative
weight
192 223 239
25. Routine room
rate*
Publi
c
Average charge for
routine care
816 627 781
Chest x-ray
(71020)*
Publi
c
Average charge for
chest x-ray
226 245 202
Coding factors
Change in
Medicare CMI %
Publi
c
Percentage change in
Medicare case mix
index (2 years)
–1.9 –2.6 2.2
Medicare CMI Publi
26. c
Measure of the
costliness of cases
treated bya hospital
relative to the national
average of all Medicare
hospital cases, using
DRG weights as a
measure of relative
costliness of cases
1.7644 1.74391.3727
CC/MCC
capture rate
(2008)
Publi
c
The number of
Medicare cases in MS-
DRGs with a CC or
MCC designation
divided bythe total
Medicare cases (2008)
0.5 0.5 0.5
Injectable drug
without
administration %
27. Publi
c
Claim chosen if
pharmaceutical item
requiring injection or
infusion present
without the
administration
procedure
24.1 8.1 14.4
Contract
negotiation
Nongovernment
payers %
Publi
c
Percent of revenue
from sources other
than Medicare or
Medicaid
34.4 27.9 33.1
Markup
(charges/cost)
Publi
c
(Gross patient revenue
other
28. operatingrevenue)/total
operating expenses
2.9 2.9 2.6
Deduction % Publi
c
Contractual
allowances/gross
patient revenue
60.7 67.5 61.7
Cost position
Hospital Cost
Index®
Publi
c
[(Average cost per
Medicare discharge/
U.S. Median) × IP
revenue %] [(average
costper visit/U.S.
median) × OP revenue
%]
117.4 78.9 100.9
Average cost per
Medicare
29. discharge (CMI
= 1.0)*
Publi
c
Medicare inpatient
costs/(Medicare
discharges × CMI)
5,603 5,054 5,504
Average cost per
visit (RW = 1.0)*
Publi
c
Average Medicare visit
costs/average relative
weight
82 40 66
Labor costs
Net patient
revenue per
FTE*
Publi
c
Net patient revenue/
FTEs
179,127106,963119,924
30. FTEs per
adjusted patient
day
Publi
c
FTEs/(adjusted patient
days/365)
4.1 6.7 4.8
Salary per FTE* Publi
c
Salaries/FTEs 67,933 44,38746,175
Departmental
cost
Direct cost per
routine day*
Publi
c
Direct routine costs/
routine patient days
299 263 311
Direct cost per
ICU/CCU day*
Publi
c
31. Direct ICU and CCU
costs/ICU and CCU
patient days
573 740 693
Overhead cost
%
Publi
c
Overhead expenses/
total expenses
25.0 21.0 32.0
Capital related
costs per
adjusted patient
day*
Publi
c
Old and new capital-
related costs/adjusted
patient days
132.0 133.0 102.0
Supply and drug
cost
32. MS-DRG 247
supply cost
Publi
c
Perc cardiovasc proc w
drug-eluting stent w/o
MCC
3,676 6,878 5,141
MS-DRG 470
supply cost
Publi
c
Major joint replacement
or reattachment of
lower extremity w/o
MCC
4,696 6,912 5,989
MS-DRG 194
pharmacy cost
Publi
c
Simple pneumonia and
pleurisy w CC
1,138 728 795
34. Nonoperating
income Days
cash on hand
Audit (Cash and cash
equivalents long-term
investments)/((total
expenses –
depreciation)/365)
219 29 33
Investment
income/
investment %
Audit Investment income/
total investments
5.9 0.0 1.9
Portfolio in
equities %
Audit Equity investments/
total investments
58.7 n/a 50.0
Investment
efficiency
Days in A/R Audit Net accounts
receivable/(net patient
35. revenue/365)
Inventory/net
patient revenue
%
Audit Inventory/net patient
revenue
0.9 2.9 1.9
Revenue/net
fixed assets
Audit Operating revenue/net
fixed assets
1.52 1.87 2.45
Plant
obsolescence
Average age of
plant
Audit Accumulated
depreciation/
depreciation expense
11.1 10.7 9.3
2-yr change in
net fixed assets
Audit (Net fixed assets – net
fixed assets(2 yr
prior))/net fixed assets
36. (2 yr prior)
37.2 44.6 5.0
Capital position
Long term debt/
equity %
Audit Long-term debt/net
assets
72.1 37.8 31.2
Average cost of
equity %
Publi
c
Risk-free rate on U.S.
government obligations
estimated beta of firm ×
market risk premium
9.1 7.8 7.6
CMI, case-mix index; MCC, major complication and
comorbidity.
