Business Plan for Hospital Construction​: Professional Guide

Business Plan for Hospital Construction​: More and more people are looking for good healthcare these days, thanks to the growing population, longer lifespans, and the need for up-to-date medical facilities. So, we’re planning a new hospital project that’s gonna tackle these issues by building a top-notch healthcare center that offers accessible, affordable, and high-quality medical services.

This business plan lays out our game plan for building a hospital that focuses on patient care, cutting-edge innovation, and serving the community. We’re aiming to create a place that’s got the latest medical tech, a team of top-notch professionals, and a commitment to putting patients first to meet the varied healthcare needs of everyone around us.

The hospital’s gonna be a place where you can get both preventive care and treatment, featuring specialized departments, emergency care units, and programs focused on research. With smart partnerships, solid management, and a dedication to doing things right, we’re looking to make a big impact on public health while also keeping things financially stable and growing for the long haul.

This project is a cool chance to mix doing good with making money, providing an important service to the community, and helping to boost the local economy at the same time.

Executive Summary

The following business plan encompasses a comprehensive design for the construction of a new hospital. It has been composed to outline the major objectives, approaches, and vision of this uniquely innovative project. This executive summary outlines the key offerings in the coming, more detailed sections.

Our commitment is to address the healthcare needs of a growing, diverse community by providing quality services, technological advances, and a broad range of specialties. Community input reveals that local healthcare providers respect the need to meet high overall community expectations.

We believe that people whose work is their passion will deliver more personalized care with better outcomes. When selecting radiotherapists and diagnostic radiologists, their very own values ask, ‘Would they view them as suitable to treat their own loved ones?’ Commitment to this, strategic services and all general specialties will be delivered within the locality, and some of the specialties will deliver networks at a regional level at the same time.

The estimated total investment in the new build development is $350 million. The Board expects the following dividends through reinvestment in property, plant, and estate; proposed income and reserves policy; and strategic investments by 2027 will be $742 million.

All partnership boards can meet 95% of elective activity within maximum standard clinical waiting times; HSMR will be 90; multi-disciplinary teams will improve control of diabetes in adults by 30%; hydrotherapy pools will provide all adults on the autism spectrum access; all staff speak another local language in response to demand at 8%; raise $30 million by 2041 with a target of $40 million reinvestment in 2017/18.

Introduction

The construction of a new 50-bed hospital is expected to fill gaps in the continuum of community-based care that have created low levels of satisfaction with the healthcare delivery system. This hospital is designed to deliver basic services such as delivering babies, treating pneumonia, and setting simple fractures, all of which would require patients to travel distances of 45 to 75 miles.

The hospital is designed to provide integrated patient care. Most services are likely to be needed by people from the immediate area, but through services to veterans and joint ventures with others, the hospital plans to attract patients from central highways.

The type of people served might vary. New arrivals to Ferry County are reported to be looking for services to which they are accustomed. Residents and professionals in Ferry County began to plan for new facilities to provide goods and services that improve health and reduce rates of chronic disease and injury.

The goal of the project is to assist the citizens of Ferry County in permanently improving the health of our environment, mind, body, and spirit. This healthcare facility project was born to provide preventative and primary outpatient care for the Ferry County community.

A partnership was formed to conduct a feasibility study. This work provided utilization estimates for integrated primary care and emergency services serving outpatients. The study also proposed the following values as goals and instructions for planning efforts. These values are spirit, inclusivity, accountability, excellence, preventative care, and education. The following are hospital design goals.

Background and Rationale

Despite recent advances in global healthcare, the United Kingdom (UK) and the wider Kingdom of Saudi Arabia (KSA) face several internal challenges. In the UK, an aging population means that a greater portion of the population requires treatment and care; it is anticipated that life expectancy will continue to rise and the percentage of over-65s will also increase.

Furthermore, of the 83 million people residing in the KSA, almost a third of them may have at least one of the risk factors for major non-communicable diseases (NCDs) – diabetes, obesity, hypertension, cardiovascular diseases, or cancer. Other national health statistics reveal that 42% of the population is pre-diabetic; 23% of KSA nationals are suffering from hypertension while 19% are overweight.

There are no plans to build a new hospital in the Blackburn with Darwen area, indicating an ideal site. As mentioned earlier, with CIC Cardiology already showing an interest in the building, other developers would quickly snap up the site should we delay putting it on the market. The site is therefore ideally suited to be converted into a state-of-the-art hospital, which will provide healthcare services for nearby socioeconomically disadvantaged individuals.

