1. Part III: Tools to Analyze Financial Operations
CHAPTER 8:
STAFFING: THE
MANAGER’S RESPONSIBILITY

2. Staffing Requirements
In Health Care, many positions
Must be filled, or covered, 7 days a week, and
Must also be filled, or covered, 24 hours a day.

3. Productive and Non-Productive Time
Why analyzed?
Employees are paid for more hours than the hours they are on duty (vacation days, etc.), so
Annualizing allows the full cost of the position to be computed through a “burden” approach.

4. FTEs for Annualizing Staff Positions
Productive Time — Represents the employee’s net hours on duty.
Non-Productive Time — Represents the paid-for time when the employee is not on duty (such as vacation time).

5. FTEs for Annualizing Staff Positions
FTE Definition for purposes of understanding annualizing positions:
The equivalent of one full-time employee paid for one year, including both productive and non-productive time.
Two employees working half-time for one year would be the same as one FTE.

6. FTEs for Annualizing Staff Positions
The calculations to annualize staff positions is a two-step process:
1. Compute the net days worked.
2. Convert the net paid days worked to a factor.
See Exhibit 8-2 as an example.

7. Number of Employees Required to Fill a Position
Why calculate by position? Because computing by position is used in controlling, planning and decision-making.
The scheduled position method is often used when forecasting new programs and services.
You will also find scheduling software using this method.

8. FTE definition for purposes of filling a scheduled position:
Number of Employees Required to Fill a Position
FTE definition for purposes of filling a scheduled position:
A factor expressing the number of employees required measured against, or the equivalent of, one full-time employee’s standard work week.

9. The calculation to fill scheduled positions is as follows:
Number of Employees Required to Fill a Position
The calculation to fill scheduled positions is as follows:
Compute the number of hours for a full-time position filled for one year. This measure is the baseline.
Compute a factor representing the position to be filled for the required number of days (a required seven-day week to cover, for example, versus a five-day work week equals a factor of 1.4).
See the cast room example in the chapter.

10. Tying Cost to Staffing
In the case of the annualizing method the cost of nonproductive days is already in the formula.
So, multiply the factor times the base hourly rate to compute cost.
Study the example in the chapter.

11. Tying Cost to Staffing
In the case of the scheduled position method the base rate must be increased, or burdened, by the nonproductive time.
First, increase the hourly base rate by a percent or factor that represents the nonproductive time. Then multiply the burdened based rate by the factor to compute the cost.
Then, multiply the factor times the base hourly rate to compute the cost.
Examine the examples in the chapter.

12. Tying Cost to Staffing
The actual cost is attached to staffing in the books and records, though.
A subsidiary journal and a basic transaction record (both of which are described in the previous chapter).
Study the examples shown in the chapter.

13. Subacute Unit Master Staffing Plan
Staffing for Eight-Hour Nursing Shift
Shift 1
Day +
Shift 2
Evening
Shift 3
Night =
24-Hour
Staff Total RN
LPN NA 2 1 5 4 3 11

14. Calculation for Annualizing Master Staffing Plan Example
Step 1: Compute Net Paid Days Worked
Total Days in Business Year
Less two days off per Week
Number of Paid Days per Year RN
364
104
260
LPN NA
Less Paid Days Not Worked:
Holidays
Sick Days
Vacation Days
Education Days
Net Paid Days Worked 9 7 15 3
226 2
227 1

15. Calculation for Annualizing Master Staffing Plan: Example
Step 2: Converting Net Paid Days Worked to a Factor RN
LPN NA
364
226 =
227
228

16. FTEs to Annualize Staffing: Practice
1. Compute Net Paid Days Worked
Total days in business year
Less two days off per week
Number paid days per year
Less paid days not worked
Holidays
Sick days
Education days
Vacation days
Net paid days worked
_______
_________
2. Convert Net Paid Days Worked to a Factor.
Total days in business year divided by net paid days worked
equals factor ____________________
2. Convert Net Paid Days Worked to a Factor.
Total days in business year divided by net paid days worked
equals factor 364/241 =
364
104
260
241 8 5 1 19
1. Compute Net Paid Days Worked
Total days in business year
Less two days off per week
Number paid days per year
Less paid days not worked
Holidays
Sick days
Education days
Vacation days
Net paid days worked