*Wage index adjusted metric to remove differences in cost of
living
**Medicaid and Medicare Days % include government-
sponsored health maintenance
organization (HMO) days
37. Dashboard: Overall Performance
Three measures of overall performance are identified in Table
11–1:
• •Return on equity (ROE)
• •Financial Strength Index® (FSI)
• •Total margin (TM)
For all three of these measures, larger values are desirable. A
quick
review of the data in Table 11–1 reveals a strong position for
Harris
when compared with U.S. medians. There may be some
financial and
operating issues that need to be addressed if Harris is to
continue as
a financially strong healthcare provider. Before we discuss
these
measures, we define them and compute values for 20X7:
Debt financing % Audit (Total assets – net
assets)/total assets
47.5 31.6 47.1
Cash flow to
total debt %
Audit (Net income
depreciation)/total
liability
17.1 29.6 10.5
Debt service
coverage
38. Audit (Net income
depreciation interest)/
(principal payment
interest)
6.9 n/a n/a
Harris’s value for ROE is 9.0%, which indicates that the firm
has a
positive bottom line. A review of the data in Appendix 9–A
shows that
Harris has reported sizable balances of both operating and
nonoperating income in 20X7 and 20X6. total margin measures
the
return on revenue from both operating and nonoperating
sources.
Harris is realizing positive returns in both areas, but
nonoperating
returns in 20X7 were lower than those in 20X6.
The final overall measure is the Financial strength index. This
index
attempts to measure the four areas of financial position that
collectively determine a firm’s financial strength:
• •Profits––measured by total margin (normalized average
target: 4%)
• •Liquidity––measured by days cash on hand (normalized
average target: 120 days)
• •Debt expense––measured by debt financing percent
(normalized average target: 50%)
39. • •Age of physical facilities––measured by average age of
plant (normalized average target: 9 years)
Simply stated, firms that have high profits, lots of cash, little
debt, and
new plants have great financial strength. Firms with losses,
little cash,
lots of debt, and old physical facilities will not be in business
long.
Each of the four measures is “normalized” around a predefined
average for the measure. This permits us to add the four
measures to
create a composite indicator of total financial strength. Harris
has a
very strong overall Financial Strength Index due primarily to its
favorable total margin position and its strong cash position.
Harris’s
strong cash position is also a factor that impacts total margin. In
20X7
nearly 50% of Harris’s total net income was derived from
investment
income. Debt levels at Harris are also below normative values,
which
further enhances its overall financial strength.
A critical objective for Harris in coming years will be to
maintain its
current financial position. We now focus our attention on
reviewing the
13 critical drivers of performance listed earlier to identify
possible
areas of opportunity for Harris.
Market Factors
Many factors influence the financial performance of a
healthcare
40. provider, as Figure 11–2 shows. Market factors play an
important role
in the final financial performance of any business. Six measures
of
market factors are identified in Table 11–1:
• 1.Inpatient revenue
• 2.Surgical cases
• 3.Market share
• 4.Medicaid days
• 5.Medicare days
• 6.Revenue growth
Inpatient revenue at Harris is only 30.5% compared with 61.9%
at
Eastside and 54.0% nationwide. In most situations a higher
percentage of inpatient revenue is desirable because profit
margins
are usually higher on inpatient product lines. For example,
many U.S.
hospitals make positive margins on Medicare inpatients, but
most
hospitals lose money on Medicare outpatients.
Harris does a lot of surgery compared with U.S. averages but
less
than Eastside does. Usually, surgical inpa-tient cases are more
profitable than are medical cases.
Market share is perhaps the most critical measure of
performance in
the market factor category. High market share often leads to
higher
realized prices and lower cost per unit. If a healthcare provider
had no
41. competitors and operated as a monopoly, it could conceivably
dictate
price to all payer groups except Medicare and Medicaid. The
market
share position of Harris is higher than that of Eastside. Harris
enjoys
greater market share, which may give it a better contract
negotiation
position. Because this market is dominated by only two
providers, both
hospitals should be able to demand and receive favorable
contract
terms because neither hospital has the capacity to service the
entire
market.