During a series of stakeholder engagement events, both residents and healthcare professionals raised the matter of a new hospital being required to serve the local population. Indeed, local Chorley councilors were calling for a new hospital to be built in town.

A survey of almost 6,000 East Lancashire residents has revealed their significant healthcare needs and proposed a new hospital after nearly half reported they had been waiting for more than 18 weeks to see a specialist at local hospitals.

However, the development will offer a range of benefits to the population of Chorley and the surrounding area, including providing high-quality, targeted healthcare for a historically underserved and socioeconomically deprived local population, hosting numerous outpatient clinics and procedures, which would hopefully reduce some of the traffic to local hospitals and provide potential savings on a power-washing contract. It is ideally set for immediate hospital construction.

Market Analysis

Industry Overview:

The past several years have experienced substantial movement within the healthcare industry. From significant reform and consolidation to the introduction of consumer-driven accounts, healthcare facilities have experienced changes in forces and competitive dynamics, unlike any time in the past.

The healthcare environment is currently driven by a powerful, direct relationship between four forces: quality, convenience, cost, and value. Throughout the past several years, the healthcare industry has experienced substantive growth in the utilization and cost of healthcare services.

Residential growth in Johnson County, coupled with other demographic and healthcare trends, would seemingly support that trend and dictate that the market would be suitable for the provision of services by the proposed facility.

Industry Trends:

Understanding the growing dynamic in healthcare rather than disease management, new technology, and a fiercely competitive economy will drive healthcare to focus on health and wellness. In providing customer-friendly, wellness-focused, non-acute care, the facility is to focus on giving basic healthcare services and business services in a low-tech, high-touch manner.

A primary service and marketing focus will be to provide healthcare services to approximately 6,000 employees of the Thrivent Companies located within the Kansas City metropolitan area. A secondary service and marketing focus will be to establish itself as a local urgent care clinic with x-ray capabilities in a geographic area in need of these services.

It is the primary intent of the organization to establish an ongoing rapport with the existing businesses and professional community as they often interact with these demographics daily.

Currently, the already established relationships and waiting lists for screenings and educational seminars within Thrivent make it evident that there exists an unmet need for these types of services and that the demand exceeds the available supply in the Kansas City metropolitan area.

Industry Overview

The U.S. healthcare industry is a large and diverse sector consisting primarily of providers, patients, and payers. In 2018, the healthcare and social assistance sector will grow to encompass over 11% of all non-farm jobs, with healthcare spending at $3.3 trillion, which is about 17.9% of the GDP.

Within the healthcare sub-sector, services are the largest segment, and hospitals are the largest employer, with a little over 13,600 hospitals in the United States.

The industry overview of this document will further explore the healthcare sector as follows:

• Service Breakout
• Regulatory Framework
• Market Trends
• Competition.

The business of hospitals operates under the principles of corporate governance. These strategic, managerial, and operational principles of healthcare are slowly coming into contact with each other.

Most hospital business plans, infrastructures, service reviews, and many professional and academic activities tend to merge these themes. Therefore, the executive management style is dealing with the whole hospital operation. Health, however, is not a business.

It is a social endeavor based on ethical imperatives to prevent behavior that is known to be injurious to health and to take care of people, providing treatment and follow-up according to the standards of knowledge.

Nationwide long- and short-term trends, mostly evident from the developed, more industrial, urban, and service-oriented states, shape the operations of the nation’s healthcare systems, including the nation’s hospitals.

Under the principles of federalism established by the U.S. Constitution, states have the primary responsibility to establish and maintain healthcare delivery systems, including the scope and operation of their hospitals. In such a complex scenario, each region and each state has detailed and specific needs.

Market Trends and Opportunities

The U.S. healthcare landscape is rapidly changing, driven by consolidation, consumerism, and advancements in technology. A high-level SWOT analysis reveals several healthcare trends that will influence the likely success or failure of our project at Turner City Health Center.

Some of these will serve as opportunities that can be capitalized on and potentially give us a competitive advantage over other healthcare providers offering similar services.

First, the patients of our target market – Menominee County and adjacent communities in the Upper Peninsula of Michigan – are beginning to demand new modes of service delivery. These include efforts to move services out of the hospital and into outpatient settings, in part due to convenience and in part due to cost.

Patients are beginning to want more and more of our offerings delivered at alternative sites so that the focus of a hospital campus can be on the delivery of emergent and urgently needed services.

The 24/7, 365-day-a-year emergency department, in association with the lab, imaging, and house-wide surgical services, will deliver on that goal for Turner City Health Center. In addition to the demand for convenient outpatient services, HCE is optimizing its new hospital to accommodate the growing demand for telemedicine services.

