NAMA FACILITY ACTIVITY DI RSU TRAINING

No Nama Facility Activity Cost Driver

1 Pelayanan RM
2 Pelayanan IPS
3 Pelayanan Laundry
4 Pelayanan Keamanan
5 Pelayanan Cleaning Service
6 Pelayanan Admin& Manajemen
Jumlah Pasien (Kunj & tindakan)
Frekuensi Pemeliharaan
Jumlah Kg Laundry
Luas Lahan
Luas Lantai
Jumlah Pasien (Kunj & tindakan)
Biaya Depresiasi Gedung di masing FA RSU TRAINING

FA Pelayanan RM

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
R. RM 30 1,000,000 30,000,000 20

Jumlah

FA Pelayanan IPS

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
R IPS 30 500,000 15,000,000 20

Jumlah

FA Pelayanan LAUNDRY

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
R cuci 10 5,000,000 50,000,000 20
R.Penyimpanan 10 1,000,000 10,000,000 20
R.setrika 15 5,000,000 75,000,000 20

Jumlah
FA Pelayanan KEAMANAN

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
R Satpam 8 500,000 4,000,000 20

Jumlah

FA Pelayanan CLEANING CERVICE

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
Gudang CS 15 1,000,000 15,000,000 20

Jumlah

FA Pelayanan ADMIN DAN MANAJ

Harga Beli (IIC) Masa Hidup (L)

No Nama Gedung Luas Harga per m2
(Rp.) (th)
Ruang Direksi 30 1,000,000 30,000,000 20
Ruang Adm 40 1,000,000 40,000,000 20
Ruang Keu 40 1,000,000 40,000,000 20

Jumlah
REKAPITULASI BIAYA DEPRESIASI GEDUNG DI RSU TRAINING

JUMLAH BI
No Nama Facility Activity DEPRESIASI
1 Pelayanan RM 1,500,000
2 Pelayanan IPS 750,000
3 Pelayanan Laundry 6,750,000
4 Pelayanan Keamanan 200,000
5 Pelayanan Cleaning Service 750,000
6 Pelayanan Admin& Manajemen 5,500,000
BIAYA DEPRESIASI
(Rp.)
1,500,000
1,500,000

BIAYA DEPRESIASI
(Rp.)
750,000

750,000

BIAYA DEPRESIASI
(Rp.)
2,500,000
500,000
3,750,000

6,750,000
BIAYA DEPRESIASI
(Rp.)
200,000

200,000

BIAYA DEPRESIASI
(Rp.)
750,000

750,000

BIAYA DEPRESIASI
(Rp.)
1,500,000
2,000,000
2,000,000

5,500,000
Biaya Depresiasi Alat Non Medis DI SETIAP FA RSU TRAINING

FA: PELAYANAN RM

Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)
1 komputer 3 Unit 4,500,000 13,500,000 4
2 Rak Berkas 15 Unit 1,500,000 22,500,000 4
3 Rak Arsip 1 Rak 1,500,000 1,500,000 4
4 Rak Berkas Rawat Jalan Keluar 1 Rak 1,500,000 1,500,000 4
5 Filing Cabinet 4 Unit 100,000 400,000 4
6 Meja Komputer 5 Buah 250,000 1,250,000 4
7 Meja Tulis 1 Buah 100,000 100,000 4
8 Meja Mesin Ketik 1 Buah 250,000 250,000 4
9 Meja Kecil 1 Buah 250,000 250,000 4
10 Kursi 6 Unit 100,000 600,000 4
11 Printer 1 Unit 1,700,000 1,700,000 4
Jumlah

FA: PELAYANAN IPS

Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)
1 Meja kerja kantor 1 buah 1,750,000 1,750,000 4
2 Komputer 1 unit 4,500,000 4,500,000 4
3 Lemari File 1 750,000 750,000 4
4 Meja Work Shop 2 1,500,000 3,000,000 4
5 Kursi 4 200,000 800,000 4
Jumlah
FA: PELAYANAN LAUNDRY

Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)
1 mesin cuci 1 unit 80,000,000 80,000,000 4
2 mesin pengering 1 unit 60,000,000 60,000,000 4
3 setrika 3 unit 250,000 750,000 4
4 almari kaca 1 unit 1,500,000 1,500,000 4
5 ALMARI KAYU RAK 1 unit 1,000,000 1,000,000 4
6 rak 2 unit 900,000 1,800,000 4
7 meja setrika 3 unit 800,000 2,400,000 4
8 meja kerja 1 unit 400,000 400,000 4
9 mesin jahit 1 unit 1,250,000 1,250,000 4