In addition to the ability to negotiate more favorable
reimbursement
terms, higher market share also can provide significant
improvements
in profits because of lower cost per unit. Greater volume
spreads fixed
costs among more patients.
Medicare and Medicaid percentages provide an indication of
payer-
segment importance. Usually, Medicaid is perceived as a less
desirable payer, whereas Medicare in many hospitals is a
desirable
payer, especially for acute inpatient care. Harris appears to have
an
unfavorable relationship here. It has much higher Medicaid
volume
compared with its competitor and U.S. averages, whereas it has
lower
percentages of Medicare. Harris’s geographical location has
placed it
closer to the Medicaid population than its primary competitor.
42. Losses
on Medicaid patients are substantial and, when combined with
Medicare losses, create a need for higher payments from the
limited
private-payer base.
Revenue growth at Harris is above U.S. averages but below
Eastside.
This is most likely a result of Harris’s greater growth in
Medicaid
volume. Although revenue growth is desirable, revenue growth
in
profitable product lines is critical. Harris has experienced
growth in
some less profitable lines such as Medicaid, and this can hurt
overall
profitability.
Conclusions reached from our review of market factors are as
follows:
• •Harris must concentrate growth strategies in product lines
that are profitable, especially inpatient surgical areas.
• •If market share enhancement is not feasible, cost cutting
must be pursued or unprofitable product lines must be
eliminated.
• •Reduced reliance on Medicaid business is desirable.
Pricing Factors
Pricing can still have a sizable influence on a health-care firm’s
profitability, even considering that many payers have fixed-fee
reimbursement schedules. Of concern to many is the price
elasticity of
healthcare services. In simple terms, will volume drop if I raise
prices?
43. This is a difficult question to answer, but in many cases price
elasticity
is believed to be negligible for many healthcare services. If a
healthcare firm’s prices are lower than its competitors’, the
issue of
price elasticity becomes less important. The first objective is
therefore
to determine whether your prices are above or below your
competitors’. The four pricing measures are all developed from
public
data sets and are presented in Table 11–1. The data show that
Harris
has prices below its competitor’s––with the exception of room
rates.
Average charge per Medicare discharge (case-mix index = 1.0)
defines the average price for a Medicare discharge with a case-
mix
weight of 1.0. Table 11–2 provides a simple example to
illustrate how
this measure is developed. Adjusting charges or cost to a case
weight
of 1.0 permits meaningful comparisons across firms. Table 11–1
also
indicates that this measure for the U.S. median is stated in the
hospital’s wage index of 0.8304. This removes potential cost-
of-living
issues that might impair comparability. Charges for a specific
discharge or an outpatient encounter are the product of two
factors:
Table 11-2 Illustration of Case-Mix
Weighting
DRG Cas
45. $9,600
Average Charge per Case (case-mix index = 1.0)
=
$288,000
36
=
$8,000
• •Intensity of service
• •Charges for specific procedures
(Cleverley 243-254)
Cleverley, William O. Essentials of Health Care Finance, 7th
Edition.
Jones & Bartlett Learning, 20101022. VitalBook file.
Chapter 12 Financial Analysis of Alternative
Healthcare Firms
LEARNING OBJECTIVES
After studying this chapter, you should be able to do the
following:
• 1.List some of the major nonhospital and nonphysician
sectors of the healthcare industry.
46. • 2.Discuss the sources of revenue for the nursing home
industry.
Average Case Weight =
36
30
=
1.2
• 3.Discuss the major sources of revenue and expenses of
medical groups.
• 4.List and describe the major organizational types of
physician groups.
• 5.Describe alternative health maintenance organization
arrangements.
REAL-WORLD SCENARIO
Laura Rose has been recently appointed to the Board of
ElderCare, a
large, for-profit operator of skilled nursing facilities (SNFs)
around the
country. Laura’s first committee assignment is to the Treasury
Committee because of her prior business experience. Although
Laura
had extensive experience as a hospital administrator, she had
relatively little familiarity with the SNF industry. Upon
reviewing
ElderCare’s recent financial statements, she was concerned
47. about the
dramatically declining financial position. She noticed that
revenues
were declining on per facility and per patient bases. Meanwhile,
the
company’s debt had been downgraded, and its borrowing costs
had
risen substantially.