Turner City Health Center has assessed the services provided in its service region. While there are several hospitals within the area, none have leveraged a localized health management strategy.

We see this as a major weakness for those healthcare providers – a flaw that Turner City Health Center will seek to take advantage of by positioning the new hospital as a one-stop shop for local hospital services.

On the other hand, there are some independent practices located in the greater Dickinson County and Gogebic-Iron County areas. These specialists generally do not have local hospital privileges. We see this situation as a strength we can capitalize on by offering “one-stop” for local consumers who need to see a specialist.

Finally, the Affordable Care Act is increasing market pressures on hospitals in general in the region, but we see this as a minor factor. While hospitals are installing new technology, offering new services, and making improvements to attract “high value” consumers, these services are not located in the areas our new facility will target.

The Affordable Care Act has not made any substantial impact in the region over the last four years in terms of bringing more health-conscious residents to the areas that we will be serving. Several of our most commonly served towns have seen population decreases.

Hospital Design and Infrastructure

This section aims to outline a philosophical template within which the development of a modern hospital campus can be initiated. The Multi-Disciplinary General Hospital Strategy, which is at the core of the Clinical Future Plans, aims to transform the hospital from an infirmary model to one that ‘does things with’ and ‘for’ patients.

The built environment is an essential multiplier of human intent. Collaboration, types of care, engagement, and the ability to heal while being healed are fundamentally underpinned by the capacity of the bricks and mortar of a hospital to continuously deliver clinical, social, and healing value.

The integration of technological advances that support the so-called Internet of Things is a baseline required infrastructure. Smart building technologies support general patient egress aid, the mobility impaired, and the safe egress of patients from the side of emergency egress and fire control, including fire-rated risers and shafts required to safely evacuate a whole hospital.

This new building concept also imagines itself as a room in the wider sense of a well-designed and functional component of a neighborhood, to which the refuge would be evacuated.

When we think about a hospital, the first thing that comes to mind is large wards with corridors, and to a large extent, this has not changed since the 18th century.

Before that, it would not have been expected to have the population level or the land availability to erect a hospital. However, the healthcare model and building use cases have progressed dramatically since the first gold-standard hospital.

Infrastructure criteria that are important in the design of successful program area treatments include regulatory requirements but importantly cannot be based solely on the technological needs of physical plant and equipment.

Currently, technology and an increasing array of national accreditation standards are driving the brief setting for healthcare fit-for-future infrastructure.

To ensure the delivery of the required solutions, it is essential to assemble a core team of architects, engineers, and project managers, as well as key personnel skilled in relevant hardware and software technologies, to lead the development of a robust hospital facility.

Staff collaboration can be achieved via on-campus working groups, and they could also work via a social collaboration platform. The required practices for the creation and construction of a modern hospital infrastructure require attention to transdisciplinary change between direct stakeholders, commencing with users and clients, and liaising with the design and construction team.

Health services providers with a track record in metropolitan and regional large-scale public infrastructure projects will provide the required know-how to deliver on these projects. Computational activities for parking, vast data records, and other activities associated with patient drop-off and engagement can function with advanced algorithms.

A complete set of views—from floor-level refurbishments to wide panoramic shots of the hospital, including inside the hospital to the river arms—conveys in clear detail every facet of this unique hospital concept. To ensure a rapid engagement of design for the mass market, a proven and capable healthcare architect can be engaged.

Local services firms engaged that have worked with these types of complex clinical facilities projects and have the local knowledge of large and medium-scale mass general hospital design. Essential for this overall solution is the need to provide a sustainable facility in terms of energy usage to drive a healthy cost to the operating model of the facility. The next section outlines the treatment and service land infrastructure.

Architectural Design Considerations

Architectural considerations are an important part of the design concept. A well-planned space and infrastructure in any healthcare project will allow patients to move easily from one place to another, minimize the need for patient transport, and separate patient and visitor corridors, thus ensuring patient monitoring and privacy.

It also helps staff move from one place to another and assists hospital managers in controlling and managing hospital operations. Another cornerstone of a hospital business plan is the design concept. Privacy is the most important factor in patient treatment.

Patients need privacy and confidentiality, with well-designed rooms that include a toilet, locker, pantry, and visitor bench, creating a home environment, flooding the room with natural light and fresh air, and providing a view of greenery and comfortable means of livelihood for the patient.

In all modern healthcare designs, the focus is on flexibility. As healthcare changes, the hospital’s infrastructure must be adaptable. Hospitals must plan for future technology, future expansion, or a change in approach. The design of the hospital must also ensure accessibility for all categories of patients, including the elderly and the disabled.

