The current study specifically deals with the presentation of the business case and asses the prominent costs cutting and financial accounting techniques used. Apart from that, the study deals with the systematic assessment of the leading cost-cutting techniques.
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Service Title Business Budget Case Student Name Student ID 1
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Contents Executive Summary....................................................................................................3 Outline........................................................................................................................4 Background................................................................................................................4 The Proposal..............................................................................................................4 Risks...........................................................................................................................5 Process.......................................................................................................................5 Resources..................................................................................................................5 Reporting of outcomes................................................................................................5 Financial Information..................................................................................................5 Attachment 1..............................................................................................................5 Attachment 2..............................................................................................................5 2
Executive Summary The current study specifically deals with the presentation of the business case and asses the prominent costs cutting and financial accounting techniques used. Apart from that, the study deals with the systematic assessment of the leading cost-cutting techniques. Nepean Mountains Hospital is one of the busiest hospitals in the Penrith region. However, one of the principal aims of the study is to provide advanced healthcare facilities to cater to the requirements of the current population. Towards the end of the study, a comprehensive financial statement is provided to enable an in-depth understanding. The study deals with the systematic assessment of the background and outline of the business case as the entire research is based on the chosen case study. However, the selected case study deals with the redevelopment plan of the Nepean Mountain Hospitals to cater to the requirement of the growing population in Sydney. 3
Outline The study deals in providing specific details regarding the redevelopment program at Nepean Blue Mountains Local Health District. The business case seeks to provide contemporary, advanced and community-based health care aims in the surrounding areas of Penrith in Australia. Apart from that, the secondary targets, of the business case is to strengthen the position of the hospital as the leading health institution for research and referral aids all over New South Wales (Eljiz et al., 2019). However, the project is further divided into three stages that lead to the systematic assessment of the predetermined goals and objectives of the project. A detailed outline of the processes involved in the two phases is provided below: Stage 1:This stage aims in fulfilling the upcoming and the current requirements of theincreasingpopulationatNepeanMountains.Apartfromthat,thecurrent population surges in Penrith and its surrounding areas require immediate attention in terms of providing sustainable medical aids. Stage 2:The second stage is involved in providing additional support to the ageing population by planning exclusive and advanced healthcare treatments and diagnosis techniques. Background Nepean hospital is located in Penrith, Sydney and is one of the prominent and busiest healthcare institutions in one of the fastest growing urban setting in Australia. Due to the prevalence of skilled trade and commerce opportunities and other options, there has been a substantial increase in the population of Sydney over the past 20 years. Therefore, to cater to the requirements of the growing community in Sydney, theNepeanhospitalhasbeenallottedasumofAUD1billiontoundertake redevelopment facilities. For the success and effective control