Detailed Project Report on Multispeciality Hospital (120 Beds)

MULTISPECIALITY HOSPITAL (120 BEDS)

[EIRI/EDPR/4206] J.C.: 2371XL

INTRODUCTION

Healthcare has become one of the largest sectors of the Indian economy, in terms of both revenue and employment. It has been growing at a CAGR of 22% since 2016, employing 4.7 Million people directly. The sector has the potential to generate 2.7 million additional jobs in India between 2017-22 -- over 500,000 new jobs per year.

Several factors are driving the growth of the Indian healthcare sector including an aging population, a growing middle class, the rising proportion of lifestyle diseases, an increased emphasis on public-private partnerships as well as accelerated adoption of digital technologies, including telemedicine, besides heightened interest from investors and increased FDI inflows over the last two decades.

The Indian Government has undertaken deep structural and sustained reforms to strengthen the healthcare sector and has also announced conducive policies for encouraging FDI. The Aatmanirbhar Bharat Abhiyaan packages include several short-term and longer-term measures for the health system, including Production-Linked Incentive (PLI) schemes for boosting domestic manufacturing of pharmaceuticals and medical devices. Additionally, India is working towards becoming a hub for spiritual and wellness tourism, as the country has much to offer in Ayurveda and Yoga.

The COVID-19 pandemic has not only presented challenges but also several opportunities for India to grow. The crisis has opened the flood gates for Indian start-ups, many of whom have risen to the occasion and accelerated the development of low-cost, scalable, and quick solutions. Further, the pandemic is providing an impetus to the expansion of telemedicine and the home healthcare market in the country.

All these factors, together, make India’s healthcare industry ripe for investment. In the hospital segment, the expansion of private players to Tier 2 and Tier 3 locations, beyond metropolitan cities, offers an attractive investment opportunity. India also has the opportunity to boost domestic manufacturing of pharmaceuticals, supported by the recent PLI schemes, alongside offering investment avenues in segments like contract manufacturing and research, over-the- counter drugs, and vaccines. India is also a land of opportunities for players in the medical devices industry, with tremendous opportunities for expansion of diagnostic and pathology centres as well as miniaturised diagnostics.

COST ESTIMATION

Land & Building (61,529 sq.mt.)    Rs. 5.43 Cr    

Plant & Machinery                    Rs. 9.42 Cr 

Working Capital for 2 Months    Rs. 1.05 Cr 

Total Capital Investment          Rs. 17.44 Cr 

Rate of Return                          9%

Break Even Point                      80%

CONTENTS

INTRODUCTION

OVERVIEW OF HEALTHCARE INDUSTRY

EMPLOYMENT GENERATION POTENTIAL OF HEALTH SECTOR

FIGURE 3: DIRECT JOBS IN INDIA’S HEALTHCARE SECTOR, 2017 – 2022 EXPECTED (IN THOUSANDS)

BUSINESS AND INVESTMENT CLIMATE

TABLE 1: FDI IN INDIA’S HEALTH SECTOR (2000-2020)

TABLE 2: SELECT PRIVATE EQUITY DEALS IN HEALTHCARE INDUSTRY OVER THE LAST FEW YEARS

OVERARCHING POLICY LANDSCAPE

AYUSHMAN BHARAT

HUMAN RESOURCES FOR HEALTH

NATIONAL DIGITAL HEALTH MISSION (NDHM)

FOREIGN DIRECT INVESTMENT

TAX INCENTIVES

HEALTH DIPLOMACY

DRIVERS OF GROWTH

DEMOGRAPHIC, EPIDEMIOLOGICAL AND HEALTH TRANSITIONS

MEDICAL VALUE TRAVEL (MVT)

ENABLING POLICY ENVIRONMENT

DEMAND-SUPPLY GAP

OTHER FACTORS

WHAT LICENSE REQUIRED TO OPEN A HOSPITAL AND THEIR PROCEDURE

NECESSARY LICENSES REQUIRED OPENING A HOSPITAL IN INDIA

REGISTRATION OF HOSPITAL

PERMITS

• LAND AND CONSTRUCTION

• ELECTRICITY AND WATER

• SEWAGE

• BIOMEDICAL WASTE

• FIRE AND HEALTH LICENSE

• REGULATIONS RELATING TO EMPLOYMENT OF STAFF

• SIGN BOARDS

• INFORMATION THAT REQUIRES IS DISPLAYED AT THE HOSPITAL ARE;