Health design is a holistic approach to designing a hospital that respects hospital staff, patient families, and the physical and mental aspects of patients. The design must consider integrating the indoor and outdoor environment. Utilizing natural light as well as wall features can enhance healing and well-being.

Preferably, hospitals should allocate more than 10% of the land to the interior garden or natural environment. The hospital’s design concept should also take into account various fundamental requirements to ensure patient safety, disaster resilience, fire safety, privacy and confidentiality, data protection, and any state government regulations that are likely to influence the design parameters.

Technological Infrastructure

Technologies play an increasingly large role in the provision of care and the operation of healthcare systems. Implementation of a comprehensive healthcare information system is necessary. These systems are used for a wide variety of functions, including patient record keeping, billing services, ordering systems for supplies and medications, and telehealth services.

Implementation of these systems is also integral for compliance with regulatory standards in the healthcare industry. These systems must be protected from hacking and other cyber threats since healthcare providers are often the targets of these types of attacks.

In addition, these systems utilize sensitive patient information and must follow all regulations for accessing and protecting this data. It is also necessary to access new and emerging medical devices to improve diagnostics, limit patient stays, and limit exposure to potential hospital-acquired infections.

Hospitals are often the first organizations to implement new medical devices and use them according to regulatory facility guidelines. Examples include new diagnostic equipment such as 3D mammography new treatments such as the UroLift and implantation of a new medication for cancer treatment.

These services can attract new private patients, either from existing insured or uninsured residents, as well as potential new patients. To enhance primary care or internal medical access, new telemedicine platforms can be developed that are compatible with home computers or cell phones.

In addition to the traditional visual visit, new telemedicine platforms include remote patient monitoring for chronic diseases or other illnesses. For example, a patient with diabetes can be given a remote glucose meter that not only provides the patient’s blood glucose values but also allows physicians to monitor the patient’s medication and problem list.

Providing unique technologies that enable patients to remain at home, enables the organization to provide comprehensive patient care while the patient remains at their location. These and other features can make routine patient visits more convenient for our patients.

Purchased equipment includes autonomous registration, 3D tomography, and other advanced technologies. In conclusion, these technological advancements allow for the ability to provide comprehensive patient care with minimal risk factors for potential infectious diseases.

In summary, a state-of-the-art technological infrastructure is required to provide quality healthcare. Although there is a significant upfront cost to build a comprehensive service, it significantly improves our competitive advantage in the region.

In addition, it also reduces the transportation dependency on patients. For enhanced telemedicine, proper system software and system development are necessary. The system becomes a user-friendly resource, therefore necessitating patient education.

It is a necessary prerequisite to compete with the various agencies and businesses wanting similar technology. Ongoing employee training is necessary to use telemedicine and maintain patient privacy while handling and transmitting patient health information safely, allowing for proper implementation.

In addition to providing a traditional office-type environment, the equipment also allows seeing patients at a distance. It makes access more convenient for some specialists. The office equipment allowed us to perform close to 70 tele-supervised surgeries at our office location.

Within a larger clinical setting, this technology will enable direct patient care from the office, which will facilitate the process at the patient’s convenience. It has the advantage of real-time ratification of the interpreted data, as well as live feedback.

The computerized provider order entry is not only for hospitals, but other services may use it by interfacing with care links. The lab interface separates the hospital and office on different systems but integrates them, so all orders for blood work are done through a cellular link. The applicator software has to be added to the integrated product.

Regulatory and Legal Considerations

Introduction Comprehensive federal, state, and local regulations exist that impact the approval, financing, construction, and operation of a hospital. Failure to comply with these regulations can derail the development, approval, and operation of the facility.

Moreover, in the sustained care and operation of a hospital, insurance coverage and risk management strategies are important. It is important to have marketing, trials, and other various management strategies in place to help ensure safety and quality. In very large hospitals, coverage for liability for the provision of care must be given special attention.

Compliance Throughout the development process, compliance with federal, state, and local regulations is essential, along with the admission of necessary care for patients and participation in Medicare and Medi-Cal. Most hospitals, including all major urban teaching hospitals, participate in Medicare.

In addition, all hospital-based care and the provision of emergency services must comply with EMTALA. The hospital must comply with licensing and certification standards imposed by the state. Separately, accreditation of the hospital is crucial for acceptance by most medical trusts.

Failure to comply with any of these laws can result in governmental fines, penalties, or loss of license or certification to operate as an inpatient hospital facility. Zoning A developer should be an active part of the master planning process for a community or city.