Jumlah

FA: PELAYANAN keamanan

Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)

nihil

Jumlah

FA: PELAYANAN CLEANING SERVICE

 Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)

nihil

Jumlah

FA: PELAYANAN ADMIN DAN MANAJEMEN

Jumlah Alat Non Medis di Harga Beli Satuan Harga Beli Total Masa Hidup (L)
No Nama/Jenis Barang
Unit Kerja (Rp.) (Rp) (th)
1 PC 2 2,000,000 4,000,000 4
2 Meja 9 1,500,000 13,500,000 4
3 Kursi 30 200,000 6,000,000 4
4 AC 4 5,355,000 21,420,000 4
5 Box Kotak Masuk 3 450,000 1,350,000 4
6 Tempat Sampah 5 65,000 325,000 4
7 Lemari Besar 3 400,000 1,200,000 4
8 Lemari Kecil 2 275,000 550,000 4
9 Meja Tempat Snack 2 600,000 1,200,000 4
10 Telpon 4 350,000 1,400,000 4
11 Vitras Berbunga 5 30,000 150,000 4
12 Korden Polos 4 750,000 3,000,000 4
13 Jam Dinding 3 70,000 210,000 4
14 Whiteboard 3 5,000 15,000 4
15 Vas Bunga 2 150,000 300,000 4
16 Dispenser 4 155,000 620,000 4
17 Telpon Fax 1 1,200,000 1,200,000 4
 18 Printer 1 740,000 740,000 4
Jumlah

REKAPITULASI BI DEPRESIASI ALAT NON MEDIS

Bi Dep Alat Non

No Nama Facility Activity Medis
1 Pelayanan RM 10,887,500
2 Pelayanan IPS 2,700,000
3 Pelayanan Laundry 37,275,000
4 Pelayanan Keamanan nihil
5 Pelayanan Cleaning Service nihil
6 Pelayanan Admin& Manajemen 14,295,000
BIAYA DEPRESIASI
(Rp.)
3,375,000
5,625,000
375,000
375,000
100,000
312,500
25,000
62,500
62,500
150,000
425,000
10,887,500

BIAYA DEPRESIASI
(Rp.)
437,500
1,125,000
187,500
750,000
200,000
2,700,000
BIAYA DEPRESIASI
(Rp.)
20,000,000
15,000,000
187,500
375,000
250,000
450,000
600,000
100,000
312,500

37,275,000

BIAYA DEPRESIASI
(Rp.)

-
BIAYA DEPRESIASI
(Rp.)

BIAYA DEPRESIASI
(Rp.)
1,000,000
3,375,000
1,500,000
5,355,000
337,500
81,250
300,000
137,500
300,000
350,000
37,500
750,000
52,500
3,750
75,000
155,000
300,000
 185,000
14,295,000
Biaya Depresiasi Kendaraan

FA PELAYANAN ADM DAN MANAJEMEN

Harga Beli
Jumlah Harga Beli Total Tahun Pembelian Masa Hidup (L) BIAYA DEPRESIASI
No Nama/Jenis Kendaraan Satuan
Kendaraan
(Rp.) (Rp) (th) (Rp.)
7 Mitshubisi L-300 1 106,992,000 106,992,000 2007 10 10,699,200
8 Honda All New City 1 74,400,000 74,400,000 2008 10 7,440,000
9 Inova 2,06 M/T 2 64,380,000 128,760,000 2009 10 12,876,000

Jumlah 31,015,200
Tabel Biaya Gaji SDM NON MEDIS DI SETIAP FA RSU TRAINING

Pelayanan RM

Take Home Pay Gaji dibebankan di PB ini

No Nama Pegawai Insentif Lain
(Slip Gaji) (THP + Insentif)
1 Sukadi 19,380,000 19,380,000
2 Sodikin 11,904,000 11,904,000
3 Moelyono 11,712,000 11,712,000
4 Eko Sugianto 12,264,000 12,264,000
5 Arko Wicaksono 12,264,000 12,264,000
Total 67,524,000

