Description
document is to build a scalable and sustainable business model for a 50 bedded Multi Specialty hospital and a Dental College.This business plan is about building a 50 bedded multi speciality hospital along with a BDS College at Ratnagiri (Maharashtra). 1st step was doing the feasibility study of the proposed location. Competitor study and disease pattern analysis along with the socio economic study was also done.
To build a scaleable and sustainable business model for a 50 bedded Multi Specialty hospital and a Dental College.
COE Marketing
MBA program Batch 2008-2010 Semester IV
Dr Vishal Bhatia
2008A44
2008A44
Page 1
Acknowledgement
A research/project is a combined effort of the researcher, his inspiration, the respondents/resources and all those people who contribute directly or indirectly towards the project. And this project is no different in that aspect. First I would like to thank my college for giving me an opportunity to prepare a challenging and interesting business plan like this. Then I would like to thank Dr Harsh Chopra and Mr Abhishek Kamle for their guidance and support throughout this project. I would also like to thank Pratima Ma’am, for she has been such an inspiring and wonderful marketing faculty for the past 2 years, and also Anita Ma’am for her constant help and support. In the end I would like to thank all the doctors, patients and other respondents who have helped me in this research directly or indirectly.
2008A44
Page 2
Table of Contents
Executive Summary .............................................................................................................................. 4 Feasibility Study .................................................................................................................................... 5 Geography:.......................................................................................................................................... 5 Demographics : ................................................................................................................................... 5 Market Analysis & Competition: ......................................................................................................... 5 Infrastructure Requirements ............................................................................................................... 8 Hospital (50 Beds): .............................................................................................................................. 8 Dental College (50 Seats Per Year): ..................................................................................................... 9 Dental Hostel (200 Seated): .............................................................................................................. 10 Equipment Requirements .................................................................................................................. 12 Medical Hospital Equipments (50 bedded hospital) : ..................................................................... 12 Equipment Dental College: ............................................................................................................... 14 Governance Plan ................................................................................................................................. 20 DENTAL COLLEGE .............................................................................................................................. 20 MEDICAL HOSPITAL ........................................................................................................................... 21 DEPARTMENTS: ................................................................................................................................. 22 Operating Cost .................................................................................................................................... 24 Hospital: Estimated Annual Operating Costs Of The Hospital .......................................................... 24 Dental College : ................................................................................................................................. 27 Cash Flow Projections ........................................................................................................................ 29 Legal Requirements ............................................................................................................................ 33 Expansion Plans (MBBS College)...................................................................................................... 37 ELIGIBILITY CRITERIA: ........................................................................................................................ 38 QUALIFYING CRITERIA: ...................................................................................................................... 38 References ............................................................................................................................................ 40
2008A44
Page 3
Executive Summary
This business plan is about building a 50 bedded multi speciality hospital along with a BDS College at Ratnagiri (Maharashtra). 1st step was doing the feasibility study of the proposed location. Competitor study and disease pattern analysis along with the socio economic study was done. Infrastructure requirement (excluding land) came out to be 2 crore for Hospital, 3.37 crore for Dental College and 3.14 crore for Hostel, totalling to 8.5 crores. Equipment cost for medical college is 1.65 crores and for dental college is 39 lakhs. Equipment cost was estimated taking into account that no super speciality interventions would be done in the hospital as it is assumed to be a secondary care facility.
Operating cost for the medical hospital and dental college was calculated separately. For the hospital and college a governance plan was made to estimate medical staffing requirements. After taking each possible expenditure into account the operating cost for hospital came out to be 1.5 crores annually. For the dental college also, annual operating cost came out to be 1.5 crores. So the total operating cost came out to be 3 crores annually.
In the end cash flow projections were done to estimate the breakeven point. These were done taking into mind that in the first few years only 30 students will be given admission in dental college. Then over the time seats can be increased up to 100 with approval from DCI. Positive cash flow was reached in the 3rd year of operation. Also the legal requirements of MCI and DCI are given at the end for reference.