• FSSAI LICENSE FOR OPERATING A KITCHEN

• PERMIT TO STORE LPG CYLINDER

• PHARMACY REGISTRATION FOR MEDICAL SHOP

• TRADEMARK REGISTRATION

• VEHICLE REGISTRATION FOR AMBULANCES

• ARMS LICENSES UNDER ARMS ACT 1959

• WASTE DISPOSAL

PLANNING THE HOSPITAL INFRASTRUCTURE

ONE MUST TAKE CARE OF THESE THINGS;

THE OTHER IMPORTANT LICENSE REQUIRED IS:

B.I.S SPECIFICATION

BRIEF DESCRIPTION OF SOME COMMON HOSPITAL EQUIPMENTS

1. DRESSING DRUM

2. SURGICAL TRAY

3. CATHETHER TRAY

4. SYRINGE CASE

5. ANIMA POT

6. BOWEL

7. BED POT (LATRINE)

8. URINAL POT

9. KIDNEY TRAY

10. SPIT-ON

11. ELECTRICAL STERILIZER

MODERN MEDICAL INSTRUMENTS

BUILDING CONSTRUCTION & FURNISHING OF HOSPITAL

THE OTHER DEPARTMENT IN A HOSPITAL ARE AS FOLLOWS:

1. CARDIOLOGY

2. E.N.T.

3. MATERNITY

4. EYE SECTION

5. CHILDREN WARD

6. LABORATORY

7. X-RAY ROOM & ECG CLINIC

8. PHYSICIAN

GENERAL HEALTH AMENITIES

DRUG SITUATIONS

MODERN MEDICAL EQUIPMENT

COMPUTER TOPOGRAPHY

ULTRASOUND

CONSUMABLE STORES

UTILITIES & OVERHEADS

HOSPITAL/MEDICAL EQUIPMENTS AND SUPPLIERS

MACHINERY & EQUIPMENT SUPPLIERS

X-RAY ACCESSORIES

AIR CONDITIONING & REFRIGERATION UNITS

IMPORTED PLANT & MACHINERY SUPPLIERS

LIST OF CONSULTANT FOR SETTING UP HOSPTAL

LIST OF NABET ACCREDITED HOSPITAL & HEALTHCARE CONSULTANT ORGANIZATIONS (NABH STANDARD)

HOSPITAL/MEDICAL EQUIPMENTS AND SUPPLIERS

LIST OF HOSPITAL IN AIZAWL DISTRICT

PROPOSED MINIMUM STANDARDS FOR PRIVATE HOSPITALS

UPTO 120 BEDDED UNIT PROVIDING MEDICAL/SURGICAL/MATERNITY SERVICES

INTRODUCTION

FUNCTIONAL PROGRAMME FOR A NURSING HOME

THE BASIC MINIMUM FUNCTIONS PROVIDED BY A HOSPITAL SHOULD

INCLUDE THE FOLLOWING:

HUMAN POWER REQUIREMENTS

QUALIFICATIONS

AVAILABILITY OF PERSONNEL:

MINIMUM REQUIREMENT OF PERSONNEL:

DUTY MEDICAL OFFICER

NURSING STAFF:

NURSING AIDS:

PARAMEDICAL STAFF:

ENGINEERING STAFF

ADMINISTRATIVE AND ANCILLARY STAFF

INSTRUMENTS AND EQUIPMENT

ENTRANCE ZONE

RECEPTION AND REGISTRATION WITH CASHIER

WAITING AREA

AMBULATORY ZONE

A. NURSING

B. TREATMENT/DRESSING ROOM AND INJECTION ROOM

C. EXAMINATION AND CONSULTATION ROOMS (OPDS) AND CASUALTY

PHARMACY

DIAGNOSTIC ZONE (OPTIONAL)

PATHOLOGY

MICROSCOPE

RADIOLOGY (OPTIONAL)

INTERMEDIATE ZONE

A. WARDS

B. NURSING STATION

C. TREATMENT ROOM

D. TROLLEY BAY

E. WARD STORE

OPERATION THEATRE

INSTRUMENTS FOR GENERAL SURGERY & (MATERNITY) OBSTETRICS/GYNAECOLOGY

OPERATION THEATRE

EQUIPMENT FOR SURGERY AND OBSTETRICS/GYN

DELIVERY SUITE: EQUIPMENT & INSTRUMENTS (FOR MATERNITY HOMES ONLY)

