@David09 - That’s probably true but I don’t think it’s the most difficult part of the job. The nurse manager job description describes administrative duties, including budgetary decisions.
That’s the biggest part in my opinion because nowadays healthcare has become very expensive. I am sure that clinics and hospitals are looking for ways to reduce costs and run the operation as efficiently as possible.
While there is certainly nothing to prevent them for raising their prices, insurance companies can impose limits on how much they can pay and that will affect the bottom line of the clinic. The HIPPA regulations were implemented as part of the process to try to bring costs down, but ultimately it will depend on how effective the management is for each nursing facility.