Management, Leadership, and Professional Practice
Management, Leadership, and Professional Practice covers budgets, staffing, leadership, ethics, and scope of practice. Expect applied questions about variances, delegation, and professional standards.
Core rules
- Operating budgets cover recurring costs (food, labor, supplies); capital budgets cover major equipment and facilities. Fixed costs do not change with volume; variable costs do.
- Variance = actual minus budget. Favorable or unfavorable depends on whether it is revenue or expense.
- Leadership styles: transformational (vision, development), transactional (rewards, monitoring), servant (service to staff), laissez-faire (minimal direction). Situational leaders match style to staff readiness.
- Delegation requires the right task, right person, right direction, and right supervision; the delegator retains accountability.
- Ethical principles: beneficence, nonmaleficence, autonomy, justice. Scope of practice follows state licensure and facility policy.
- Medicare covers MNT for diabetes and renal disease with a physician referral; documentation supports reimbursement.
Worked example
Food cost was budgeted at $50,000 for 10,000 patient days, or $5.00 per patient day. Actual cost was $54,000 for 12,000 patient days. The volume-adjusted expectation is 12,000 × $5.00 = $60,000, so the manager is $6,000 under budget despite spending $4,000 more than the original budget. This is a favorable volume effect, not overspending.
Traps
Calling an expense overrun unfavorable without adjusting for volume; confusing capital with operating items; delegating accountability; and assuming a clinical dietitian may order parenteral nutrition without privileges or policy.