2008A44
Page 4
Feasibility Study
As per the requirements Devrukh (Ratnagiri) is selected as the location for the setup of 50 bedded hospital and a BDS college. Following are the outcomes of our research and the location study. DEVRUKH : Geography:
Latitude Lat (DMS)
17.0500 17° 3' 0N
Longitude Long (DMS)
73.6167 73° 37' 0E
Altitude (feet) Altitude (meters)
616 187
Devrukh stands on an open plain or table-land about twelve miles south of Sangameshvar, between Kundi and Amba passes, at the foot of the Sahyadri range and below the fort of Mahipatagad. The headquarters of the taluka was moved from Sangameshvar to Devrukh in 1878. Devrukh lies on the motorable road between Sakharpe at the foot of Amba pass and Sangameshvar. It is healthy, well-wooded and picturesque. The nearest railway station is Kolhapur, 61 miles to the south-east. Vegetables, grocery and cloth are brought from Kolhapur. Demographics :
Nearby airports: Code VARG FR3205 VAKP IATA RTC Name RATNAGIRI KARAD KOLHAPUR Distance 30 Km W 63 Km E 82 Km E
Market Analysis & Competition: ? Private hospitals in Devrukh – Matrumandir General Hospital
2008A44 Page 5
Matrumandir is a registered NGO(R.E. 68) & established in 1954 by Late Smt. Indirabai Halbe. This NGO works in the field of Child Welfare, Women Development & rural development in last 50 year in the area of Ratnagiri & Sindhudurg District. Details of Matrumandir General Hospital : ? No. of beds – 40 ? No. of patients availing services: ? General Consultancy above 50 patients/day ? Rates Charged : ? @ Rs.10/- for services provided by NGO # Medicines are included with consultation fee for patients through NGO and are charged no extra cost. ? @ Rs. 30/- to Rs.100/- by private Kind of Patients visiting this Hospital and the rates they are charged : ? ? ? ? ? Minor OT around 50 patients/month at Rs. 500/- to Rs.1000/? Minor Accident cases ~ 15-20 patients/month. 20 major operations/month at an average of Rs. 5000/- to Rs.10000/Ultrasound machine ~ 70 patients/month at Rs.250/For delivery ~ 30 cases/month at Rs. 1400/No CT scan facility available but provide recommendation to 30-50 patients/month to Ratnagiri. Cost in Ratnagiri at Rs. 1000/- to Rs.1200/-
Major Diseases ? Common Cold ? Fever/ Seasonal Fevers ? Malaria ? Water Bourne diseases ? Accidents mainly related to incident like construction/manufacturing not car/traffic related. Doctors present: ? 3 visiting doctors ? 2 resident doctors ? 2 MD’s, 2 Doctors (MBBS), 1 ONCO present at the hospital on daily basis. ? New eye care facility coming up.
2008A44
Page 6
Facilities available: ? Pathology ? Operation theatre ? X-ray ? Ambulance facility etc. for poor & weaker section of society Courtesy# Dr. Dhar (Resident Doctor) ? Government hospitals in Devrukh ? No. of beds 50 ? No. of in-patients and out-patients every day is between 30-50 ? Facilities available – Basic Facilities required for a General Hospital. ? Other Health related organisations ? 7 NGO’s in Ratnagiri District ? Population: around 22,000 ? Female population: 53% ? Male Population : 47% ? Literacy 65.13% # Approximations: Based on the consensus (2001) of Ratnagiri District Possible disadvantages/risks of location ? Population is very low.
