This 3-year operational budget plan proposes expanding a nurse navigator program to reduce readmission rates for patients aged 65 and older. The plan aims to reduce readmissions from 19% to 9% in year 1, 6% in year 2, and 3% in year 3. It will provide nurse navigators, office space, equipment, and vehicles for home visits and transportation. Financial projections estimate the program will be profitable while improving patient outcomes and satisfaction. Staffing will begin with 1 full-time and 2 part-time nurse navigators and increase capacity each year as the patient population grows. Training and ongoing support will be provided to ensure navigators can prevent 90% of readmissions.

1. Running head: THREE YEAR OPERATIONAL BUDGET PLAN 1
COLORADO HEALTHCARE ASSOCIATES MEDICAL CENTER
BUSINESS PLAN
Prepared by: Shannon Gates 3/12/15

2. THREE YEAR BUDGET i
Table of Contents
Page
Confidentiality Agreement ii
1) Executive Summary 3
2) Company Description 4
Advisors 4
Products and services 5
Long Term Aim of Business 5
Objectives 5
3) Market Analysis 5
Target market 5
Total market valuation 6
4) Marketing/Sales Strategy 7
Pricing 7
Market and Communications Strategy 7
5) Staffing and Operations 7
Management Organisation Charts 8
Staffing 8
Training Plans 8
Operations 9
6) Financial Projections 9
Key Assumptions 9
Profit and Loss Accounts 10
Balance Sheets
Reference Page 10
7) Appendices/spreadsheet (next week) 10

3. THREE YEAR BUDGET ii
Confidentiality Agreement
The undersigned reader acknowledges that the information provided in this business
plan is confidential; therefore, the reader agrees not to disclose it without the express
written permission of Colorado Healthcare Associates Medical Center.
It is acknowledged by the reader that information to be furnished in this business plan
is in all respects confidential in nature, other than information that is in the public
domain through other means, and that any disclosure or use of this confidential
information by the reader may cause serious harm or damage to Colorado Healthcare
Associates Medical Center.
Upon request, this document is to be immediately returned to Colorado Healthcare
Associates Medical Center.
________________________
Signature
________________________
Name (printed)
________________________
Date
This is a business plan. It does not imply offering of securities.

4. THREE YEAR BUDGET 3
1. Executive Summary
This business plan is being prepared for the purpose of reducing all readmissions rates
for patients 65 and older from the current rate of 19% to 9% within the first year of
the proposed new plan, and 6% by the plan’s second year; increased compliance with
nurse navigators during the second year is anticipated to reduce all readmission rates
to 3%. The new program, which is anticipated to begin nine months from now, will
use nurse navigators to intervene and solve problems before there is a readmission.
Historical data from other states indicates navigators prevent readmissions by 90%
when using assessment tools for readmission risks for all chronic diseases patients
who join the program.
Purpose:
The success experienced with the organization’s Oncology nurse navigator program
has created the desire to expand the current nurse navigator role in Oncology to
include specialty trained Chronic Disease navigators for ALL CHRONIC DISEASES
the organization treats for patients who are 65 years or older on Medicare.
• The advantages of nurse navigators are numerous, providing priceless services
to patients.
This plan will provide all office equipment, phones, supplies, and space for
free during the first three years of the plan. In addition to office associated
supplies and space, the organization will leased two hybrid cars to be supplied
to the nurse navigators for their patients that will require home visits (20% of
the patient load) and those requiring transportation services to their doctor
appointments. In addition, hybrid cars will be leased at a cost of $225 a month
with a $75 a month insurance payment, maintenance included. The role of
nurse navigator is highly dependent on adequate technological resources in
order to prevent 90% of readmissions. Therefore, the organization will provide
a $100 phone stipend for full time nurse (FTE) navigators using their personal
phones and a $50 phone stipend for part time nurses (PTE) using their own
phones
• The market opportunity and advantage of services provided by nurse
navigators is enormous; by increasing efficiency the organization earns higher
profits as well as higher HCAHPS scores thereby increasing overall patient
volume which allows for future growth and expansion of products and
services.
Year 1 Year 2 Year 3
Sales N/A N/A N/A
Exports N/A N/A N/A
Net Profit before Tax
$6,718,7
19.25
$33,621,
516.00
$41,748,
133.75
Investment N/A N/A N/A