She is aware that Medicare implemented a SNF prospective
payment
system as part of the Balanced Budget Act of 1997. Payment
increases by Medicare and Medicaid have not kept pace with
increases in costs in recent years. She wonders whether this
might be
a factor in the company’s financing issues. In general,
profitability in
the long-term care industry has declined significantly in recent
years,
and several industry leaders had filed for bankruptcy protection.
Although some believe that SNF prospective payment systems
were
largely to blame, other factors, such as ill-advised acquisitions,
excessive long-term debt, and poor balance sheets, probably
contributed as well. In essence, she is unsure whether
ElderCare’s
financing difficulties are unique to management issues at
ElderCare or
whether they reflect more general market conditions and
economic
and reimbursement trends.
To understand the issue better, Laura needs to estimate the
direct
financial impact of SNF reimbursement. She asked the
ElderCare
48. treasury and controller’s office staff to prepare an analysis of
the
financial performance of selected long-term care facilities over
the
period 2006 to 2010. In particular, she wants to know how SNF-
bond
ratings have been affected by prospective payment systems and
what
other factors might have contributed to the industry’s
deteriorating
financial performance.
In Chapter 11 we discussed the measures and concepts of
financial
analysis in some detail, but most of the examples and industry
standards were from the hospital sector. The hospital industry is
by far
the largest sector in the healthcare industry, but it is not the
only
sector; its rate of growth in recent years has been slower than in
other
areas. This chapter provides some additional information about
alternative health-care firms.
LEARNING OBJECTIVE 1
List some of the major nonhospital and non-physician sectors of
the
healthcare industry.
First, we discuss the financial characteristics of the following
three
specific alternative sectors:
• 1.Nursing homes
• 2.Medical groups
• 3.Health plans
49. It is impossible to describe all the specific operating
characteristics for
these three sectors in one chapter, but we highlight the
important
differences that affect financial measures. It is important to
remember
that the financial measures and concepts discussed in Chapter
11 are
still applicable. For example, the concept and measurement of
liquidity
are the same for a hospital as they are for a health plan.
However,
operating differences between health plans and hospitals
produce
different values and standards. Health plans have much lower
days in
receivables than do hospitals and are required to carry much
higher
cash balances to meet transaction needs, namely claims
payment.
It is not just the higher relative growth rates of non-hospital
sectors
that cause us to separately examine the topic of financial
analysis for
alternative health-care firms. Many of the alternative healthcare
firms
have been consolidating through both horizontal and vertical
mergers
and have now become major corporations in our nation’s
economy.
For example, UnitedHealth Group, Aetna, and Wellpoint are
among
the largest corporations in the country, employing large
50. numbers of
people and absorbing significant amounts of capital to finance
their
continued growth. Much financial analysis and discussion are
now
devoted to these firms because of their almost continuous needs
for
financing. Major brokerage houses now have analysts who
devote
their time to narrow sectors of the healthcare industry, such as
home
health firms or medical groups.
Table 12–1 presents 2008 financial ratio medians for two of the
three
sectors, along with comparative values for the investor-owned
hospital-industry sector. We calculated ratio averages by
computing
the ratio average for three large publicly traded firms in each
industrial
group. Table 12–2 shows the composition for each of the three
groups.
Table 12-1 Financial Ratio Medians, 2008
Nursing
Homes
Health
Insurers
Investor-
Owned
ospitals
Liquidity
Current 1.41 0.74 1.50
Days in receivables 56.65 16.60 52.04
51. Days-cash-on-hand 35.21 146.92 14.67
Capital structure
Debt financing percentage 62.81 65.22 81.79
Long-term debt to capital 42.72 30.95 73.74
Cash flow to debt
percentage
11.39 9.00 9.57
Times interest earned 4.87 8.69 2.82
Activity
Case StudyPresentation Outline:
Video: 15 min. length w/ PPT (approx. 2.5min/section)
1. Culture Overview (very brief summary)
2. Communication
a. Language and dialects typically spoken
b. Cultural Communication Practices
3. Family Roles and Organization
4. Behaviors and Health
a. High-Risk Behaviors
b. Common health conditions
c. Diet
d. Spirituality and Death Rituals
5. Healthcare Practices
a. Use of Western, Eastern or Other medical practices
b. Types of Practitioners utilized
c. Cultural Response to Pain
d. Considerations for Health Promotion and Planning by health
professionals
6. Conclusion/Summary
a. Important Points for PTAs to know about this culture based
on your findings
PHT 1020 Case StudyResponse: 1 paper submitted by the group
52. in APA format.