2008A44
Page 7
Infrastructure Requirements
Infrastructural & Functional Requirements: Hospital (50 Beds): The Infrastructural required for Hospital for a BDS college is Pre-specified by the DCI. Minimum immediate requirement for the hospital has been calculated. Few architects were consulted to do the costing part. Infrastructural & Functional Requirements Of 50 Beded Hospital LENGTH WIDTH PARTICULARS BEDS AREA(m2) (mts) (mts) Surgery 8 Beds 12.00 18.00 216.00 Medicine 8 Beds 12.00 18.00 216.00 Gyn. & Obs 8 beds 12.00 18.00 216.00 Paediatric 8 Beds 12.00 18.00 216.00 Dental 4 Beds 9.00 6.00 54.00 ICU 3 Beds 9.00 6.00 54.00 Nephrology 3 Beds 9.00 6.00 54.00 Mis.- ENT + OPD 15.00 24.00 360.00 Radiological (X-Ray) 9.00 15.00 135.00 Pathology 9.00 6.00 54.00 Physiotherapy 9.00 6.00 54.00 Pharmacy 9.00 6.00 54.00 Administrative 9.00 15.00 135.00 Emergency & Trauma 15.00 21.00 315.00 2 16 Operation Theater 9.00 9.00 81.00 Tables 17 Minor Operation Theater 9.00 6.00 54.00 TOTAL 2,268.00 Sl. No. 1 2 3 4 5 6 7 8 9 10 11 13 14 15 TOTAL AREA OF ROOMS 2,268.00
Total Construction reqd. (In Sq. Feet) Rate per sq. ft for construction Cost Of Builtup Can be taken as Electrical & Sanitation as @ 10% TOTAL COST OF Hospital
2008A44
22,413 sq. ft 800 1,79,30,400 17,93,040 1,97,23,440
Page 8
* Area for Toilet, Store, Wash rooms, Corridor, Garden and Parking are assumed and can be changed as per requirement at the site.
Dental College (50 Seats Per Year): Infrastructure & Functional Requirements Of Dental College S.No QT LENGTH( WIDTH( PARTICULARS AREA(M2) . Y. M) M) 1 Administrative block 1 12.50 15.00 187.50 2 Library 1 15.00 28.00 420.00 3 Lecture Halls 4 7.00 11.00 308.00 4 Central Stores 1 4.00 9.00 36.00 5 Maintenance room 1 5.00 11.00 55.00 6 Photography and artist room 1 4.00 6.00 24.00 7 Medical Stores 1 4.00 6.00 24.00 8 Amenities area 1 10.50 18.00 189.00 Compressor and room for gas 9 1 3.50 5.50 19.25 plant 10 Cafeteria 1 7.50 10.00 75.00 11 Examination hall 1 11.00 15.50 170.50 12 Auditorium ( For 400 people) 1 12.50 30.00 375.00 13 Laboratories (Dental Subjects) 1 9.00 12.00 108.00 Pre-clinical Prosthodontics and 14 1 10.00 14.00 140.00 dental material lab 15 Pre-clinical conservative lab 1 10.50 12.00 126.00 Oral biology and oral pathology 16 1 10.50 12.00 126.00 lab Laboratory for orthodontics and 17 1 7.00 11.00 77.00 Pedodontics 18 Laboratories (Medical Subjects) 1 14.00 30.00 420.00 Anatomy dissection hall with 19 storage for cadavers, osteology, 1 10.00 14.00 140.00 demonstration room etc. One laboratory for physiology and pathology and microbiology 20 with stores and preparation 1 10.00 14.00 140.00 rooms for individual subjects attached to it. Laboratory for biochemistry and pharmacology with store and 21 1 10.00 14.00 140.00 preparation rooms separately for both subjects 22 Laboratories (Clinical) 1 9.00 12.00 108.00 23 Prosthodontics 1 10.50 12.00 126.00
2008A44 Page 9
Conservative Dentistry Oral pathology for 25 histopathology Haematology and clinical 26 biochemistry TOTAL TOTAL AREA OF ROOMS Total Construction reqd. (In Sq. Feet) Rate per sq. ft for construction Cost Of Builtup Can be taken as Rs Electrical & Sanitation as @ 8% TOTAL COST OF PROJECT
24
1 1 1
4.00 5.00 3.50
7.00 8.00 6.00