17. FTEs to Annualize Staffing: Assignment
Compute Net Paid Days Worked
Laboratory
Medical Records
Total Days in Business Year
Less Two Days off Per Week
Number of Paid Days Per Year
364
104
260
Less Paid days Not Worked
Holidays
Sick Days
Education Days
Vacation Days
Personal Leave Days 9 7 3 15 21
Net Paid Days Worked 34
226 30
230
Covert Net Paid Days Worked to a Factor:
For the Lab.
Total days in business year divided by net paid days worked = factor 364/226 =
For Medical Records
Total days in business year divided by net paid days worked = factor 364/230 =
Compute Net Paid Days Worked
Laboratory
Medical Records
Total Days in Business Year
Less Two Days off Per Week
Number of Paid Days Per Year
_________
________
Less Paid days Not Worked
Holidays
Sick Days
Education Days
Vacation Days
Personal Leave Days
Net Paid Days Worked
_______
Covert Net Paid Days Worked to a Factor:
For the Lab.
Total days in business year divided by net paid days worked = factor _______________
For Medical Records

18. FTEs to Fill Position: Example 8 Hour
Emergency Department Scheduling for Eight-Hour Shifts:
Shift
One
Day
Two
Evening
Three
Night =
24-Hour
Scheduling
Total
Position:
Emergency Room Intake 1
Eight
Hour
Shifts
Staff needed to cover position 7/24
1.4
4.2 FTEs
One full time employee works 40 hours per week. One eight-hour shift per day times seven days per week equals 56 hours on duty. Therefore, to cover seven days or 56 hours requires 1.4 times a 40 hour employee.

19. FTEs to Fill a Position: Practice 8 Hour
Scheduling for Eight-Hour Shifts:
Shift
One
Day
Two
Evening
Three
Night =
24-Hour
Scheduling
Total
Position:
Admissions Officer
Four Eight
Hour Shifts
FTEs to cover position equals
Position
Clerical
One Eight
Hour Shift
Scheduling for Eight-Hour Shifts:
Shift
One
Day
Two
Evening
Three
Night =
24-Hour
Scheduling
Total
Position:
Admissions Officer 2 1
Four Eight
Hour Shifts
FTEs to cover position equals
2.8
1.4
5.6
Position
Clerical
One Eight
Hour Shift

20. FTEs to Fill a Position: Assignment 8 Hour
Scheduling for Eight-Hour Shifts:
Shift
One
Day
Two
Evening
Three
Night =
FTEs
Seven Day
Week
Position:
Nursing Supervisor
Technician
Nurses
Clerical
Aides
2.8
4.2
1.4
5.6
7.0
9.8
Total FTEs needed to cover all shifts
25.2

21. FTEs to Fill a Position: Example 12 Hour
Emergency Department Scheduling for Twelve-Hour Shifts: 36 Hour Week
Shift
One
Two =
24-Hour
Scheduling
Total
Position:
Emergency Room Intake 1
Twelve
Hour
Shifts
Staff needed to cover position 7/24
2.33
4.66 FTEs
One full time employee works 36 hours per week. One twelve-hour shift per day times seven days per week equals 84 hours on duty. Therefore, to cover seven days or 84 hours requires 2.33 times a 36 hour employee.

22. FTEs to Fill a Position: Assignment 12 Hour
Scheduling for Twelve-Hour Shifts: 36 Hour Week
Shift
One
Two =
FTEs
Seven Day
Week
Position:
Nursing Supervisor
Technician
Nurses
Clerical
Aides
4.66
2.66 7
1.4
2.33
9.33
11.66
Total FTEs needed to cover all shifts
31.75

23. FTEs to Fill a Position: Example 12 Hour
Emergency Department Scheduling for Twelve-Hour Shifts: 48 Hour Week
Shift
One
Two =
24-Hour
Scheduling
Total
Position:
Emergency Room Intake 1
Twelve
Hour
Shifts
Staff needed to cover position 7/24
1.75
3.5 FTEs
One full time employee works 48 hours per week. One twelve-hour shift per day times seven days per week equals 84 hours on duty. Therefore, to cover seven days or 84 hours requires 1.75 times a 48 hour employee.

24. FTEs to Fill a Position: Assignment 12 Hour
Scheduling for Twelve-Hour Shifts: 36 Hour Week
Shift
One
Two =
FTEs
Seven Day
Week
Position:
Nursing Supervisor
Technician
Nurses
Clerical
Aides
3.50
5.25
1.4
2.33
1.75 7
8.75
Total FTEs needed to cover all shifts
24.73