Question

Delaware Medical Center operates a general hospital. The medical center also rents space and beds to separately owned entities rendering specialized services, such as Pediatrics and Psychiatric Care. Delaware charges each separate entity for common services, such as patients’ meals and laundry, and for administrative services, such as billings and collections. Space and bed rentals are fixed charges for the year, based on bed capacity rented to each entity. Delaware Medical Center charged the following costs to Pediatrics for the year ended June 30, 20x1:

	Patient Days (variable)			Bed Capacity (fixed)
Dietary	$	560,000			—
Janitorial		—		$	77,000
Laundry		290,000			—
Laboratory		430,000			—
Pharmacy		330,000			—
Repairs and maintenance		—			36,000
General and administrative		—			1,380,000
Rent		—			1,510,000
Billings and collections		260,000			—
Total	$	1,870,000		$	3,003,000

During the year ended June 30, 20x5, Pediatrics charged each patient an average of $300 per day, had a capacity of 60 beds, and had revenue of $6 million for 365 days. In addition, Pediatrics directly employed personnel with the following annual salary costs per employee: supervising nurses, $25,400; nurses, $20,700; and aides, $8,200.

Delaware Medical Center has the following minimum departmental personnel requirements, based on total annual patient days:

Annual Patient Days	Aides		Nurses		Supervising Nurses
Up to 22,000	20		10		4
22,001 to 26,000	25		14		5
26,001 to 29,200	31		16		5

Pediatrics always employs only the minimum number of required personnel. Salaries of supervising nurses, nurses, and aides are therefore fixed within ranges of annual patient days.

Pediatrics operated at 100 percent capacity on 85 days during the year ended June 30, 20x1. Administrators estimate that on these 85 days, Pediatrics could have filled another 10 beds above capacity. Delaware Medical Center has an additional 10 beds available for rent for the year ending June 30, 20x2. Such additional rental would increase Pediatrics’ fixed charges based on bed capacity. (In the following requirements, ignore income taxes.)

Required:

Calculate the minimum number of patient days required for Pediatrics to break even for the year ending June 30, 20x2, if the additional 10 beds are not rented. Patient demand is unknown, but assume that revenue per patient day, cost per patient day, cost per bed, and salary rates will remain the same as for the year ended June 30, 20x1.

Assume that patient demand, revenue per patient day, cost per patient day, cost per bed, and salary rates for the year ending June 30, 20x2, remain the same as for the year ended June 30, 20x1. Prepare a schedule of Pediatrics’ increase in revenue and increase in costs for the year ending June 30, 20x2. Determine the net increase or decrease in Pediatrics’ earnings from the additional 20 beds if Pediatrics rents this extra capacity from Delaware Medical Center.

Answer 1

SOLUTION

A. Minimum no. of patient days required to breakeven-

The breakeven point is the volume of activity where the expenses and the revenues of an organization are equal. At this point, the organization has no profit or loss, it break evens.

Breakeven sales in units = Fixed expenses / Contribution

Variable costs-

	Amount ($)
Dietary	560,000
Laundry	290,000
Laboratory	430,000
Pharmacy	330,000
Billing and Collections	260,000
Total	1,870,000

Fixed costs-

	Amount ($)
Janitorial	77,000
Repairs and Maintenance	36,000
General and administrative	1,380,000
Rent	1,510,000
Supervising nurses (25,400 * 4)	101,600
Nurses (20,700*10)	207,000
Aides (8,200*20)	164,000
Total	3,475,600

No. of patient days = Total revenue for the year / Revenue per patient day

= $6,000,000 / 300 = 20,000 patient days

Variable cost per patient day = Total variable cost for the year / Total Patient day

= $1,870,000 / 20,000 = $93.50

Unit contribution margin = Revenue per patient day - Variable cost per patient day

= $300 - $93.50 = $206.50

Breakeven point in patient days = Fixed expenses / Contribution

= $3,475,600 / 206.50 = 16,830 patient days

2. Computation of Change in Earnings From Rental of Additional Beds-

	Amount ($)
Increase in revenue (20 beds *85 days * $300)	510,000
Increase in expenses:
Variable charges by medical center (20 beds *85 days * $93.50)	158,950
Fixed charges by medical center ($3,003,000/60*20)	1,001,000
Total increase in expenses	(1,159,950)
Net change in earnings from rental of additional 20 beds	(649,950)