28.00 40.00 21.00 3,623.25 3,623.3 38998 sq.ft 800.0 3,11,98,400 24,95,872 3,36,94,272
Dental Hostel (200 Seated): INFRASTRUCTURAL AND FUNCTIONAL REQUIREMENTS OF 200 SEATED HOSTEL Width S.No. Department Qty. Length (m) (m) Area (m2) 1 4 Beded Rooms 30 5.00 6.00 900.00 2 2 Beded Rooms 25 3.00 4.00 300.00 3 1 Beded Rooms 30 3.00 4.00 360.00 4 Toilet Wings 50 2.00 3.00 300.00 5 Recreation Rooms 3 12.00 21.00 756.00 6 Dining Hall / Mess 2 15.00 24.00 720.00 7 Warden Office / Living 1 5.00 10.00 50.00 TOTAL 3,386.00 TOTAL AREA OF ROOMS Total Construction reqd. (In Sq. Feet) Rate per Sq. ft. Cost Of Builtup Can be taken as Rs Electrical & Sanitation as @ 8% TOTAL COST OF HOSTEL 3,386.0 36447 Sq. Ft 800.0 29157600 23,32,608 3,14,90,208
2008A44
Page 10
Total Expenditure Required on Infrastructure for the Project : Details Hospital College Building Hostel Area (Sq. Feet) 22,413 38,998 36,447 Total Cost of Development 1,97,23,440 3,36,94,272 3,14,90,208 8,49,07,920/-
Requirements As Per Government Guidelines: Hospital Building Requirements: ? Department wise requirement of beds: Department General Ward – Medical including allied specialities General Ward –Surgical including allied specialities Private Ward (A/C & Non A/c) Maternity Ward Paediatric Ward Intensive Care Services (4% of bed strength) Critical Care Services (6% of bed strength) ? Area Requirements (As per Bureau of Indian Standards): Particulars Required Covered Area 20 sq.m./ bed Inpatient Services 40% Outpatient Services 35% Department and supportive services 25% DENTAL COLLEGE BUILDING: ? Total Constructed Area Required: 30,000 sq. ft. ? Staff quarters should be separate from hostel.
No. of Beds 30 30 9 15 6 4 6
Available
2008A44
Page 11
Equipment Requirements
Medical Hospital Equipments (50 bedded hospital) : ? ? ? ? The attached sheet contains the list of all the major equipment required in the hospital with their approximate cost. Apart from these some minor instruments and other medical goods would be required but they form a very small part of the total cost. As it is a scalable model so as and when more beds will be added more equipment will be required. The costs given in the sheet are Approximate and negotiable and not exact because a lot of variability exists between various models of equipments and that from vendor to vendor. Tenders can be floated for equipments required and bids can be invited for the same to get the instruments at effective cost.
?
Hospital equipment cost Price Range Available in market
Dept Medicine Surgery ot
Equipment Nebulizers Ot tables Cautery Anaesthesia gas machine +ventilator Suction Autoclave Monitor Labour room setup
Number Cost 2 2500 2 50000 1
Total Cost
5000 2000-5000 100000 20000-100000 70000 50000-150000 4 LAKHS - 10 600000 LAKHS 7000 7000 1.5 LAKHS-4 200000 LAKHS
1 1 1 1
Gynae
2008A44
50000
Page 12
ICU
Ventilator Defibrilator
1 1
3 LAKHS TO 8 500000 LAKHS 70000 50000-200000 1.5 LAKHS- 3 200000 LAKHS 4 LAKHS- 10 700000 LAKHS NEW FROM 80 LAKHS TO 2 10000000 CRORES REFURBISHED 60 LAKHS 8 LAKHS TO 15 1000000 LAKHS APPROXIMATE 1300000 COST APPROXIMATE 500000 COST APPROXIMATE 500000 COST APPROXIMATE 150000 COST APPROXIMATE 25000 COST
Radiology
X-Ray(Digital) Ultrasound
1 1
CT Scan
1