5. 3 YEAR BUDGET PLAN 4
Employment
3; 1
FTE, 2
PTE
Same as
1st
year
2 FTEs
1 PTE
*KEY: N/A=DATA NOT SUPPLIED BY COLORADO CHRISTIAN
UNIVERSITY*
1ST
YEAR: Total Population of patients willing to us nurse navigator is 8,000
8,000/52=153.85 YR1 1FTE Nurse Navigator=100 PTS/WEEK, 2 PTE Nurse
Navigator=100 200 TOTAL PATIENTS (MAXIMUM CAPISITY).
2ND
YEAR: Total population of patients willing to us nurse navigator increases by
25% thereby increasing the total patient population willing to work with nurse
navigators to 10,000 (an increase of 2,000 additional patients)thus, nursing staff
remains adequate in the second year as the data presented below suggests.
200*52 (WEEKS IN A YEAR)=10,400 PATIENTS MAXIMUM CAPASITY
3rd
Year: Promote 1 current PTE to FTE thereby increasing maximum patient
capacity to
250 patients*52 (WEEKS IN A YEAR)=13,000 PATIENTS MAXIMUM
CAPASITY
*assuming projected growth increases steadily at 25% per year.
2. Company Description
Small healthcare facility mainly servicing oncology patients
Advisors
Colorado Christian University
8787 W. Alameda Ave.
Lakewood, CO. 80226
Sonia K. Foster, RN, MSN, CNM
Teacher of Financial Management in Healthcare (HCA410) for Colorado Christian
University
sfoster@ccu.edu
828-464-1021 or 828-234-8581
Products and Services
The nurse navigation program is a personalized service and abundant resource for
patients. Services provided by nurse navigators include the following:
• Home visits
• Phone calls to various services such as lay services, social workers,
physicians, specialists, etc.
• Nurse navigator prevent readmissions by 90 percent
• Nurse navigators are advantageous to their patients for the following reasons:
o Eliminate barriers to health care and therefore health disparencys

6. 3 YEAR BUDGET PLAN 5
o Enhance access
o Empower patients
 Empower health, confidence, and consistency.
• Foster preventative health and will be paramount in the success of patient
physician collaboration as the Patient Protection and Affordable Care Act
influence the delivery of healthcare.
http://youtu.be/RcZITfZ1C1A
Long Term Aim of the Business
The long term business goals are as follows:
-Significantly cut all re-admissions rates for patients 65 and older for all chronic
diseases.
-Use nurse navigators to intervene and solve problems before there is a readmission.
-Attempt to break even in the first year if possible.
-Transition from 1 FTE and 2 PTE nurse navigators to 2 FTE nurse navigators and 1
PTE nurse navigators.
Objectives
The total number of all readmitted cases is approximately 40,000 patients will drop
from a total of 30 percent to 9 percent readmission rate within the first year of the
expanded program, meaning that 3,600 of the total patients would be readmitted
instead of 40,000 total patients. In the second year the total patient population using
nurse navigators is expected to increase to 25 percent. The third year of the program is
anticipated to generate even more excitements assuming the patient volume willing to
work with nurse navigator’s increases again by 25 percent. The population willing to
work with the expanded nurse navigator program will reach exciting milestones over
the next three years of the program’s implementation by reaching an additional 2,000
patients with chronic diseases by the second year, and another 2,000 in the programs
third year thereby future reducing the readmission rate.
3. Market Analysis
Target Market
The targeted market for 2015 is patients 65 and older. According to the organizations
data provided by Colorado Christine University, the emergency room receives 25,000
chronic disease cases a year and 15,000 in patient cases per year which amounts to a
total population of 40,000 patients. Unfortunately, 15% of each department’s patients
are readmitted. Patient interviews confirm that 20% of the entire population
(approximately 8,000) is willing to work with nurse navigators during the first year
with growth projected to increase by 25% (approximately 10,000).
• Size of each market segment
o 40,000 total chronically ill patients per year; 25,000 Emergency
department patients and 15,000 In-patients.