of the processes of the proposed project, it is divided into two individual stages. Additionally, Stage 1 of the project is funded by a lump sum amount of AUS 550 millionofthetotalallocatedfundsfortheNepeanHospitalRedevelopment. Furthermore, the stage includes the construction of a brand new healthcare aid block. Apart from that, it also deals with the construction of 12 new operating theatres (Partel 2015). Moreover, the Stage 2 of the Nepean Hospital Redevelopment plan is funded with an additional investment of AUD 450 million that will critically seek in the furtherdevelopmentofotherbetterfacilitiestoprovidetheaidoftheageing population.Apartfromthat,thedemographicpopulationofSydneyismajorly dominated by old people therefore, there is a current surge in the prominence of myriad health ailments. The Proposal The proposal deals explicitly in catering to various healthcare requirements of the growing population in Sydney and therefore, seeks for the redevelopment of the Nepean hospital. Aims The primary aim of the proposal is to look into the healthcare requirements of the growing population Toincreasestheexcellenceofmanagementinprovidingbetterandadvanced healthcare facilities To increase the efficiency of the doctors and physician in treating a particular disease with the help of advanced diagnostic tools 4
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Benefits Efficiency gains One of the prominent efficiency gains of the proposal is the implementation of heavy machinery and diagnostic technology to reduce the costs of additional recruitment of doctors and physician in the hospital that would retain the share of profit thereby, reducing the percentage of costs (Dodson et al., 2018). Potential savings/increased costs Increased expenditure on advanced technology implementation Savings on the recruitment of additional workforce FactorBenefits PatientsEnhanced healthcare facilities with additional accommodation care unit FacilityAdvanced facilities that would help in the effective diagnosis of a particular health ailment CliniciansEnsuringtheneedsofthepopulationandstabilisingthe condition of student that is driven by the elderly population. Toprovideadditionalexpertiseofthecliniciansandother executives thereby increasing the scope OtherExpandedinfrastructuralfacilitythuscontributingtonthe economic growth and development of the region Table 1: Additional Benefits assessed by the Proposal (Source: As created by author) Risks Risk IssueSeverityImpactMitigation Plan Notes Financial risks HighEquities, Investment, forerunning ofthe business Assessment of financialrisks, formulationof effective strategiesto minimisesthe effectofthe risk,rightful allocationof financial resources Financialrisk isoneofthe prominent hazards assessedby theproposal. To mitigate the impactofthe risks an overall capital spendingand healthcareIT mustbe formulated. PatientsMediumDeathof patients, Occurrence Maintenance ofsufficient biomedical Extracareof thestipulated measures 5
ofunwanted accidents waste management facilities, Regularly checkingthe security system would lead to a decrease amountof contingencies inthe operating environment InsurancesHighIncurring substantial costs by the organisation, Maintaininga stringent Insurance policynorms thatwould criticallylook after the needs of the patients andhelpsin recurrenceof fraudulent activities The maintenance ofa comprehensive insurance framework wouldleadto furthercost cutting Table 2: Risks assessed by the Proposal (Source: As created by author) Financial Risks: One of the prominent risks associated with the healthcare industry is the effective management of investment in limited capital surroundings. Apart from that, frequently changing legislation and business laws and the increasing demands of the patients concerning extensive healthcare facilities require additional access to the financial resources (Jackman 2017). Moreover, the considerable practice of cost-cutting in a hospital leads to a pertinent scenarioofineffectiveallocationoffinancialresources,therebyaffectingthe forerunning of the business. On the other hand, access to digital innovation and technologicaltransformationisoneofthecrucialfactorsthatdeterminethe functionality of the hospital. Moreover, meeting up with the compliances and health regulations set by the regulatory bodies is also one of the prominent financial risks assessed by the project. Patients: Patients are the prime customers' bases of the specified there are a series of