Nephrology
Dialysis machine
1
Blood Bank Setup Pathology and Biochemistry lab
Semiautoanalyser Blood Gas Machine
1 1
Eye
Slit Lamp
1
Paeds Air Conditioning for surgery ot, icu, labour room
Incubator
1
APPROXIMATE 250000 COST APPROXIMATE 300000 COST Total 1,65,34,000
Generator
2008A44
Page 13
Equipment Dental College: The setup of dental college could be said be done in two phases to reduce the expenditure costs at the initial level. Phase 1 Setup - The Equipment costing as mentioned in the table below is for the Departments (prosthodontics and endodontics) which are required for the first two years of the college, as per DCI guidelines. Because the first two years are Non Clinical 1) 2) 3) 4) PROSTHODONTICS Ceramic and Cast Partial Lab CONSERVATIVE DENTISTRY AND ENDODONTICS Chemical Lab 1. PROSTHODONTICS EQUIPMENT REQ DCI 17 PER UNIT 80,000 TOTAL REFERENCE
Dental Chairs and Units 40 Semi articulator 2 adjustable
1360000
60000-80000(confident) 2lac-5lac(cavo) Hanau) –wide vue 70000 H250000 Whipmix Artex(amangirpach)6080000 height800-2500 gothic arch 8000-15000 8000-15000 1500-3000 10000-20000 10000-20000 30000 5000 2500-20000 2500 8000-15000 10000
2
80,000
160000
Extra oral/intra oral tracer 2 Dewaxing unit5-7 Curing unit5-7 Dental casting machine1 Wax burnout furnace1 Pre heating furnace Surveying unit Heavy duty hand piece Autoclave 2 Needle burner with syringe cutter Plaster Dispenser Model Trimmer with Carborandum Disc
2008A44
2 1 1 1 1 1 1 3 1 1 2 1
2000 11000 11000 3000 15,000 15,000 30,000 5,000 12,000 2,500 12,000 10,000
4000 11000 11000 3000 15000 15000 30000 15000 12000 2500 24000 10000
Page 14
Model Trimmer with Diamond Disc Acrylizer Lathe Flask press Mechanical Press Sand blasting unit5-7000 Ultrasonic cleaner5-7000 Model Trimmer Hot water sterilizer Geyser Heavy duty lathe
1 2 1 4 1 2 1 2 1 1 2
10000 10,000 10,000 200 1000 7000 7000 10000 2500 8000 10000 Total
10000
500/disc
20000 8000-15000 10000 5 TO 15 800 200 1000 1000 14000 7000 20000 2500 8000 20000 17,85,800
2. CERAMIC AND CAST PARTIAL LABORATORY EQUIPMENT Plaster Dispensor Duplicator Pindex System Circular saw Sandblasting machine Model Trimmer with Carborandum disc Model Trimmer with Diamond disc Induction casting machine Heavy duty lathe with suction Preheating furnace Ultrasonic cleaner Micro surveyor PRE-CLINICAL PROSTHETICS LABORATORY REQ DCI 2 1 1 1 1 1 1 1 1 1 1 1 60 PER UNIT 7000 2500 12000 10000 7000 10000 10000 3000 10000 15000 7000 5000 3000 TOTAL 14000 2500 12000 10000 7000 10000 10000 3000 10000 15000 7000 5000 180000 REFERENCE
TOTAL 2,85,500
2008A44 Page 15
3. PLASTER ROOM FOR PRE-CLINICAL WORK Plaster dispenser Lathe Model Timmer Carborandum Disc Diamond disc 2 2 1 1 12000 10000 10000 10000 TOTAL 24000 20000 10000 10000 64,000
2. CONSERVATIVE DENTISTRY AND ENDODONTICS EQUIPMENT Name Dental Chairs and Units Autoclaves Ultrasonic cleaner Needle burner with syringe cutter Plaster dispensers Casting machine Intra-oral X-ray Unit Radiovisiography 17 2 1 3 2 1 1 1 80,000 12000 7000 2500 12000 3000 30,000 200000 TOTAL 1360000 24000 7000 7500 24000 3000 30000 200000 16,55,500 REQ DCI PER UNIT TOTAL REFERENCE Quantity Available 60-80000 2500-20000 5-12000 2500 8-15000
