Financial Case Study

Financial case study; One of the important duties of a nurse leader is to manage personnel and personnel budgets. In this assignment, you will assume the role of a nurse manager. You will use given data to make important decisions regarding budgets and staffing.

Some nurse managers have computer spreadsheets or software applications to help them make decisions regarding budgets and staffing. You will only need simple mathematical operations* to perform the needed calculations in this assignment because the scenario has been simplified. Furthermore, some data have been provided for you that a nurse leader might need to gather or compute in a real setting. Still, you will get a glimpse of the complexity of responsibilities nurse leaders shoulder regarding financial management.

Read the questions very carefully. Watch your instructions if it says “round to the tenth” don’t forget to do so. The assignment is based on a 40 hour work week.

PLEASE MAKE SURE TO LOOK AT THE RUBIC ATTACHED WITH THE ASSIGNMENT!!!

Community Health Task 1, Financial Case Study

Ronda Manworren

Western Governors University

A. Sentinel City Action Report

See attached PDF’s

B. Assessment of Needs and Risks

Demographics Assessment:

The estimated population of Sentinel City in 2012 was 634,265, an increase of approximately 5% from 2010. Sentinel City consists of four districts, Industrial Heights, with a population of 24,672; Nightingale Square, population of 269,550; Acer Tech Center, population of 166,300; and Casper Park District, population of 352,643. The majority of residents in Sentinel City, 21.7%, are over the age of 18 years, of which 10.5% are over 65 years. In 2012, 80.6% of the residents reported as being White, while 12.4% reported as being African American or Alaska Native, 3.7% reported as being Asian, and 3.1% reported as being two or races.

According to the CDC, the national average of uninsured people in 2012 was only 27.9%, but in Sentinel City the percentage of uninsured residents in the combined four districts totals 55.2% whereas, Nightingale Square is 0.7%, Acer Tech Center is 1.5%, Casper Park District is 22.7% and Industrial Heights is 37.5%. And according to American Community Services, the 2012 U.S. median household income was $51,371, while Sentinel City’s median household income is $49,091 the four neighborhoods breaks down as follows: Nightingale: $269,550; Acer Tech Center: $166,300; Casper Park District: $80,134; and Industrial Heights $24,672.

Neighborhood/Community Safety Inventory

While walking through the city, only two stray dogs, one stray cat and one rat were observed. There are several boarded buildings, that have areas with knocked over trash cans and trash bags littered on the ground. While walking through Industrial Heights, graffiti was observed on several buildings, along with a couple of abandoned cars, one of which is on fire, and trash burning in barrels. There is some presence of police on the streets, but not enough since the gang related crimes have all increased over the last five years; homicide rate has increased approximately 900%, followed by simple assault 100%, robbery 82% and aggravated assault 2%.

Most police time is spent on arrests for Warrants 23%, Cannabis 23%, Controlled substances 16%, Battery 17%, Criminal trespassing 9%, reckless conduct 6%, and Public intoxication 6%.

When emergency services are needed, Sentinel City’s response times are dispatched approximately 56% faster than the national average of 14-16 minutes. Fire department is estimated at being dispatched in 6 minutes, Emergency Medical Services in 7 minutes, Advanced Life Support in 7 minutes, and Time to shock in 6 minutes.

Windshield Survey

Sentinel city is an urban city consisting of four communities: Industrial Heights, Nightingale Square, Acer Tech Center and Casper Park District, with no real distinction of leaving one community when entering the next community, in other words, there are no visual signs announcing the names of the communities. Most all of the housing in Sentinel city is older, multi- level buildings, concrete or brick, and are connected, but, there is some new apartment units being constructed at the Affordable Housing Project site. I did not observe any single family residence homes with yards. There are some areas with graffiti on the buildings and boarded windows and some garbage located in piles. I observed some people walking and riding bikes, I saw one stray dog, a cat and a rat. I saw several police officers standing on the streets. Some people gathered around a fire barrel with a fire, next to a couple of abandoned cars on the street. There were some demonstrators with signs outside City Hall and a line of people standing outside the soup kitchen. There is bus transportation available and I heard the sounds of a train passing overhead in one area. I only observed one church, Interfaith Church, one school yard, where children were playing outside, and one daycare. I saw one grocery store, grocery stand, few restaurants, one clinic, one hospital, dentist office, and the local radio station. The primary ethnicity is White and the primary language is English.