risks associatedwiththepatientsconcerningthespecifiedservicesprovidedbythe hospitals. Moreover, in the hospital setting patients are comparatively exposed to a more significant threat of infection with the lack of proper sanitation and compelling biomedical waster management techniques. Apart from that, the increase in violent incidents in the hospital is one of the many risks assessed by the patients in the hospital. Insurance: The current changes in the various healthcare legislation have created remedial measures to backlash the insurance norms provided by the hospital for individual gains and profits. The recurrence of such events leads to extra expenses on the hospitalandincreasesiscostexpendituretherebyresultingintheineffective allocation of funds to competent activities. 6
Process The table below provides a detailed explanation of the action plan implemented by the proposal for the timely completion of the predetermined tasks. FUNDIN G NUMBE R FULL PROJECT NAME 14523 00ERK Nepean Hospital Redevelopment PROJEC T MANAGE RTECHNOLOGY DEPLOYED ACTION ITEM NUMBE R DATE OPENED Mr Beker Bond LK 32 5 08/ 03/ 201 6 DESCRIPTI ON PR IO RI TY PAR TY RES PON SIBL E D AT E D U E DAT E OF CO MP LET ION NOTES S T A T U S FG 75 3 14/ 07/ 201 6 Expansion of medical oncology Se ver e Pe ter Alfre d 08 /0 6/ 20 17 10/0 8/20 18 Construction of new operation theatres, upgrading the energy department O P E N UT 45 6 04/ 08/ 201 6 Demolition of existing infrastructur e Lo w Ro lland Gett ysbu rg 10 /0 9/ 20 17 22/0 9/20 17 Demolition of unwanted structures and creating space for the building of new infrastructures O P E N W Q7 89 02/ 09/ 201 6 Constructi on of multi- storey car park Me diu m M alish ka Flore nce 15 /0 8/ 20 17 30/0 8/20 18 Discussion on the design of the multi-storey car park and the assessment of prominent risks that have a bearing on the completion of the project O P E N Planning for the implementati on of new services Se ver e Ky le Lync h 14 /0 8/ 20 17 16/0 8/20 17 Gathering funds for the investment in advanced technologic solutions O P E N Table 3: Showing the Action Plan (Source: As created by author) TABLE DROPDOWN DATA SETTINGS 7
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PRIORITYSTATUS HIGHOPEN MEDIUMOPEN LOWOPEN MEDIUMOPEN Table 4: Showing the Drop Down data of the Action Plan (Source: As created by author) As per the provided action plan, the Project Manager Mr. Becker Bond has decided plan in the table above the sequencing and the timeline of various lined up processes to ensure the timely attainmentofthe predetermined goalsand objectives.To implemented effective control and directing the project, a team of project executives are held responsible for the completion of a particular task. Moreover, the timeline of various lined up tasks are set by considering the prominent factors that can lead to further delays of the project and therefore has an grip on detoriation of the quality of the project. The sequences of the tasks are not done in a haphazard manner to ensure full safety of the patients and the employees working in the construction field. Apart from that, the construction and demolition of the infrastructural structures is initiatedbyensuringprominentsafetymeasuresoftheboththepatientsand consumers.However,thehospitalstaffshasalsoensuedtherehabilitationof patientsthatrequiremoreacreandaresensitivetoheavysoundsandother disturbances. The contract and its prominent norms were decided in 2016 and therefore, the project manager forecast the predetermined goals of the plan would be completed by 2019. The drop down data of the action plan for the initiation of the project is also provided above that includes the systematic assessment of the priority of the sequenced activities of the project along with the current status of the project. Resources Theadditionalrequirementsthatareneededinthecompletionoftheproject, supplementary legislationis to be provided concerning the various construction requirements specified in the contract. Apart from that, there is a severe lack of competent contractors possessing a clear idea about the current setting of the hospital, which would provide higher expertise to the contractors in solving the future contingencies (Hay et al., 2017). Furthermore, additive legislation seeking to maintain the ecological balance in the operating environment must be incorporated to explore excellent recycling and waste disposal facility, thereby avoiding further contingencies. An effective