7. 3 YEAR BUDGET PLAN 6
o Within 9 months of launching the proposed said operational budget
plan, 20 percent of this total population (8,000) will work with nurse
navigators with an anticipated increase of 2,000 patients, or 25 percent
by the second year of the program (10,000 total patients).
• The data clearly shows that the targeted population is growing and will
continue to grow during the second year of said program. Consequently,
continued growth is expected.
• Characteristics of potential clients:
o According to Young (2014) “Health Care USA: Understanding its
Organization and Delivery,” collected data and international
comparisons reveal common trends among various developed
countries; birth rates have fallen while life expectancies have
lengthened, making an increasing portion of total population senior
citizens. In 2009, senior citizens represented 12.9 percent of the
population with an expected increase in number representing 19
percent of the total population (over 72.1 people by the year 2030).
Importantly, epidemiologic studies have indicated this population (also
known as “baby boomers’) have high-prevalence rates for depression,
suicide, anxiety, and alcohol and drug abuse. It is also important to
note that despite suffering from many of the same mental disorders as
the younger population, diagnosis and treatment for this population is
often complicated by medical conditions which mimic or mask
psychiatric disorders. Encouraging trends have shown that numerous
health care professionals have improved their capacity to rescue many
disabled and dependent adults who would have otherwise been
moribund (pp. 5, 406-407).
o Obviously, the proposed operating business plan is highly
advantageous to the targeted population as well as the organization
itself; nurse navigators drastically prevent readmissions and are share
paramount role is their patients’ health by naturally reducing anxiety,
depression, and feelings of isolation that are commonly associated with
chronic diseases. Characteristically, the population this program
anticipates to serve consist of patients with chronic diseases.
According to the data provided by Colorado Christian University, 20%
of this program’s nurse navigator patients require home visits per 100
patients, 60% of the 100 will exclusively require care by phone calls
which take approximately 20 minutes, and another 20% of the 100
need assistance going to their doctor or connecting to lay services and
social workers for assistance. The latter group’s care is estimated to
typically take 30 minutes. The Nurse navigator’s total estimated
weekly hours per 100 patients spent meeting the specified needs as
noted above total 70 hours per week and 3,640 hours per year.
Total Market Valuation
The market value of the proposed program is significant and far reaching; investing in
such a program is comprehensive winning solution for patients and a potential game
changer for the healthcare industry. Nurse navigators drastically enhance the patient’s
healthcare experience by serving as a beacon and compass to patients, especially
those with comorbid (or complex) illnesses; providing consistency and eliminating

8. 3 YEAR BUDGET PLAN 7
barriers associated with navigating the intricately overwhelming healthcare system is
a level of value that is simply priceless. According to Harold P. Freeman M.D.,
original founder and pioneer of the patient navigation movement observed that
uninsured or underinsured breast cancer patients of his Harlem medical practice had
significantly higher mortality rates than his insured patients. Dr. Freeman noticed that
many of his female at he was treating were often diagnosed in the later more critical
stages of the disease when mortality rates are significantly higher rather than earlier in
the disease when survival rates are higher and more favourable. 1995, Dr. Freeman
found that a similar cohort of patients utilizing nurse navigators at the same facility as
his practice had an increased 5 year survival rate of 70 percent from the standard 39
percent (Moore, 2012). Clearly, nurse navigators and programs such as the proposed
operational budget are vital to ensuring the future health and longevity of generations
and their families.
Pricing
Current Price of Emergency readmissions Current Price of Readmitted In-Patients
$7,000 per patient $18,000 per patient
*Note that the average In-patient stay according is 3 days. For re-admissions
occurring after 30 days payments shall be paid by Medicare and any re-admissions
prior to 30 days shall not be paid by Medicare and shall become the company’s
responsibility. The proposed nurse navigator program creates a significant financial
opportunity and incentive for not only the targeted patient population but the company
as well by reducing re-admissions by 90 percent as presented by the evidence
supporting patients using nurse navigators
Marketing and Communications Strategy
The marketing strategy is rooted in the philosophy of investing in the people the
organization serves. It has been said “Whoever sows sparingly will also reap
sparingly, and whoever sows bountifully will also reap bountifully (2 Corinthians 9:6
New Living Translation).” The priceless benefits and extraordinary outcomes of
highly experienced nurse navigators is a bountiful investment in people’s lives; the
very success and future of their health shares a direct relationship to their quality,
access, and experience of health care provided. Other marketing techniques may
include the following:
• Exhibitions and conferences
o Management will provide newly hired nurse navigators 40 hours of
classroom training on the program as well as a practice model prior to
taking on the expected patient workload of 100 patients a week.
• Word of mouth
6. Staffing and Operations
The diagram featured below illustrates the staffing organization for the new
operational plan. The manager will be a full time employee (FTE) with an hourly
wage of $44 plus a 33 percent benefit package. The plan also includes a full time staff
assistant whose major priority will be taking messages and calling nurse navigators
when needed. The staff assistant will be paid $18/hr plus a 33 percent benefit
package. The organization will also hire 3 nurse navigators to pilot the new program;