Population Health Scavenger Hunt

The Sentinel City Department of Parks and Recreation offers several programs for children and adults, such as: swimming lessons, gardening, after school programs, nutrition programs, summer programs, city sports leagues, and adult fitness. The department also handles complaints and citations for the parks with the number one compliant last year being the homeless at 35%, followed cleanliness/stray animals 20%, drugs/crimes 10% and location 5%. Citations issues most by the department are: trespassing after hours 31%, crimes 24% intoxication/drugs 11%, littering 11%, and prostitution 9%. The homeless are welcomed by the Interfaith church soup kitchen, each month they serve 40,000 plus meals with 64% of the receipts being homeless and 12% veterans. There are additional resources for the residents of Sentinel city found through Social services at City hall, such as healthcare assistance, WIC and SNAP, along with child care and adoption services. Even though teenage pregnancy has decreased by 55% in the last two years, there were still 500 births last year according to the Community Health Center. The health center offers the community many resources for screening of breast/cervical cancer, contraceptive/pregnancy counseling/testing, and STD services to name a few. Sentinel City’s other health service provider has the resources for the elderly, such as: government entitlement services, meals on wheels, elderly abuse prevention advocates, medical care advocates, and helps seniors locate housing from long term care to assisted living units to independent apartment units. Then there is the Affordable Housing Project which helps residents with lower income move into a studio, one bedroom or two bedroom apartment. Last year, the average income for occupants of a two bedroom was approximately $17,000, a one bedroom $28,000, and a studio $32,000. Only 45% of the studio apartments are rented, 25% of the one bedroom, and 45% of the two bedrooms. The crime rate is sustainably lower than the neighborhood rate or the city’s rate, which is a plus. The biggest complaints from the residents being factory smoke 21%, dogs barking 18%, noise 17%, and loitering 13%.

Analysis of Collected Data

Other important data in Sentinel city, teen pregnancy rate, girls ages 15 – 17 years, even though it has decreased over the last three years, from 900 pregnancies three years ago, to 600 two years ago and 400 pregnancies in the last year. Sentinel city still had over thirteen hundred teenage births in the last three years. Along with teen pregnancy, comes the spread of STD’s, girls ages 15-24 gonorrhea 70%, syphilis 20%, HIV 2%, HSV-2 45%, chlamydia 62%, Hepatitis B 5% and Trichomoniasis 12%. Abortion rates for teens 15-17, three years ago 350 abortions were reported, two years ago 250 abortions, and last year just 200 were reported.

Vision is another health issue, although there was a 15% decrease in need for vision correction from previous year, there was still 25% of the residents that have significant eye disease whereas 5% of that is uncorrectable.

C. Top Three Health Concerns/Problems in Relation to Healthy People 2020 Goals in Sentinel City

In accordance with Healthy People 2020 Goals, the following three most important health concerns in Sentinel City in my opinion are:

1. Sexually Transmitted Diseases, the Healthy People 2020 objectives: Promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications. As stated in STD-6: Reduce gonorrhea rates; STD-6.1: Reduce gonorrhea rates among females aged 15 to 44 years.

2. Family Planning (teen pregnancies), Healthy People 2020 objectives: Improve pregnancy planning and spacing, and prevent unintended pregnancy. As stated in FP-8: Reduce pregnancies among adolescent females; FP-8.1: Reduce pregnancies among adolescent females aged 15 to 17 years; and FP-8.2: Reduce pregnancies among adolescent females aged 18 to 19 years.

3. Vision, Healthy People 2020 objectives: Improve the visual health of the Nation through prevention, early detection, timely treatment, and rehabilitation. As stated in V-5: Reduce visual impairment; V-5.1: Reduce visual impairment due to uncorrected refractive error; V-5.2: Reduce visual impairment due to diabetic retinopathy; V-5.3: Reduce visual impairment due to glaucoma; V-5.4: Reduce visual impairment due to cataract; V-5.5: Reduce visual impairment due to age-related macular degeneration (AMD).

Availability of Community Resources

The number one health concern in Sentinel city in my opinion is the sexual transmission of diseases (STD’s), especially gonorrhea, among girl’s ages 15-24 years of age. In accordance with STD-6, reduce gonorrhea rate, of the Healthy People 2020 objectives. The best resource the community has to help with this problem is the Better Health Clinic, which provides services such as sexually transmitted disease services, cervical screenings, and other helpful screening and preventive services. Also, the Parks and Recreation offers several programs for children and adults, such as: swimming lessons, gardening, after school programs, nutrition programs, summer programs, city sports leagues, and adult fitness, get them involved in a program so they do not have time to be sexually active.

Primary Prevention Topic

Prevention of sexually transmitted infections.

D. Reflection:

Application of Learning from Simulation to Future Community Assessment Strategies

References

Stanhope, M., & Lancaster, J. (2014). Foundations of nursing in the community: Community oriented practice. St. Louis, Missouri: Mosby.

Centers for Disease Control and Prevention, retrieved from: https://www.cdc.gov/nchs/fastats/health-insurance.htm

Noss, Amanda (2013). Household Income: 2012 American Community Survey Briefs

Auto Insurance Center Response Times, 2017, retrieved from:

Office of Disease Prevention and Health Promotion, retrieved from: