A business office manager at a skilled nursing building opens the monthly spend report from corporate and sees the dietary line sitting higher than last month. On the same call, the controller says dietary came in under budget. Both are looking at the same invoices. The controller is reading them per patient day.
PPD stands for per patient day. In long-term care finance, a PPD figure is a period's spend divided by the patient days in that same period, so a full month and a slow month can be read side by side.
How is PPD calculated?
PPD is calculated by dividing a category's spend for a period by the patient days in that period. Add up the invoices that posted to the category during the month, add up the census for each day of the month, and divide the first total by the second. The result is a dollar amount per patient day for that category, and the same arithmetic works for one department or for a whole building.
A PPD figure does not say whether the price on any one invoice was the contracted price. It says what the month cost for each day a resident was in the building. The table shows what each reading answers.
| Reading | What it answers | What moves it |
|---|---|---|
| Total dollars for the month | How much the building spent | Prices, order quantities, and census |
| Per patient day | How much the building spent for each day a resident was served | Prices and order quantities, with census divided out |
A building that spent more because it had more residents is not over on supplies, and the per patient day reading is what shows that.
What counts as a patient day?
A patient day is one resident in the building for one day, and a period's patient days are the daily census added up across the period. A resident who stays the whole month counts once for every day of that month. How the daily count is taken is a decision each operator makes. The first question to ask before comparing two buildings is whether bed-hold days count.
Why does a PPD figure move when the census moves?
A PPD figure moves when census moves because census is the bottom of the fraction. Flat spend with fewer residents produces a higher PPD, and the same spend with more residents produces a lower one. A PPD budget runs the other direction, turning a per-day allowance into a dollar total that rises and falls with the daily count. What that recalculation does to a dietary manager's order in a short-census week is worked through in how a per patient day budget moves when the census moves.
Why do long-term care budgets use PPD instead of total dollars?
Long-term care budgets use PPD because much of a building's supply spend follows the number of residents. Meals and incontinence products are the clearest cases. A dollar budget set in the fall reads differently by spring if the census has changed. A PPD budget states the allowance per resident per day and lets the total follow the census. Setting one up by department and by category is covered in the PPD budget tracking guide.
A published supply PPD only means something once you know what spend is in it and how its census was counted, which is taken apart in what a supply PPD benchmark has to state and in what's the average supply spend per patient day in skilled nursing.
How PPD budgets work in Adelpo
In Adelpo, the census under a per-patient-day budget comes from the operator's EHR, sent daily by API connection or file export from PointClickCare, MatrixCare, or another EHR, and the PPD budgets adjust daily from it. The operator chooses how census is counted for its budgets, and spend categories are set up per customer, so dietary can be split into raw food, dietary supplies, dairy, and produce. Whoever builds a cart at the facility sees the budget impact in the cart's Budgets tab, and only an approved cart, which becomes a PO, applies to the budget. Incoming invoices are cross-referenced and update the budget, and when an order is submitted, an approval rule can send it to another approver if it would take the department past a set share of its budget, measured the way each customer sets it up.
Questions controllers ask about PPD
is ppd the same as per resident day?
Per resident day, often written PRD, is computed the same way. The spend for the period is divided by the days residents were in the building during that period. Before comparing a PPD figure with a PRD figure, check that both count the same days.
how do i calculate ppd for a month?
Add the invoices that posted to the category during the month, add the census for each day of the month to get patient days, and divide the spend by the patient days. Use the same census count for every month you compare, or the figure will move for reasons that have nothing to do with buying.
does supply ppd include food?
Supply PPD includes food only if the operator put food in the supply category, and that is a setup choice rather than a rule. One operator may keep food in a dietary line and use supply to mean nursing, housekeeping, laundry, and other non-food purchases. Before comparing a supply PPD with any outside figure, find out whether food is in it. Adelpo runs a supply PPD benchmark survey and will publish a report from the operator data once it is in.
what is the difference between a ppd budget and a dollar budget?
A dollar budget fixes the amount a department may spend in a period before the period starts. A PPD budget fixes the amount per resident per day and lets the period total follow the census, so the allowance rises when the building fills and falls when it empties. At month end both are compared with the same invoices, and the PPD version answers whether spending kept pace with the residents the building served.