For obvious reasons, it is often easier to locate a hospital in a community or district that supports the presence of a hospital zone. Experience has shown that, for several political and legal reasons, the re-zoning will be approved. However, representation and leadership by the hospital sponsor for such approval may require strong leadership.

Particularly, if the planned facility is small, there may be lessened adverse impacts. Site selection is important and requires careful study. It serves as the foundation for the care given. Also, site selection usually requires more than just an understanding and commitment to good medicine but also to good care.

The engagement of a land use consultant may prove critical. Knowledge of the legal rules about approval of the use and site selection must be consulted. The use of a legal or public entity consulting expert who knows the environmental and planning approval process will be helpful.

Licensing and Permits

The area we have chosen for our hospital service is urban as well as well-populated. To start any hospital, nursing home, or clinic at this location, one must meet a few basic requirements.

• The hospital must be registered as a hospital or nursing home under the Nursing Home Act, municipal corporation, or registration of a family physician or practitioner on our site.
• Before establishing this, it is necessary to obtain a No Objection Certificate.
• Obtain consent, generally from the NOC of the Central Pollution Control Board.
• It is mandatory to have a nutritionist or OT King Certificate, fire department permissions, awareness, and permission from other participating bodies.

The statutory clearances and licenses, such as hospital or clinic registration, pollution committee license, and lift license, are necessary before opening the hospital; it is advisable to have documentation in hand before taking shelter. It was agreed that they did not wait for all licenses to open the camp from the start.

The first part, issued by the Chief Fire Department or Controller, applies to the consultant. Obtaining all the necessary licenses and operating authority is the first step in starting a hospital. It comes under regulation guidelines.

Human Resources Planning

The key to a successful hospital organization is to recruit and retain large numbers of trained professionals. The best ways to attract more professionals are to support strategies for education and workforce development, to provide generous salaries and benefits to attract the right core competencies, and to make staff work desirable and enjoyable.

The core competencies of professional staff such as physicians and nurses include providing quality care and using information systems to generate good patient outcomes. The competencies for administrative staff and support staff focus primarily on high levels of customer service.

Competitive salaries in comparison to the market are an effective way to attract qualified medical professionals and administrative staff necessary for the hospital.

An analysis of the labor market conditions in and around the proposed hospital may be done to get an idea of the number of available medical professionals. A compensation package is needed which includes strong benefits packages, which can be fairly affordable.

The hospital will need to develop a comprehensive compensation package, to include salary and hourly wages as well as the ancillary benefits. The compensation package, however, should be slightly higher than that of other hospitals if the hospital wants to compete and have the best in the market.

Employee recruitment, hiring, and retention initiatives will be dominated by performance-related approaches including an emphasis on creating an enjoyable work experience and a positive, employee-friendly corporate culture.

Staffing Requirements

The efficient operation of our new hospital is dependent on staffing the medical, administrative, and support positions essential to maintaining a broad spectrum of medical capabilities. The first two elements of the Patient Care Model employed in this planning process helped to determine the various departments and functions needed to operate this facility.

The second element, identification of the appropriate care for the various conditions of patients served by the hospital, has not only determined the specialties of physicians needed to staff the hospital, but also the patient mix, and therefore, the final size of the hospital.

Labor intensity standards and essential service labs suggest additional support staffing levels in select areas. Other departments also have specialized staffing ratios reflecting increased requirements in surgery, outpatient care, emergency services, and other areas.

The quality of the staff and physicians in any hospital is proportional to the quality of the available labor market. Recruiting and retaining the best people available for all positions in the hospital can be a major competitive advantage.

To maximize our efficiency, we intend to explore the desirability of additional pooled resources for such activities as questions of recruitment, training, benefits design, performance evaluation and feedback, and staff assignments.

Because of the complexity of labor-intensive services, the management of personnel for truly general medical skills is not simple. Labor-intensive service industries with a rigid staffing system typical of those found in manufacturing industries cannot adjust to rapid changes in demand.

Addressing the needs we have defined should therefore include a more flexible staffing system that will allow us to recruit and train multiple team members capable of performing various functions. Full- and part-time alternatives can also be pursued.

Ensuring appropriate staffing as service demand cycles have been identified for a wide range of services may pose significant scheduling requirements initially as well as periodically. Staffing levels and the physician recruitment plan may need to remain under regular review until the patient flow patterns and volumes stabilize.

Financial Projections

This business plan anticipates breaking even in Year 2 and turning a profit of $350,000 thereafter. In total, the business anticipates net profits of $2,723,327 in Year 1, $3,821,482 in Year 2 and almost $7 million between Years 3 and 4.