Pelayanan IPS

Take Home Pay Gaji dibebankan di PB ini

No Nama Pegawai Insentif Lain
(Slip Gaji) (THP + Insentif)
1 Heriyanto 30,108,000 30,108,000
2 Imam Kuswidianto 17,496,000 17,496,000
3 Zainul Muchidi 17,376,000 17,376,000
4 Amin Husin 16,404,000 16,404,000
Total 81,384,000

Pelayanan Laundry

Take Home Pay Gaji dibebankan di PB ini

No Nama Pegawai Insentif Lain
(Slip Gaji) (THP + Insentif)
1 Maulidah Fahdian 16,650,000 16,650,000
2 Saminto 11,664,000 11,664,000
3 Rifa'i 11,664,000 11,664,000
4 Suherman Hadi 11,664,000 11,664,000
Total 51,642,000
Tabel Biaya Gaji SDM NON MEDIS DI SETIAP FA RSU TRAINING

Pelayanan Keamanan

Take Home Pay Insentif Lain/ Gaji dibebankan di PB ini

No Nama Pegawai
(Slip Gaji) Lembur (THP + Insentif)
1 M. Baskori 11,812,308 4,800,000 16,612,308
2 Rizal 11,670,240 4,800,000 16,470,240
3 Baroto 18,000,000 4,800,000 22,800,000
4 Bp Supri 13,200,000 4,800,000 18,000,000
5 Bayu 11,670,240 4,800,000 16,470,240
Total 90,352,788

Pelayanan Cleaning Service

Take Home Pay Gaji dibebankan di PB ini

No Nama Pegawai Insentif Lain
(Slip Gaji) (THP + Insentif)
1 nihil
2
3
4
5
Total -

Pelayanan Admin& Manajemen

Take Home Pay Gaji dibebankan di PB ini

No Nama Pegawai Insentif Lain
(Slip Gaji) (THP + Insentif)
1 Surya Utama 11,664,000 11,664,000
Tabel Biaya Gaji SDM NON MEDIS DI SETIAP FA RSU TRAINING

2 Totok K. 11,664,000 11,664,000

3 Agung P. 11,712,000 11,712,000
4 Sumas'ud 12,264,000 12,264,000
5 Abd. Ghofur 11,712,000 11,712,000
6 Dhimas A 11,664,000 11,664,000
7 Sriwijaya P 11,664,000 11,664,000
8 Teguh A 12,264,000 12,264,000
9 Afif S 11,712,000 11,712,000
10 Jampi L. 11,904,000 11,904,000
11 Ubaidillah 11,952,000 11,952,000
12 Agus S. 12,312,000 12,312,000
13 Mat Syafik 12,264,000 12,264,000
Total 154,752,000

REKAPITULASI BI GAJI SDM NON MEDIS

BI GAJI SDM
No Nama Facility Activity
NON MEDIS
1 Pelayanan RM 67,524,000
2 Pelayanan IPS 81,384,000
3 Pelayanan Laundry 51,642,000
4 Pelayanan Keamanan 90,352,788
5 Pelayanan Cleaning Service nihil
6 Pelayanan Admin& Manajemen 154,752,000
Tabel Biaya Bahan Non Medis Habis Pakai Per FA

Pelayanan RM

No. Nama Bahan Jumlah Harga Satuan

1 Kertas HVS A4 70 gr 5 Rem 30,000
2 Kertas HVS F4 70 Gr 3 Rem 31,500
3 continous paper 1 Box 295,000
4 Kertas Karton Berwarna 6 Lembar 450
5 Kertas Sambungan Rawat Jalan Umum 24 Rem 60,000
6 Kertas Sambungan Rawat Jalan Umum Gigi 12 Rem 40,000
7 Kertas Sambungan Rawat Jalan Karyawan 24 Rem 60,000
8 Kertas Sambungan Rawat Jalan Gigi Karyawan 12 Rem 40,000
9 Lembar Laporan Surveilens AFP 1 Rem 40,000
10 Lembar Laporan Wabah 1 Rem 40,000
Jumlah