3. CHEMICAL LAB EQUIPMENT Plaster Dispenser Model TrimmerCarborandum disc Diamond disc Heavy Duty Lathe Ultrasonic cleaner Burnout furnace Porcelain furnace Sandblasting Machine
2008A44
REQ PER TOTAL REFERENCE DCI UNIT 2 12000 24000 1 10000 10000
1 1 1 1 1 1
10000 10,000 7000 15000 10000 7000
10000 10000 7000 15000 10000 7000
5-15000 5000 to 7000 10-20000 10000 5000 to 7000
Page 16
Casting machine Motor cast/induction casting preferred
1
3000
3000
TOTAL
96000
Total Expenditure Required For Phase I Set Up Of Dental College = Rs. 38,88,600/-
Phase II Requirements : The following departments will be added second year onwards as these are mandatory third year onwards; approximate costing for them is mentioned below. This is the cost that will be incurred after 2 years of starting the college. This is the list of departments that must be added 2nd year onwards. 1) 2) 3) 4) 5) ORAL PATH AND MICROBIO ORAL & MAXILLOFACIAL SURGERY PERIODONTOLOGY ORTHODONTICS PAEDIATRIC AND PREVENTIVE DENTISTRY (PEDO LAB) 6) ORAL MEDICINE AND RADIOLOGY. 7) PUBLIC HEALTH DENTISTRY
COST PER 1) ORAL PATH AND PROPOSED UNITS UNIT TOTAL MICROBIOLOGY PROPOSED DENTAL CHAIRS 4 80000 320000 MICROSCOPES 10 5000 50000 MISCELLANEOUS EQUIPMENTS 20,000
COST PER 2) ORAL & MAXILLOFACIAL PROPOSED UNITS UNIT TOTAL SURGERY DENTAL CHAIRS 17 80,000 1360000 AUTOCLAVE 1 12,000 12000 ULTRASONIC CLEANER 1 7000 7000 COMPUTER 1 25000 25000 MISCELLANEOUS EQUIPMENTS 20000
2008A44
Page 17
3) PERIODONTOLOGY DENTAL CHAIRS AUTOCLAVE ULTRASONIC CLEANER MISCELLANEOUS EQUIPMENTS
PROPOSED COST PER UNITS UNIT TOTAL 17 80,000 1360000 1 12,000 12000 1 7000 7000 50000
4) ORTHODONTICS DENTAL CHAIRS AUTOCLAVE ULTRASONIC CLEANER MISCELLANEOUS EQUIPMENTS
PROPOSED COST PER UNITS UNIT TOTAL 17 80,000 1360000 1 12,000 12000 1 7000 7000 250000
COST PER 5) PAEDIATRIC AND PROPOSED UNITS UNIT TOTAL PREVENTIVE DENTISTRY DENTAL CHAIRS 10 80,000 800000 AUTOCLAVE 1 12,000 12000 ULTRASONIC CLEANER 1 7000 7000 COMPUTER 1 25000 25000 MISCELLANEOUS EQUIPMENTS 300000 PEDO LAB 70,000
6) ORAL MEDICINE AND PROPOSED COST PER RADIOLOGY. UNITS UNIT TOTAL DENTAL CHAIRS 10 80,000 800000 Panoramic X-Ray with Cephalometric 1 150000 150000 Intra Oral X-ray Unit 1 30000 30000 General X-ray Unit 1 150000 150000 COMPUTERS 2 25000 50000 MISCELLANEOUS EQUIPMENTS 200000
7) PUBLIC HEALTH DENTISTRY DENTAL CHAIRS MOBILE DENTAL VAN
2008A44
PROPOSED UNITS
COST PER UNIT TOTAL 5 80,000 400000 1 800000 800000
Page 18
MISCELLANEOUS EQUIPMENTS TOTAL Expenditure Required for the Phase II set up of Dental College would be = Rs. 72, 66,000/This expenditure is to be incurred after first two years of the Dental college. 7266000
2008A44
Page 19
Governance Plan
The following document contains the governance plan for the whole institute. Management: Chairman and Director Chairman (1): ? ? ? Overall in charge of the whole institution. Owner of the institute, responsible for financing and overall administration of the institution. Looks after the admission process of the management seats
Director (1): ? ? ? ? Administrative In charge of the Institution, To deal with the DCI and other legal requirements with Directorate of Medical education, Maharashtra health department. The conduct of admission test Looks after the admissions from the university side.