plan of managers to look into the progress of the project must be provided to compare the efficacy of the operation concerning the predetermined goals and objectives of the concern. Reporting of outcomes The authentication of the outcomes would be reported to the project managers, Mr Becker Bond who is in charge of the operation team that consists of 14 project executives and 120 employees. The corrective reporting of a project outcome is equally essential for the success of a business as it lays the further steps for the control and evaluation of critical risk factors that have a bearing in the successful completion of the project. The reporting of outcomes is designed in a systematic 8
manner that consists of various lined up steps to minimise the noticeable effects of the faulty derivation of results (Broom 2016). The reporting of an outcome involves the establishment of active communication links between the lower and the upper levels of management. Communication plays a crucial role in reporting a particular issue therefore; to avoid further contingencies, the healthcare aid must implement a flexiblecommunicationchannel.Practicalanalysisoftheassessmentof predetermined goals is equally important to examine the attainment of objectives determinedinadvancecritically.Moreover,tofulfilthestructuredaimsofthe proposalalreadymentionedintheprevioussectionofthestudy,itisequally significant to recruit skilled and competent executives to look after the success of the project.Theprocessofcontrollinganddirectingdependsontheprocessof successful conveyance of the outcomes of the task to the executives. Financial Information Budget: In it critically significant to predetermine the estimated costs and expenditure of a particular project to have a clear idea about the success of the project in the long run. The following section provides a detailed description of the annual cash budget. Particulars20182017 Cash Flows from Operating activities Payments Employee Related4,5004,200 Grants and Subsidies500850 Finance cost4,5005,000 Equivalent tax income7,5007,000 Other Payments4,5203,600 Total payments21,52020,650 Receipts Appropriation450600 Cluster Grant revenue10,52514,524 Change in operating assets and liabilities4550 Cash Reimbursements4,7500 Transfer to NSW00 Cash Transfers to NSW healthcare aid00 Sale of Medicines00 Retained taxes, fees and fines450750 Grants and contributors8,5009,500 Interest Received465500 Other Receipts075 Total receipts25,18525,999 Net Cash flows from Operating activities3,6655,349 Cash Flows from Investing activities Proceeds from the sales of property450230 Purchases of advanced diagnosis equipment780560 Purchase of investments7,5004,500 Other Investments450780 Net Cash flows from Investing activities9,1806,070 9
Net Increase/decrease in cash5,515721 Opening cash equivalents254349 Reclassification of cash equivalents00 Cash transfers for Administrative reconstructing00 Closing Cash and cash equivalents5,261372 Table 5: Showing the cash budget of the project (Source: As created by author) The chart above shows a detailed analysis of the prominent costs and payments to be incurred by the project over a period of two years. However, it can be analysed that the closing cash and cash equivalent for the second years are comparatively low. One of the prominent reasons for the severe decrease in the cash and cash equivalent due to the ineffective allocation of funds. Income$18,520.0 0 Budgete d $60,870.0 0 Remainin g -$42,350.00 CategoriesRecommendedActualDifference Percentag e AmountPercentag e Amount Giving0.00%$032.51%$6,020.00-$6,020 Services15.00%$2,778149.57%$27,700.0 0 -$24,922 Accommodati on 25.00%$4,63054.54%$10,100.0 0 -$5,470 Utilities5.00%$92616.74%$3,100.00-$2,174 Food2.00%$3704.86%$900.00-$530 Recruitment10.00%$1,8528.91%$1,650.00$202 Maintenance18.00%$3,3344.86%$900.00$2,434 Medical11.00%$2,03724.30%$4,500.00-$2,463 Insurance4.00%$74124.30%$4,500.00-$3,759 Recreation5.00%$9260.00%$0.00$926 Debts3.00%$5568.10%$1,500.00-$944 98.00%$18,150328.67%$60,870.0 0 -$42,720 IncomeAmount Services Provided$12,500.00 Investment in Shares$5,000.00 Interest received$570.00 Tax Refund$450.00 $0.00 Total$18,520.00 GivingAmount Loan$4,500.00 Refund of fees$1,520.00 $0.00 $0.00 10