Pelayanan IPS

No. Nama Bahan Jumlah Harga Satuan

1 Minyak Tanah 200 liter 6,000
2 Solar 200 liter 4,500
3 Kaporit 360 kg 368,182
4 Garam tambak 200 kg 1,000
Jumlah

Pelayanan Laundry

No. Nama Bahan Jumlah Harga Satuan

1 Flash Detergent 20 Galon 201,600
2 Flash Softener 20 Galon 188,100
3 Flash Alkali 20 Galon 246,600
4 JF. Oxferox Bleach 20 Galon 207,900
5 JF. Emulsifier 20 Galon 267,760
6 LPG 50 Tab 75,000
7 Kresek Hitam Besar 1 Pak 15,500
8 Han San Glove (M) 120 buah 350
9 Masker Karet 120 buah 850
10 Pre Sept 120 buah 575
 Jumlah

Pelayanan Keamanan

No. Nama Bahan Jumlah Harga Satuan

1 NIHIL
Jumlah

Pelayanan Cleaning Service

No. Nama Bahan Jumlah Harga Satuan

nihil
Jumlah

Pelayanan Administrasi & Manajemen

No. Nama Bahan Jumlah Harga Satuan

1 kertas A4 12 30,000
2 Spidol 48 5,000
3 Ballpoint 48 1,000
4 Stabilo 48 5,500
5 Tinta Stempel 2 24,000
6 Perangko 720 1,000
7 Staples 48 10,000
8 Pensil 96 2,500
9 Kertas Kop RSPG 6 95,000
10 Kertas Memo 6 95,000
11 Kertas F4 6 31,500
12 Penghapus Pensil 96 1,650
Jumlah

REKAPITULASI BI BHP NON MEDIS

BI GAJI SDM
No Nama Facility Activity
NON MEDIS

1 Pelayanan RM 4,462,200
2 Pelayanan IPS 134,845,520
3 Pelayanan Laundry 26,217,700
4 Pelayanan Keamanan Nihil
5 Pelayanan Cleaning Service nihil
6 Pelayanan Admin& Manajemen 3,887,400
Total
150,000
94,500
295,000
2,700
1,440,000
480,000
1,440,000
480,000
40,000
40,000
4,462,200

Total
1,200,000
900,000
132,545,520
200,000
134,845,520

Total
4,032,000
3,762,000
4,932,000
4,158,000
5,355,200
3,750,000
15,500
42,000
102,000
69,000
 26,217,700

Total
-
Nihil

Total

nihil

Total
360,000
240,000
48,000
264,000
48,000
720,000
480,000
240,000
570,000
570,000
189,000
158,400
3,887,400
Tabel Biaya Umum Listrik, Air, Telpon dan Internet

FA PELAYANAN Administrasi dan Manajemen

No. Bulan Listrik Telpon/internet Air

Januari 7,000,000 24,000,000 4,000,000
Feb 8,000,000 25,000,000 2,000,000
Maret 9,000,000 27,000,000 2,000,000
April 7,000,000 24,000,000 3,000,000
Mei 8,000,000 25,000,000 2,500,000
Juni 9,000,000 27,000,000 2,700,000
Juli 7,000,000 24,000,000 4,000,000
Agust 8,000,000 25,000,000 2,000,000
Sept 9,000,000 27,000,000 2,000,000
Okt 7,000,000 24,000,000 3,000,000
Nov 8,000,000 25,000,000 2,500,000
Des 9,000,000 27,000,000 2,700,000

Jumlah
Jumlah
35,000,000
35,000,000
38,000,000
34,000,000
35,500,000
38,700,000
35,000,000
35,000,000
38,000,000
34,000,000
35,500,000
38,700,000

432,400,000
Biaya Lain-lain

FA PELAYANAN Cleaning service

No. Bulan Biaya Untuk Jumlah Biaya

Januari outsourcing 5,000,000
Feb 5,000,000
Maret 5,000,000
April 5,000,000
Mei 5,000,000
Juni 5,000,000
Juli 5,000,000
Agust 5,000,000
Sept 5,000,000
Okt 5,000,000
Nov 5,000,000
Des 5,000,000

Jumlah 60,000,000
 NAMA FACILITY ACTIVITY DAN RATE PER COST DRIVERNYA

JUMLAH BIAYA DI
No Nama Facility Activity Cost Driver MASING2 FACILITY
ACTIFITY

1 Pelayanan RM Jumlah Pasien (Kunj & tindakan) 84,373,700

2 Pelayanan IPS Frekuensi Pemeliharaan 219,679,520
3 Pelayanan Laundry Jumlah Kg Laundry 121,884,700
4 Pelayanan Keamanan Luas Lahan 90,552,788
5 Pelayanan Cleaning Service Luas Lantai 60,750,000
6 Pelayanan Admin& Manajemen Jumlah Pasien (Kunj & tindakan) 641,849,600