The largest component of this revenue will be generated from direct billings to customers. In the start-up year for the business, the business anticipates borrowing $10,000,000 to be repaid over 20 years.

A. Sources and uses of funds: Financing will be used to pay for land and construction of the building. The business will take a loan for $10 million with 5% interest.

This sum will be used as startup capital to pay for: the $2 million needed to purchase the land, $6 million for the construction of the hospital, $1.5 million for medical equipment and furnishings, and $500,000 for startup expenses including consultants and staff training.

B. Fixed vs. Variable Costs: The fixed costs include the expenses required to build this building and to have staff to work. The variable costs include the equipment, staff salaries, and benefits, grant staff, and supplies needed to provide services.

C. Revenue: The hospital estimates to have revenues at: $7,842,320 in Year 1, $10,900,000 in Year 2, $11,982,000 in Year 3, and $11,045,500 in Year 4.

D. Deductions: $1,219,660 in consulting and management costs, $253,080 in utilities, $120,000 in depreciation, and 30% of grants received to pay for staffing. E. Breakeven: The breakeven for the project is between Year 1 and Year 2. F. Financial Input, KPIs

Funding Sources: Private Investors $11,370,000; Loan: $10,000,000. Marketing can commence once the building is available. Medical equipment is being leased and therefore a line of credit is not needed. However, additional financial resources may be required in Years 2 and 3 to operate the business until revenues grow.

It is necessary to have greater demand than the supply of services to have a financially viable business plan. Therefore, the business will be evaluating Key Performance Indicators. In addition, the hospital will establish other industry standard Key Performance Indicators that help ensure we are operating in a fiscally sustainable manner.

Commercially, developing solid relationships with current insurance companies and billing insurance companies directly leads to co-pays and coinsurance that can pay for our Key Performance Indicators. Building strong relationships with potential donors, community groups, and nonprofit organizations can help support the costs of the uninsured in our medically underserved area.

Cost Estimates

To fully appreciate the financial aspects of constructing and operating the hospital, anticipated costs must be evaluated. Construction costs include land, architectural and engineering planning, site work, utilities, building structure, interior finishing, equipment, and landscaping.

Ongoing operating expenses would include personnel, utilities, insurance, equipment, maintenance, monitoring expenses, education, rent, administration, and professional services. Although purchasing materials and cashing for labor when due may provide some temporary cash flow advantage, ultimately the cash flow will be used at the end of the entire project.

It might also be operational for intermediate financing. The issue of reserving and contingency could be structured to restrict dipping into the reserves.

Budgeting and cost estimation during the construction and operational phases of the hospital involve estimating costs for necessary equipment, labor, and services. Cost estimation and detailed planning during the development phase will help the project flow smoothly without any hitches.

Cash flow control and construction phase timing will keep the project from being stalled or overextended. Proper planning is key to being able to construct a hospital with minimal liabilities. The sudden need for a large infusion of cash reserves could lead to project termination if funds do not become available.

If the funding is not available, the institutional partners may be left with unfinished buildings or neglected facilities and forced to declare bankruptcy. This situation should be avoided at all costs. Failure is not considered in this plan; neither is it an option. Building a hospital takes time, skill, dedication, and money. Effective planning is crucial.

Revenue Projections

The preceding text presented the costs necessary to operate the main functions of the hospital. This subsection will focus on identifying possible sources of income and drafting reasonable projections for these income streams.

These predictions are vital to constructing our pro forma income statements and understanding our hospital’s basic ability to pay salaries, outstanding loans, and other startup costs.

If our hospital is incapable of generating adequate funds to repay our founders and shareholders, we will be unable to open or achieve long-term sustainability. Our creditors will rely heavily on these figures as they lend us the necessary funds for operation.

The primary revenue stream for this new hospital will be patient admissions. Several hospitals have the full-service inpatient bed model that we plan to use. However, we only have a projection of 1% growth due to over-saturation in the populous area and the intended more personalized and integrative medicine we plan to bring to the region.

Our admissions total is 12,215 inpatient days in our third year of operation, growing at an expected 1% over the last six months of this period. People use hospitals for location, not much else. A second large income stream is expected to come from outpatient services.

We have utilized an industry average to estimate our first-year and third-year visits, consultations, and treatments. Outpatient services include, among other services, emergency medical care. Patients who do not require inpatient admission will be billed and asked to pay cash or, in the case of insurance, pay any necessary deductibles upfront before any care is administered.

Therefore, our unpaid ratio of operating income is not an area that we need to focus on. It is considered fairly negligible. Revenue and occupancy may fluctuate seasonally but should show strong overall growth during the initial ten years of operation.