1. Culture Overview
2. Case Study Responses
a. Each category above should be answered in its own paragraph
w/ headings and subheadings
3. Conclusion/Summary
4. Reference page
**Please see the writing lab or Dr. Krenkel for assistance with
APA.
Important Points:
· Need to use sources other than the textbook to find answers
· Wikipedia does NOT count as a reliable source
· All sources, including the textbook MUST be properly cited
both within the paper and in the reference page using APA.
· Do not just read directly from the slides.
· Proofread paper and slides for grammar and spelling errors.
· Everyone must participate verbally in the presentation
Group Case Study Written Response
Student Names:
________________________________________
CATEGORY
7
5
3
0
Points
Organization
Information is very organized with well-constructed paragraphs
53. and subheadings.
Information is organized with well-constructed paragraphs.
Information is organized, but paragraphs are not well-
constructed.
The information appears to be disorganized.
Quality of Information
Information clearly relates to the main topic. It includes several
supporting details and/or examples.
Information clearly relates to the main topic. It provides 1-2
supporting details and/or examples.
Information clearly relates to the main topic. No details and/or
examples are given.
Information has little or nothing to do with the main topic.
Sources
All sources (information and graphics) are accurately
documented in the desired format. Including within text
citations.
All sources (information and graphics) are accurately
documented, but a few are not in the desired format. Or,
Citations are accurate but within text citations are missing or
inaccurate.
Some sources (information and graphics) are accurately
documented, but many are not in the desired format. Or, within
text citations are missing.
Most sources are not accurately documented.
Paragraph Construction
All paragraphs include introductory sentences, explanations or
details, and concluding sentence.
Most paragraphs include introductory sentences, explanations or
details, and concluding sentence.
Paragraphs included related information but were typically not
constructed well.
Paragraphing structure was not clear and sentences were not
54. typically related within the paragraphs.
Mechanics
No grammatical, spelling or punctuation errors.
1-3 grammatical, spelling or punctuation errors
4-5 grammatical, spelling, or punctuation errors.
6+ grammatical, spelling, or punctuation errors.
Points TOTAL: /35
Cultural Case Study InstructionsPaper Total Points: 35 points
PowerPoint Total Points: 28 pointsCollaborative Skills
Points: 21 pointsIndividual Presentation Points: 16 points
You will work in a group to create an evidence-based
paper and PowerPoint (PPT) presentation and video presentation
on your assigned culture. The PPT will be distributed to your
classmates to use as a study guide for the final exam.
The Paper:
The paper will be written as a group and submitted to Turnitin
to check originality. If your paper has more than 25% of its
material that is not original, your group will receive a “0”. You
will have two chances to submit your paper to Turnitin, the first
submission will allow you check the originality and make
improvements to the paper as needed to avoid plagiarism. The
second submission will be the final and graded submission.
Resources: Textbook, encyclopedia, academic journals,
and appropriate websites (this should be no more than 1 or 2
websites and NOT include Wikipedia). ALL must be referenced
per APA guidelines.
Formatting: You must use APA formatting throughout the
entire paper. You DO NOT need to include an abstract. Your
paper should include a cover page, introduction, body,
conclusion, and references page. You must use headings and
55. subheadings as you move between topics in the paper. Please
see the APA folder in Coursesites to guide you.
The PowerPoint:
The PPT will be used by classmates as a study guide for the
final exam. So, it should include a sufficient amount of
information on each slide. You may use a combination of
pictures and words. You PPT must have an introduction slide,
then at least one slide per topic, a conclusion slide, and end
with a slide of the references (same ones as your paper).
The Video Presentation:
Your group will video record the presentation of the PowerPoint
and submit it on a SD Card. The presentation must be 15
minutes (least 12 minutes in length and no more than 16
minutes). Everyone must speak and present a few slides. Each
person will be graded individually on their presentation skills.
The lab and projector will be available for use to record the
presentation and will be by appointment only if needed.
Collaborative Skills:
Each group member will evaluate their peers on their ability to
work as a team during this project. Therefore, each person
should do their best to contribute equally to each portion of the
group project. The collaborative skills scores will be grouped
and averaged so the scores provided are anonymous and each
member can be honest in their evaluation of their team
members.