DATA COST DRIVER PER UNIT KERJA

No Nama Facility Activity Cost Driver POLI GIGI

1 Pelayanan RM Jumlah Pasien (Kunj & tindakan) 900

2 Pelayanan IPS Frekuensi Pemeliharaan 10
3 Pelayanan Laundry Jumlah Kg Laundry 7,500
4 Pelayanan Keamanan Luas Lahan 20
5 Pelayanan Cleaning Service Luas Lantai 20
6 Pelayanan Admin& Manajemen Jumlah Pasien (Kunj & tindakan) 900

PEMBEBANAN FA KE MASING-MASING UNIT PRODUKSI

No Nama Facility Activity Cost Driver POLI GIGI

1 Pelayanan RM Jumlah Pasien (Kunj & tindakan) 138,066

2 Pelayanan IPS Frekuensi Pemeliharaan 5,491,988
3 Pelayanan Laundry Jumlah Kg Laundry 1,406,362
4 Pelayanan Keamanan Luas Lahan 301,843
5 Pelayanan Cleaning Service Luas Lantai 303,750
6 Pelayanan Admin& Manajemen Jumlah Pasien (Kunj & tindakan) 1,050,299
JUMLAH COST
RATE PER COST
DRIVER
DRIVER
SELURUH RS

550,000 153
400 549,199
650,000 188
6,000 15,092
4,000 15,188
550,000 1,167

PEMULASARAN
POLI BEDAH POLI ANAK IRNA KLAS 3 IRNA KLAS 2 IRNA KLAS 1
JENAZAH

1,249 7,500 5,110 1,460 1,460 52

4 2 20 12 5 1
10,000 6,000 200,000 120,000 100,000 1,500
20 20 500 300 150 100
20 20 500 300 150 100
1,249 7,500 5,110 1,460 1,460 52

PEMULASARAN
POLI BEDAH POLI ANAK IRNA KLAS 3 IRNA KLAS 2 IRNA KLAS 1
JENAZAH

191,605 1,150,550 783,908 223,974 223,974 7,977

2,196,795 1,098,398 10,983,976 6,590,386 2,745,994 549,199
1,875,149 1,125,090 37,502,985 22,501,791 18,751,492 281,272
301,843 301,843 7,546,066 4,527,639 2,263,820 1,509,213
303,750 303,750 7,593,750 4,556,250 2,278,125 1,518,750
1,457,582 8,752,495 5,963,366 1,703,819 1,703,819 60,684
#REF! #REF!
 REKAPITULASI BIAYA FACILITY ACTIVITY
Facility Activity

Pelayanan RM Pelayanan IPS

No. Komponen Biaya

(Rp) (Rp)
1 2
A. BIAYA DEPRESIASI
1. Depresiasi Gedung 1,500,000 750,000
2. Depresiasi alat non medis 10,887,500 2,700,000
3. Depresiasi Kendaraan
Jumlah A : 12,387,500 3,450,000
B. BIAYA OPERASIONAL
1. Biaya gaji tenaga non medis 67,524,000 81,384,000
2. Biaya BHP Non Medis 4,462,200 134,845,520
3. Biaya Umum (listrik, air, telepon)
4. Biaya Lain-lain
Jumlah B : 71,986,200 216,229,520
C. BIAYA PEMELIHARAAN
1. pemeliharaan
Jumlah C :
JUMLAH TOTAL BIAYA DI FA 84,373,700 219,679,520
 Facility Activity

Pelayanan Pelayanan Pelayanan Admin&

Pelayanan Laundry
Keamanan Cleaning Service Manajemen

(Rp) (Rp) (Rp) (Rp)

3 4 5 6

6,750,000 200,000 750,000 5,500,000

37,275,000 nihil nihil 14,295,000
31,015,200
44,025,000 200,000 750,000 50,810,200

51,642,000 90,352,788 nihil 154,752,000

26,217,700 Nihil nihil 3,887,400
432,400,000
60,000,000
77,859,700 90,352,788 60,000,000 591,039,400

121,884,700 90,552,788 60,750,000 641,849,600

Tabel Biaya Pemeliharaan

FA PELAYANAN

No. Bulan Biaya Untuk Jumlah Biaya

Jumlah -