We anticipate performing 2,425 MRIs and conducting 2,600 CTs in our third year. Revenue sources may change due to strategic planning, funding through government and other grant opportunities, and research partnerships. For these reasons, we may gain further income through actual research opportunities or joining research networks.

There is no estimated income created in this plan from these sources because of the significant, stand-alone administrative costs. Where possible, we have left our revenue models flexible so that our hospital will remain viable in various market scenarios. We will not offer services that are not in demand.

Our prices are set to compete with established community hospitals by utilizing market-based charging features of our system, by reviewing hospitals in the area, and through direct conversations with the hospital’s chief financial officers. Our discounted rates, rates that insurance carriers will pay, are competitive and positioned below the established hospitals.

Risk Management

The Creation and operation of a hospital entails a real estate project dealing with various sources of uncertainty. Risk is the possibility of an event happening that will have an impact on resource availability or project objectives. Hospital management and control need to be founded on potential risks and opportunities affecting service delivery.

This section identifies and classifies risks to increase the likelihood of success of the developed hospital. It presents risks, followed by stakeholder risk analysis, and finally, strategies to deal with the risks.

Risk analysis has increasingly become important in examining the safety of health care. The objective of hospital risk management in this section is to have the organization realistically assess the risks that may affect the hospital’s successful creation, completion, and operation.

Through this process, the hospital undertakes to take steps to ameliorate risks wherever possible with the intention to reduce them to a manageable level. The hospital’s commitment is to identify and report all risks encountered through the process and will develop and implement strategies to mitigate the risks associated with the project.

The risk management process includes risk identification, risk analysis classification, assessing and evaluating, risk treatment, monitoring, and review. Ongoing risk monitoring and reassessment are integral to ensuring the hospital operates in line with international good industry practices.

Risk management for the project includes assessing strategies such as risk abandonment, retention, control, sharing, and reduction. Each of these has its associated costs and benefits. The hospital will be able to assign risk priorities based on the scope of the consequences, time, cost, and probability.

The assessment methodology enables the team to allocate adequate attention and resources to the appropriate responses to each risk and therefore increases the possibility of success of the hospital.

Identification and Mitigation of Risks

In this section, the most critical risks inherent to the project are identified. Internal risks and external risks are considered according to their origin. Then, the likelihood and impact of each of these risks are evaluated, and finally, strategies to mitigate them are presented, taking into account the ranking thus obtained.

Internal Risks:

The internal factors that can pose a threat to the hospital construction project are the following. Constructed areas near the hospital facility, and de-roofing of the hospital when fully occupied can cause damage to equipment and injuries to staff members, and patient safety can be compromised.

Failure to meet standards could lead to fines or injury to staff. Latent subfloor moisture can cause tile permeability failure and fungal growth. Failure to terminate room fog but not isolating point fog can cause infiltration and cross-contamination in multi- and single-entry rooms.

Failure to close temporary wall penetrations can cause noise infiltration and potential fire hazards in the sub-floors between levels. The vented barrier will have to be highly coordinated with IT, medical, electrical, and plumbing.

External Risks:

In this section, external factors that can pose threats to the project are presented and analyzed. Failure to perform critical construction tasks within observed deadlines and poor project preparation will result in scrutiny from authorities, causing employee inefficiency or additional and costly construction oversight.

Results during construction, construction noise will affect employee concentration and the patient healing environment. Noise issues will result in office worker complaints.

Treated water supply line failure will affect hospital operations, leading to a loss of water supply, failing toilet flush valves, apparatus sterilization, drinking water, and cleaning water, resulting in a minimum of 4-6 week delay. It may require driving 1000 LF using 18-foot piles plus problem-solving.

Implementation Plan

The success of the hospital project will rely on the effective execution of the strategy and plans outlined by the project team. Key elements of the project include effective management of the construction program and the operational readiness of the hospital services and staff. The project will be constructed with a design and construct model with the successful contractor.

The project will be developed as a joint process with all key stakeholders including the Executive Project Control Group, Project Control Group, Project Team, and specialist subcommittees in consultation with our construction and operational partners. Once the project is operational, the facilities and operations team will provide ongoing facility support and development services.

The following table sets out the key milestones to be achieved underpinning the facility development and management plan. The project will be structured to achieve these milestones and manage the ongoing project roles appropriately. The current implementation framework assumes that minimal consultant services may be used.

If deemed appropriate through the strategic planning process, consultants may provide additional support to targeted operational readiness and close-out requirements.