EXAMINATION AND PREPARATION

LABOUR ROOM

DELIVERY ROOMS

EQUIPMENT FOR SERVICE ZONE

LAUNDRY

GENERATOR

MINIMAL FUNCTIONAL AND SPACE REQUIREMENTS

ENTRANCE ZONE

AMBULATORY ZONE

DIAGNOSTIC ZONE (OPTIONAL)

THIS ZONE SHOULD IDEALLY BE INTERPOSED BETWEEN OPD AND IPD

CRITICAL ZONE

OPERATING SUITE

BASIC DESIGN STANDARDS

MINIMUM SPACE REQUIREMENTS

A. PROTECTIVE ZONE

B. CLEAN ZONE

C. ASEPTIC ZONE

INTERMEDIATE ZONE

INPATIENTS NURSING UNITS

SERVICE ZONE

BUILDING ENGINEERING ENVIRONMENTAL STANDARDS

1. LOCATION

2. CEILINGS

3. FLOOR HEIGHT

4. FLOORS AND WALLS

5. DOORS:

6. WINDOWS

7. CORRIDOR

8. WATER SUPPLY, PLUMBING AND OTHER PIPING SYSTEMS

FOR MORE THAN 20 BEDS

FOR LESS THAN 40 BEDS

OXYGEN CYLINDERS

9. ELECTRICAL STANDARDS

PANEL BOARDS

10. ACCESS ROUTES TO VARIOUS FACILITIES OF THE NURSING HOME:

11. COMMUNICATION SYSTEM

12. FIRE-FIGHTING SYSTEM

13. VENTILATION REQUIREMENTS FOR AREAS AFFECTING PATIENT CARE IN NURSING HOMES

14. REQUIREMENTS FOR SANITARY FITMENTS IN NURSING HOMES FOR PATIENTS

OUTPATIENT BLOCK

THE RADIOLOGY DEPARTMENT MUST HAVE FOLLOWING SPECIAL TOILET FACILITIES IN CASE IT CARRIES OUT PROCEDURES LIKE IVP.

15. WASTE DISPOSAL:

PLANT LOCATION FACTORS

PRIMARY FACTORS

1. RAW-MATERIAL SUPPLY:

2. MARKETS:

3. POWER AND FUEL SUPPLY:

4. WATER SUPPLY:

5. CLIMATE:

SPECIFIC FACTORS

6. TRANSPORTATION:

A. AVAILABILITY OF VARIOUS SERVICES AND PROJECTED RATES

7. WASTE DISPOSAL:

8. LABOR:

9. REGULATORY LAWS:

10. TAXES:

11. SITE CHARACTERISTICS:

12. COMMUNITY FACTORS:

13. VULNERABILITY TO WARTIME ATTACK:

14. FLOOD AND FIRE CONTROL:

EXPLANATION OF TERMS USED IN THE PROJECT REPORT

1. DEPRECIATION:

2. FIXED ASSETS:

3. WORKING CAPITAL:

4. BREAK-EVEN POINT:

5. OTHER FIXED EXPENSES:

6. MARGIN MONEY:

7. TERM LOANS:

8. TOTAL LOAD:

9. LAND AREA/MAN POWER RATIO:

PROJECT LOCATION

ABOUT AIZAWL DISTRICT

IMPLEMENTATION SCHEDULE

LIST PLANT & MACHINERY

ANNEXURE-I

SPECIFICATIONS OF STANDARD LIST OF MEDICAL EQUIPMENTS

APPENDIX – A:

01. PLANT ECONOMICS

02. LAND & BUILDING

03. PLANT AND MACHINERY

04. OTHER FIXED ASSESTS

05. FIXED CAPITAL

06. RAW MATERIAL

07. SALARY AND WAGES

08. UTILITIES AND OVERHEADS

09. TOTAL WORKING CAPITAL

10. TOTAL CAPITAL INVESTMENT

11. COST OF PRODUCTION

12. TURN OVER/ANNUM

13. BREAK EVEN POINT

14. RESOURCES FOR FINANCE

15. INSTALMENT PAYABLE IN 5 YEARS

16. DEPRECIATION CHART FOR 5 YEARS

17. PROFIT ANALYSIS FOR 5 YEARS

18. PROJECTED BALANCE SHEET FOR (5 YEARS)