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$0.00 Total$6,020.00 SavingsAmount Emergency Fund$7,800.00 Provision$5,400.00 Recruitment$6,000.00 Redevelopment$8,500.00 $0.00 Total$27,700.00 AccommodationAmount Bedding facilities$4,500.00 Accommodation for people $5,600.00 $0.00 $0.00 $0.00 Total$10,100.00 UtilitiesAmount Electricity$540.00 MRI$750.00 CT$560.00 Internet$450.00 Advanced Diagnosis$800.00 Total$3,100.00 FoodAmount Groceries$450.00 Restaurants$450.00 $0.00 $0.00 $0.00 Total$900.00 RecruitmentAmount Recruitment of doctors$700.00 Group D staff$500.00 Maintenance/Repairs$450.00 $0.00 $0.00 Total$1,650.00 MaintenanceAmount Purchase of equipment$500.00 Formulation of strategies$400.00 $0.00 11
$0.00 $0.00 Total$900.00 MedicalAmount Purchase of drugs$4,500.00 $0.00 $0.00 $0.00 $0.00 Total$4,500.00 InsuranceAmount of insurance facilities$4,500.00 $0.00 $0.00 $0.00 $0.00 Total$4,500.00 RecreationAmount Vacations$0.00 Hobbies$0.00 Books/Movies$0.00 $0.00 $0.00 Total$0.00 DebtsAmount Long Term Borrowings$400.00 Debentures$500.00 Lease$600.00 $0.00 $0.00 Total$1,500.00 Table 6: Showing the Zero base Budget (Source: As created by author) Contingency Plan ParticularsStrategy Assessment of labour and non labour expenses Aclearevaluationofthevarious employmentandnon-labour expenses helps in reducing the cost ofhealthcareaidtoaconsiderable level. EliminationsofUnnecessary Expenses Removalofunwantedcostsinthe costs structure of the company is one of the prominent ways of reducing the cost to a certain extent 12
DeploymentofCaremanagement Strategy Astheageingpopulation accompaniesthepopulationof Sydney;therefore,itissignificantly essentialtoimplementacare managementstrategy.The implementationofthecare managementstrategyleadstoa furtherdecreaseinthecostsby limiting the other lined up processes and departments. Budget ReportingSelection of an effective strategy that seekstomeasuresthecompetent expenses in the individual department ofthehospitaldepartment.The evaluationspecificallyincludeda detailedanalysis ofthequalityand servicescomponentsthatarean activepartoftheobjectivesofthe project. Table 7: Showing the Cost Reduction Techniques in the Project (Source: As created by author) Break-Even Analysis The break-even point is the point where is there exists no profit and loss despite the further production of the company. Moreover, it is the individual decision of the companytooperateinthecurrentscenario.Furthermore,thebreak-evenis calculated in terms of two major determinants that includes sales value and output level. 13
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Figure 1: Showing the Graphical Representation of the BEP (Source:Broom 2016) Break Even Point Calculation Break Even point in box= Fixed costs/ (Revenue per Unit- Variable Cost per Unit) Revenue from Operations= 750,000 Output Level= 23,000 Total Fixed Cost= Fixed cost per year:Amount Manufacturing overhead450,000 Sales and administration500,000 Total fixed cost950,000 Total Sales per Unit= Total revenue from sales/ no. of boxes =750,000 / 23,000 Boxes = 33 per boxes Selling price per material= 150 per material Total Variable cost per Unit Variable cost per box:RM Direct materials30.50 Direct labour17.50 Manufacturing overhead10.50 Selling expenses5.50 Total variable cost per box64.00 Total variable Cost per Unit=64 per boxes 14
Break Even point in boxes (per unit) =950,000/ (150-60) per unit = 10,556 units Break-Even point in RM= Sales per Unit * Break-even points in units Hence, Break-Even point in RM=150 RM per unit * 10,556 unit = $1,583,400 15
References Broom, M. (2016). Facilitating change and evaluating impact during a neonatal intensive care redevelopment: A participatory action research project. Dodson, J., Palm, M., Whitzman, C., Hamilton, C., Kellet, J., Maginn, P., & Martinus, K. (2018). Transformational Infrastructure Projects In Australia’s Fast Growing Outer Suburbs. Eljiz, K., Greenfield, D., Derrett, A., & Radmore, S. (2019). Health system redesign: Changingthoughts,values,andbehavioursfortheco‐productionofasafety culture.The International journal of health planning and management. Hay, A., Zuo, J., Han, S., & Zillante, G. (2017). Lessons Learned from Managing a Remote Construction Project in Australia. InProceedings of the 20th International Symposium on Advancement of Construction Management and Real Estate(pp. 939-948). Springer, Singapore. Jackman, A. A. (2017). Putting the" RT" in redevelopment.Canadian Journal of Respiratory Therapy,53(2). Partel, K., Director, A., Healthcare, A., & Hospitals Association. (2015). Toward better implementation:Australia’sMyHealthRecord.InternationalJournalofMedical Informatics,83(12), 889-900. 16
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