Resource Allocation:

The resources required to deliver to the hospital will be significant and will require the tediousness of various aspects including:

• Financial
• Human resources and expertise Establish clear lines of accountability for decision-making and project delivery.
• Ensure clear directions and responsibilities for all parties working on the project and respective areas of the project.
• Encourage an open, collaborative approach to the project’s design, development, and delivery.
• Responsible, timely decisions and actions to achieve project objectives.
• Develop a shared understanding of the project, project milestones, and the responsibilities for delivery with all stakeholders.
• Ensure community and stakeholder engagement in the project is appropriate at the strategic, design, and delivery phases.
• Develop and implement structured and regular communications plans that outline clear roles and responsibilities in consultation with the project stakeholders.

Features include:

• Report progress against the project’s business case
• Identify project variations, key deliverables, risks, issues, and any potential impacts on the external environment.
• Advise progress concerning the consent process, approvals, and government decisions affecting the project. The facility developments and associated asset development must be operational and be able to support the local community in times of greatest demand.

Critical success factors include:

• On-time opening of all necessary hospital services and facilities
• On a budget to meet the affordability requirements.
• A services delivery model that is in line with community-agreed drivers.

Timeline and Milestones

1. Please see the attached file for information on the Tamale Teaching Hospital comprehensive business proposal submitted to the Board. This proposal includes an assessment of the status, goals, and financial plan.

A timeline and milestones are included in this plan and, as previously agreed, distributed to Board members. If the Board accepts the plan, a request for accreditation will be submitted in November for formal accreditation in March 2010.

2. Timeline and Milestones: The construction and operational rollout time required to complete all the above components is 48 weeks. Major milestones for the project include the following:

A. Project kickoff and site preparation. This could include the addition of a new dedicated kitchen and separate mortuary facilities; it will also be dependent on approval of the plan and acquisition of land for the new structure. a. 28 August 2025 – Issue of the contract by the design team.

Finalization of site clearing plan. b. 15 February 2026 – Take all necessary steps to begin obtaining site-clearing equipment. c. 1 June 2026 – Contracting for site completion including environmental safeguards. Already started with environmental consultants. d. Early May 2026 – Launch of advertising for equipment. e. Early May 2026 – Begin clearing the site.

A 4-6 week job. f. Early June 2026 – Commence footings (a 5-8 month job). iii. 8-15 November 2026 (depending on total construction schedule) – Contract sum reduced.

The following is a detailed timeline for the project’s construction and operation. A total of 9 tasks make up the critical path, with approximately 47 weeks needed to complete the plan.

Originally estimated 72 weeks (with 85% accuracy), a construction industry consultant indicated that the project would take a minimum of 60 weeks. “Many construction projects would add 10-20% to the legal time of completion but are not bound to that.”

Conclusion

The vision behind the healthcare complex is to create a Harney County community that has the best access to exceptional healthcare. The proposed hospital design will complement the existing medical facility investment in the community.

Throughout the plan, the need for and market that would use the proposed facility has been identified. Operating strategy and steps to enhance future growth are clearly defined. There is an abundance of working capital for the first year of operations, but additional investment would allow for a quicker capital recovery.

This investment option provides the highest return. Combined, these strategies will lead to financial viability. The opportunity for investment to support the Harney County Healthcare Infrastructure project is now being developed.

Decision-makers must be confident that all operational and financial details have been identified, discussed, and documented. To support the project of regional significance, provide access to care not currently available, and invest in a small rural community in need.

We are asking for your immediate attention to this opportunity and your support for the project. The completion of the financial part of the plan summarizes projected income statements over the first three years of operations. It reflects that with the additional investment, annual income would be realized in the fourth year post-operation.

It is anticipated that additional feasibility and profitability from potential investment options will be available to the board for review. Our commitment as a foundation is to dedicate our support to the Harney County Court, Harney County Board of Health, and the Harney County Hospital District Board of Directors.

Our role is as support and advocates. We know we have the importance of our unique resources at heart and support the experts’ ability to find us an affordable solution. Loving the challenge, we have a strong conviction to take collective action. The future of a community with access to exceptional healthcare could not be brighter.

The foundation looks forward to the hospital, public health, and behavioral health facilities being created and experienced in this valley. Optimizing the health of our children, family, friends, and co-workers is the hallmark of the Harney County spirit.

In conclusion, this project plan acknowledges and appreciates all the hard work and terrific discussions, comments, and input provided over the recent months. We are grateful to have the opportunity to contribute and provide financial input.

We know that these decisions will generate great results for the community of Harney County. A very brief and straightforward summary of this report is as follows: Harney County must have a new hospital. Whether it will become a reality will be up to the Harney County taxpayers to decide.

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