This chapter explains how the administrator fits into the financial aspect of nursing facility operation and the need for strategic business planning. The administrator’s primary role as financial manager is to use the financial information to make informed decisions about the facility. The chapter explores two systems of accounting: cash and accrual, and discusses two main steps in the accounting process: keeping the books and preparing the financial statement. A common approach to analyzing financial statements is to perform a ratio analysis. Capital assets are those used to provide services during more than one time period. Knowledge of costs and the ability to control and reduce them permit liquidity of limited funds, making them available for other uses. Knowledge of the facility’s past financial performance and insight into the reason for earlier budget shortfalls or successes are essential for preparing a realistic and useful budget.
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This chapter provides an overview of the nonprofit organization in the United States, the main characteristics of nonprofit organizations, and the reality of the nonprofit sector today. It describes the differences between a nonprofit and a for-profit corporation. Nonprofit organizations have existed for many centuries, especially through religious groups or religious-based activities. The nongovernmental sector is growing throughout the world. Increasingly, these organizations are playing key roles in the economic and social contexts of their countries. Unlike private-sector organizations concerned primarily with making a profit, nonprofit organizations are focused on carrying out a specific public-service mission. Successful nonprofit organizations require substantial capability in key areas of management: developing strong boards of directors, recruiting and motivating talented staff and volunteers, creating plans to focus resources on relevant goals and innovative programs, winning the support of diverse stakeholders, raising funds, and wisely managing fiscal and human resources.
This chapter discusses the term “service delivery” and describes a service delivery system in the context of a nonprofit organization. Servitization is the process whereby an organization develops creative and innovative ways to create a product-service system that integrates value-based products and service offerings. The chapter discusses the roles of client-centeredness, decision making, scheduling, priority setting, effective and efficient flow of services or activities, quality assurance, and continuing quality improvement, and how these factors contribute in their own context to influence positively or negatively the financial sustainability of a nonprofit organization. A customer-centric service design is a service delivery system that focuses on providing the best quality service possible to customers or clients or the service target, based on a service concept, a service decision path, service sustainability, and service quality. The chapter explains the relationship between service delivery and financial sustainability.
This chapter defines the concept of social marketing and provides some of the common areas for the use of social marketing by nonprofit organizations. The term “social marketing” has been used for several decades to refer to a systematic process of using marketing strategy to influence current behaviors of a target population into a desired behavior in order to positively change a social or community issue. The chapter describes the contents of a social marketing plan. A social marketing plan is a document that justifies the needs for a social marketing campaign, as well as the process of implementation by outlining a SWOT (strength, weakness, opportunity, threat) analysis, a description of the target population, the goals and objectives, an impact statement, the marketing mix strategies, an implementation plan, an evaluation plan, and a budget. The chapter establishes the relationship between social marketing and financial sustainability.
In policy analysis framework we will treat normative analysis and stakeholder analysis together because they are so tightly linked. However, one could also address them separately when writing the policy analysis. Individuals have multiple and conflicting values, and within every culture different individuals will both share values and hold different values. A society in which all individuals can act solely on their own personal values is anarchy. The political system is the social construct that has been created to establish value priorities that are binding for members of that geopolitical system. Social authority over children is also an important aspect of the social system. Understanding the value conflicts underlying our proposal will allow us to identify the major stakeholders for our policy proposal. Knowing the important stakeholders generally comes from political experience and knowledge.
This chapter provides background material for the policy issue that people have chosen. In fact, most policy issues and proposals get recycled over and over again. Most legislation in the United States is based on incrementalism, the notion that most policy changes are small changes of existing policy rather than comprehensive policy changes. Transplanting policies from one jurisdiction to another is always fraught with the obstacle of trying to convince policy makers that despite all the differences in geopolitics, the policy could still work in a different environment. The fact that obesity is principally a behavioral issue and that it was emphasized by a conservative Republican administration as well as a Democratic administration has important policy implications in coalition building and framing of the issue of obesity. The legal authority to act is a critical element in the development of any policy proposal.
People might want to focus on the part of the obesity issue that is the most practical or the easiest to gain a political coalition for policy adoption. People might want to think of the obesity problem as an incremental problem, building their initiative on top of another previously enacted policy. Congressional staffers, organizationally based policy persons, lobbyists, and others might have valuable insights and information that can assist people in crafting a statement of their particular policy issue. This chapter clarifies the primary area of focus for people’s policy initiative. People may also very well have to expand or further contract the scope of their policy proposal later in the political process in order to gain political support for its adoption. The literature discussion in the policy background section needs to support people’s narrowing of the policy issue.
This book guides readers through the process of developing a policy analysis. It illustrates questions to be addressed by using general policy issues as well as childhood obesity as a specific example. The book discusses specific areas of politics, policy, health, policy analysis, data, and analytical studies that will be important as readers work their way through the text. The statement of the policy issue is a very precise statement that narrows the focus of their area of concern to a specific area and geopolitical unit. The book deals with the importance of understanding the role of values in the political process. It explains the importance of coalitions, advocacy, and compromise in the political process and deals with the criteria for success, laying the foundation for policy evaluation and developing specific and measurable goals for their policy to achieve. The book further covers the systematic review of policy options within the framework. It discusses the various issues that readers will confront in evaluating one alternative versus another. It discusses the strengths and weaknesses of incrementalism and the role of evidence-based policy. Finally, the book deals with two different parts of the framework: recommendation and strategies. The most important element in terms of strategy is to gain a sense from policy makers how much political capital they are willing to expend to make this proposal a reality.
This chapter provides an overview of important concepts that people will need to remember in doing their health policy analysis. It also provides an overview of some of the interdisciplinary knowledge that is required for doing health policy analysis. The creation and distribution of wealth, the educational system, natural and built environments, including but not limited to the creation of safe living and work environments, and access to the medical care system all play critical roles in determining the health status of a given population or a particular individual. Environmental policy has an impact on health. Educational policy has an impact on health. Economic policy has implications for health. The effectiveness literature focuses on demonstrating what works to improve the health of the individual or the population. The United States has dramatically increased its spending per capita and percentage of gross national product for health care.
This chapter explains the policy implications of incrementalism and its strengths and weaknesses. The person who popularized the concept of incrementalism in the U.S. policy process is Charles Lindblom. He put forth this theory of the decision-making process as both a descriptive and normative good. Incrementalism is based on building marginally on policy that already exists rather than starting from scratch or dramatically changing policy direction. One advantage of incrementalism is that the existing stakeholders are less likely to oppose a small change in the status quo as opposed to a major change. Any policy changes within the business environment, including health care, tend to realign factors that advantage some stakeholders and disadvantage others. Public health uses the precautionary principle as an important foundation for policy advocacy. Policy makers use this principle to justify decisions in situations in which there is the possibility of harm from not taking action.