Multispeciality Hospital 350 Beds

MULTISPECIALITY HOSPITAL 350 BEDS

[EIRI/EDPR/4381] J.C.: 2574XL

INTRODUCTION

The Project was planned in order to provide better health care facilities in eastern UP. Varanasi has more than 100 hospitals set ups .With around 25-100 bedded facility every footfall of OPD in Varanasi is around 10000 patients everyday with 4000-5000 IPD on daily basis.Benaras Hindu University (BHU) alone is a very big hospital set up with more than 2000 beds but still patients do not get adequate medical facility and bed on time.Varanasi cater lot of patients from Bihar and its periphery region.

We have selected our location based on patients comes from Bihar which is a majority of patient share in Varanasi. Lots of patient itself comes from HINDALCO, Renukoot. (A unit of Aditya Birla Group). We have a target to cater patients from West Bihar, Mirzapur, Chandauli, Ghazipur, Sonebhdra, Hindalco, Shakti Nagar, Vindhnagar etc.

Being on national highway we have great advantage to benefit patients by saving their precious time of travelling to Varanasi city which takes another 40 minutes from our location to reach the hospital in city.Being the largest infrastructure in private hospital sector in whole Purvanchal we have ability to incorporate any special requirements of super specialization such as bunker for Onco- treatment, nursing college etc.Currently we have started Urology department with one of our modular operation theatres. Being a new start up we have started our exercise to get registered in Ayushman, Insurances and TPA’s.

COST ESTIMATION

Plant Capacity            354 Nos/Day

Land & Building (6960 sq.mt.)    Rs. 38.00 Cr

Plant & Machinery                    Rs. 22.43 Cr

Working Capital for 3 Months    Rs. 1.90 Cr

Total Capital Investment          Rs. 63.85 Cr

Rate of Return                          12%

Break Even Point                      70%

CONTENTS

DETAILING CONCEPTION

WE HAVE FOUR FULL TIME DOCTORS WITH US:

SERVICES

IN FIRST AND SECOND PHASE WE HAVE A PLAN FOR FOLLOWING SERVICES (SOME SERVICES ARE ALREADY UP AND RUNNING IN PRESENT TIME).

HOSPITAL PLANNING

THE PLANNING OF HOSPITAL IS PREPARED UNDER THE GUIDELINE OF COMMITTEE WITH VARIOUS EXPERTISE DETAILS ARE AS FOLLOWS:

INTRODUCTION

OVERVIEW OF HEALTHCARE INDUSTRY

FIGURE 1: MAJOR SEGMENTS IN INDIA’S HEALTHCARE SECTOR

FIGURE 2: GROWTH TREND OF INDIA’S HEALTHCARE SECTOR (USD BILLION)

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

THE LICENSES THAT ARE REQUIRED TO START A HOSPITAL IN INDIA ARE:

• 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

LISTED BELOW ARE THE DESIRED FEATURES OF AUTOMATED BIOCHEMICAL ANALYZERS.

MODERN MEDICAL EQUIPMENT

COMPUTER TOPOGRAPHY

ULTRASOUND

CATHETERS IN INTERVANTIONAL PROCEDURES ARE MAINLY USED FOR:

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 (NABH STANDARD)

HOSPITAL/MEDICAL EQUIPMENTS AND SUPPLIERS

PROPOSED MINIMUM STANDARDS FOR PRIVATE HOSPITALS

INTRODUCTION

THE BASIC MINIMUM FUNCTIONS PROVIDED BY A HOSPITAL AS 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

D. PHARMACY

DIAGNOSTIC ZONE (OPTIONAL)

PATHOLOGY

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

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. CATION

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 50 BEDS

FOR LESS THAN 100 BEDS

OXYGEN CYLINDERS

9. ELECTRICAL STANDARDS

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

INPATIENT WARDS AND NURSING UNITS

OUTPATIENT BLOCK

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

15. WASTE DISPOSAL:

PROJECT 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:

PLANNING OF EACH FLOORS ARE AS FOLLOWS

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:

ENVIRONMENTAL MANAGEMENT PLAN

AIR ENVIRONMENT

NOISE ENVIORNMENT

SOLID WASTE MANAGEMENT

OPERATION PHASE

WATER MANAGEMENT (SOURCE & SUPPLY OF WATER)

WATER USE CALCULATION

SEWERAGE

SCHEME OF SEWAGE TREATMENT PLANT:

TREATMENT PROCESS:

