Keelwright · staffing plan report
Illustrative model built from the assumptions below · Source: keelwright.app · Formulas: keelwright.app/how-it-works · Printed
Rooftop A · Results
What tomorrow costs, and where it could cost less
The group total waits until every staffed rooftop has a plan: Rooftop B has rooms but no shift blocks yet.
All 5 numbers behind these results are still the sample: physician pay, CRNA pay, resident pay, benefits load, maximum ratios. CRNA weekday call stipend not entered, counted as $0. Replace them →
Rooftop A: staffing for the day
$11,800.00
No time past assigned blocks. 1 coverage gap still open (Step 4).
Unused supervision capacity
$31.25
0.25 of a physician 6:30a–7a, at the regular rate.
Hours per person
- Physicians
- 10.0 h
- CRNAs
- 10.4 h
- Residents
- 8.0 h
A cheap plan that overloads people shows up here.
FTE pool check
Staffable
Uses 2 of 4 physicians, 5 of 9 CRNAs, 1 of 2 residents. Still works if everyone on call works past midnight.
Where the day’s cost comes from
| Role | People | Hours | Cost |
|---|---|---|---|
| Physicians | 2 | 20.0 h | $5,000.00 |
| CRNAs | 5 | 52.0 h | $6,500.00 |
| Residents | 1 | 8.0 h | $300.00 |
| Total | 8 | 80.0 h | $11,800.00 |
Hours come from the Step 4 blocks. Loaded hourly rates from Step 0: physician $250.00, CRNA $125.00, resident $37.50.
Hours per person
- MD-A12.0 h
- MD-B8.0 h
- CRNA-18.0 h
- CRNA-212.0 h
- CRNA-312.0 h
- CRNA-48.0 h
- CRNA-512.0 h
- Resident-18.0 h
A full bar is the whole planning day (12.0 h).
The cliff: what the next General OR room costs at Rooftop A
8-hour blocks, MD + CRNA at 1:4. A physician block is $2,000.00, and a CRNA block is $1,000.00. The rooftop’s other rooms count too.
Counted at their busiest: 1 General OR room with MD + resident, 1 Endoscopy room and 1 OB / L&D room. They share these physicians.
Light bars: care team cost · solid black bar: where you are · green hatched top: less with a physician working alone · red dashed line: the bar after it needs another supervising physician
Show the numbers as a table
| General OR rooms with MD + CRNA | Care team | With a physician alone | Note |
|---|---|---|---|
| 1 | $1,000.00 | $1,000.00 | |
| 2 | $2,000.00 | $2,000.00 | |
| 3 | $3,000.00 | $3,000.00 | you are here |
| 4 | $6,000.00 | $5,000.00 | +1 MD |
| 5 | $7,000.00 | $7,000.00 | |
| 6 | $8,000.00 | $8,000.00 | |
| 7 | $9,000.00 | $9,000.00 | |
| 8 | $12,000.00 | $11,000.00 | +1 MD |
| 9 | $13,000.00 | $13,000.00 | |
| 10 | $14,000.00 | $14,000.00 | |
| 11 | $15,000.00 | $15,000.00 | |
| 12 | $18,000.00 | $17,000.00 | +1 MD |
Next threshold: room 4
Going from 3 to 4 rooms adds $3,000.00: a whole new physician plus a CRNA, with 3 of 4 supervision slots left for later rooms.
Where a physician working alone costs less
rooms 4, 8 and 12: $1,000.00 less each. Revenue isn’t modeled, and it can change this.
Net impact: revenue next to cost
Waiting on billing inputsThis fills in once the reimbursement rules for medical direction and medical supervision, and a blended rate per billing unit, have been researched and entered. Until then, Keelwright shows staffing cost only.
Open questions
Not included
- Revenue
- Call pay unless you enter it
- Minimum shift lengths
- Breaks and relief
- Handoff overlap
- Non-room duties (pre-op, PACU, blocks)
- Overnight blocks
- Vacancies and recruiting
- Case volume, case length, and utilization
- What any payer, CMS, or state requires
“Supervision” means one physician responsible for several rooms, in the plain operational sense. It is not a billing category.
Every assumption
Values marked sample are illustrative.
| Physician pay | $416,000 / 2,080 h = $250.00/h loaded; past block 1.5×; call: in base pay | sample |
|---|---|---|
| CRNA pay | $208,000 / 2,080 h = $125.00/h loaded; past block 1.5×; call: per shift, amounts not entered | sample |
| Resident pay | $62,400 / 2,080 h = $37.50/h loaded; past block 1.5×; call: not paid by group | sample |
| Benefits load | 25% | sample |
| Max ratios (CRNA / resident) | General OR 1:4 / 1:2; Endoscopy 1:4 / 1:2; NORA 1:2 / 1:1; OB / L&D 1:2 / 1:2 | sample |
| Day, post-call, added block | 6:30a–6:30p; on call ⇒ out until 8a; shortest added block 4.0 h; 250 days/yr | |
| Pool | 4 physicians (1 on call), 9 CRNAs (1 on call), 2 residents (0 on call); call shifts 1/1/0 (weekday) | |
| Rooftop A | OR 1 MD + CRNA 6:30a–2:30p; OR 2 MD + resident 6:30a–2:30p; OR 3–4, OB 1 MD + CRNA 6:30a–6:30p; ENDO 1 MD + CRNA 7a–3p | |
| Rooftop B | OR 1–2 MD + CRNA 7a–3p; OR 3 MD + CRNA 7a–5p | |
| Rooftop C | closed |
All 5 numbers behind these results are still the sample: physician pay, CRNA pay, resident pay, benefits load, maximum ratios. CRNA weekday call stipend not entered, counted as $0.
Not included: revenue; call pay unless you enter it; minimum shift lengths; breaks and relief; handoff overlap; non-room duties (pre-op, PACU, blocks); overnight blocks; vacancies and recruiting; case volume, case length, and utilization; what any payer, CMS, or state requires. “Supervision” is used in its plain operational sense, not as a billing category.
Share or print
A share link carries this scenario after the #, a part of a web address browsers never send to any server.
The link contains your numbers. Treat it like the spreadsheet.