What type of budget is adjusted to reflect actual census changes?

A flexible budget is adjusted to reflect actual census changes, making it the appropriate choice in this context. This type of budget allows for variations in income and expenses depending on the level of activity or volume, such as patient census in a healthcare setting.

Unlike a fixed budget, which remains the same regardless of changes in operation volume, the flexible budget can adjust the projections to align with actual data. This adaptability enables organizations to better manage financial resources and respond to fluctuating demands.

The operational budget is a more comprehensive plan that covers day-to-day operations but does not inherently adjust for changes in census levels. Meanwhile, a static budget, similar to a fixed budget, does not accommodate any changes once it is set, which limits its effectiveness in dynamic environments. Thus, the flexible budget's ability to adapt to actual census changes makes it the correct answer.