THE PROCESS FOR SEWAGE TREATMENT PLANT BASED ON MBBR TECHNOLOGY

SCHEMATIC REPRESENTATION OF STP BASED ON MBBR TECHNOLOGY

BENEFITS OF USING MBBR TECHNOLOGY

PROCESS FLOW DIAGRAM FOR ETP

ETP DESIGN

TREATED EFFLUENT CHARACTERISTICS

WATER CONSERVATION & AUGMENTATION

RAINWATER HARVESTING TABLE:

RAINWATER HARVESTING CALCULATIONS

BLOCK DIAGRAM FOR PROPOSED RAIN WATER HARVESTING/AQUIFER RECHARGING SYSTEM

SCHEMATIC REPRESENTATION OF THE RAINWATER HARVESTING SYSTEM

SOLID WASTE MANAGEMENT

SOLID WASTE GENERATION

TABLE: TOTAL SW GENERATION FROM THE PROPOSED PROJECT

NO OF TRANSIT CENTERS:-

COMPOST FORMATION POTENTIAL OF THE PROJECT

COMPOST GENERATION POTENTIAL OF THE PROJECT (CHEN, 2016)

TENTATIVE DETAILS OF ORGANIC WASTE CONVERTOR:

STANDARD OPERATING PROCEDURE OF ORGANIC WASTE CONVERTER:

TABLE: HOSPITAL AND BIOMEDICAL WASTE GENERATION FROM BEDDED AREA (MINISTRY OF HEALTH AND FAMILY WELFARE; PANDIT ET AL 2006)

SEGREGATION OF BIOMEDICAL WASTE AND ITS STORAGE:-

BIOMEDICAL WASTE CATEGORIZATION

BMW WILL BE SEGREGATED AND COLLECTED AND THEN WILL BE HANDED OVER TO A UPPCB APPROVED BMW VENDOR

AIR POLLUTION CONTROL:

STACK HEIGHT CALCULATIONS

LANDSCAPING & HORTICULTURE

SHRUBS/HERBS TO BE PLANTED

PROJECT LOCATION

IMPLEMENTATION SCHEDULE

LIST PLANT & MACHINERY

DEPARTMENT OF NEPHROLOGY

DEPARTMENT OF CARDIOLOGY

DEPARTMENT OF UROLOGY

DEPARTMENT OF ORTHOPAEDICS

DEPARTMENT OF NEUROSURGERY

MAJOR LIST OF EQUIPMENTS

DEPARTMENT OF NEPHROLOGY

MAJOR EQUIPMENTS

DIALYSIS MACHINE

MICROSCOPE

MICROSCOPE

DEPARTMENT OF CARDIOLOGY

MAJOR EQUIPMENTS/INSTRUMENTS

ECHO CARDIOGRAPHY MACHINES

TMT WIPRO GE MACHINE

TWO FLAT PANEL CATH LABS

ST. JUDE EP SYSTEM

HOLTER MONITOR – ECG

AMBULATORY BP

CX 50

TILT TABLE

DEPARTMENT OF UROLOGY

MAJOR EQUIPMENTS

DA VINCI ROBOT

MODULAR OPERATION THEATRES

60 W QUANTA HOLMIUM LASER

ALLENGERS C ARM

DORNIER COMPACT SIGMA LITHOTRIPSY MACHINE

MEDISON ULTRASOUND MACHINE

RIGISCAN PLUS

MMS URODYANAMICS MACHINE

ENDO UROLOGY INSTRUMENTS

100 WATT HOLMIUM LASER

A MOBILE C-ARM IS A MEDICAL IMAGING DEVICE

DEPARTMENT OF ORTHOPAEDICS

MAJOR EQUIPMENTS

ARTHROPLASTY

ARTHROSCOPY SET

INTERLOCK NAIL

ARTHROSCOPY TROLLEY

DEPARTMENT OF NEUROSURGERY

MAJOR EQUIPMENTS

MEDTRONIC 58 NAVIGATION SYSTEM (FULLY LOADED CRENIAL AND SANAL OPTICAL AND ELECTROMAGNETIC SYSTEM)

DEDICATED CUSA (CAUITRON ULTRASONIC SURGICAL ASPIRATDR)

MEDTRONICS HIGH SPEED DRILL SYSTEM

WELL EQUIPPED OPERATION THEATER WITH INTEGRATED WORKSTATION (MICROSCOPE, ENDOSCOPE AND NAVIGATION SYSTEM)

DEDICATION WELL EQUIPPED NEUROSURGICAL ICU

MICROSCOPE:- FIRST FULLY LOADED ROBOTIC 3D MICROSCOPE WITH 30 EXOSCOPE AND ENDOSCOPE

FULLY EQUIPPED OPERATION THEATER

SPECIFICATIONS OF STANDARD LIST OF MEDICAL EQUIPMENT

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)