9. 3 YEAR BUDGET PLAN 8
1 FTE paid at a rate of $35/r plus a 33 percent benefit package and $100 phone
stipend for using their personal phone and 2 part time navigators (PTE) paid at a rate
of $42/hr benefits not include and a $50 phone stipend for using their personal phone.
FTE will work a maximum of 2080 hours per year, or 40 hours per week and PTE
will work a maximum of 1040 hours per year, or 20 hours per week.
Staffing
The staffing arrangement will stay the same during the plans second year with 1 PTE
promoted to FTE during the plan’s third year. The promotion will assume the FTE
hourly pay, benefits package, and phone stipend as previously presented. Nurse
navigators must be highly experienced nurses possessing a Bachelor of Nursing
(BSN) as well as a Masters of Nursing and have acquired at least 10 years of general
experience and preferably 10 years of specialized experience dealing with chronic
diseases or trauma services. The listed requirements regarding nurse navigators are
typical according to several healthcare facilities in the market such as Northbay
Healthcare located in Fairfield California http://www.northbay.org/services/cancer-
center/Nurse-Navigators.cfm.
Training Plans
The training plan for the expanding nurse navigator program will require each nurse
to be undergo 40 hours of training. The training will be provided by the manager and
include the previously mentioned methods. Training 3 nurse navigators is anticipated
to cost the organization approximately $6,520.00. This figure can be obtained by
adding the sum of each nurse navigator’s hourly pay multiplied by the amount of
training required. The additional hourly pay of the manager multiplied by the required
hours of training must be added to the figure obtained from the three nurse navigators.
Mathematically the previous statement can be represented by the simple equation
below:
$35+$84=$119/hr*40hrs=$4,760 total cost per hour for nurse navigators
$44*40=$1,760/hr total cost for manager to provide training
$4,760+1,760=$6,520 total training cost
Manager
FTE
Nurse Navigator
PTE
Nurse Navigator
PTE
Nurse Navigator
Staff Assistant

10. 3 YEAR BUDGET PLAN 9
Operations
• Equipment
o Managerial Expenses will cover the newly start-up department for the
first 12months.
o Space, office equipment, office phones, and office supplies will be
provided by the hospital for free for three years.
o The expanded program will also include 2 leased cars for the cost of
$225 per month insured for $75 per month with maintenance included.
• Other Costs involved
o Total projected phone stipend costs amount to $15,600 during the first
and second years of the expanded program and increase to $18,200 in
the third year as a result of the promotion of 1 PTE.
7. Financial Projections
I Key Assumptions
• Income sources
o Medicare
• Expense calculations
o 1st
year: $449,723.00,
o 2nd
year: $465,984.00
o 3rd
year: $633,428.25
The expense total provided can be calculated by adding the sum of the following
expenses benefits, training, salaries, phone stipends, car expenses, fuel expense, and
home visit supplies. It is important to note that during the 2nd
and 3rd year training is
not calculated into the total expenses. It is also important to note that the flexible
budget, the expenses which fluctuate from year to year as patient volume increases,
increases costs during the 2nd
and 3rd
year (Norwicki, 2011 p.283). These variable
costs include phone stipends, fuel expenses, and home visit supplies (see Appendix).
II Profit Accounts
Years Annual Surplus (Capital Budget)
1st
Year After 3 Months Running $6,718,719.25
2nd
Year $33,621,516.00
3rd
Year $41,748,133.75
The figures represented in the annual surplus can be calculated by taking the total
savings of the combined departments minus the organization’s total expenses.
III Balance Sheets
For the first three years of the company’s projected balance sheets refer to the
accompanying appendix.
9. Appendices

11. 3 YEAR BUDGET PLAN 10
Balance Sheet (refer to the attached Excel spreadsheet)
References
Hospitals, T. C. (2012). The emerging field of patient navagation: A golden
oppurtunity to improve healthcare. Cleveland: Center for Health Affairs.
Life Application Study Bible: New living translation. (1996). Wheaton: Tyndale
House Publishers, Inc.
Moore, E. T. (2012, December). The emerging field of patient navigation: A golden
oppurtunity to improve healthcare. Retrieved March 14, 2015, from The
Center for Health Affairs:
http://www.chanet.org/.../~/.../A92355F0A6E140F1A13493BC3C349CAB.as
h..
Nowicki, M. (2011). Introduction to the financial management of healthcare
organizations. Chicago: Health Administration Press.