DENTAL COLLEGE 1. HEAD OF INSTITUTE (DEAN/PRINCIPAL) (1) Qualification: MDS ? ? ? ? Administration of college and Dental hospital. Responsible for the implementation of academic schedule in the institute Looks after confirmation of DCI norms In charge of dental hospital supplies
2008A44
Page 20
2. Head of the department Qualification: MDS ? ? ? ? ? In charge of the respective department All the staff in the dept. to report to HOD Duty rosters for entire department Implement and design academic schedule Clinical dental work and consultation
# Initially at the time of set up as per requirements two functioning departments are needed: Prosthodontics and Conservative dentistry.
MEDICAL HOSPITAL
1. MEDICAL SUPRITENDENT (1) – Qualification: MBBS/MD ? ? ? ? ? ? ? ? Head of medical hospital. Responsible for ensuring the medical supplies To look after the duties of resident doctors Plans schedules of visiting consultants Ensure adherence to bed occupancy rates as recommended by the DCI Coordinates with the matron and other staff in charges for paramedical to ensure smooth running of hospitals General administration of hospital sanitation, medicine supply, equipment maintenance Plans health camps and programs for publicity of hospital
2. Nursing Supdt. ? To look after staff nurse, ANM and ward boys
Page 21
2008A44
?
In charge of ward maintenance
DEPARTMENTS: (a) Medicine Department ? 2 Specialist Doctors (MD) ? 1 Doctor (MBBS) ? 1 Staff Nurse ? 1 Ward boy (b) Obstetrics & Gynecology ? 1 Specialist Doctor (MD Gynecology) ? 1 Doctor (MBBS) ? 1 staff nurse ? 1 Ward boy (c) Pediatrician ? 1 Specialist Doctor (MD Pediatrics) ? 1 Doctor (MBBS) ? 1 Staff Nurse ? 1 Ward boy (d) Emergency ? 1 Doctor (MBBS) ? Ward boy
(e) Pulmonary Medicine ? 1 Specialist Doctor (MD Respiratory medicine) (f) Radiology
2008A44 Page 22
? 1 Radiologist ? 1 Radiographer
(g) Surgery department ? 2 surgeons MS general surgery with 3 years post MS residency ? 1 Doctor (MBBS) ? 1 staff nurse (h) ENT department ? 1 MS ENT (i) EYE ? 1 MS eye (j) Consultant Anaesthetist - On call from Ratnagiri. (k) Nursing staff ? Nursing head is the matron ? ? ? 4 staff nurse 6 ANM 6 ward boys
(l) Paramedical staff ? 1 Pathologist 1 Lab technician
? 1 Pharmacist
2008A44
Page 23
Operating Cost
Hospital: Estimated Annual Operating Costs Of The Hospital Main Staff Designation Dean Director Medical Superintendent Medical staff General Surgery General Medicine Obstetrics & Gynaecology ENT Paediatrics Anaesthesia Orthopaedics Ophthalmologist Pulmonary Medicine Radiologist GDMO Community Medicine Hospital Administration Emergency Doctors Nursing Staff Matron Sister In charge O.T. Nurses General Nurses Labour Room Nurses 2 2 1 1 1 1 1 1 1 1 1 1 1 3 1 3 2 7 2 35,000 35,000 35,000 35,000 35,000 30,000 40,000 35,000 35,000 40,000 18,000 30,000 20,000 15,000 10,000 7,000 7,000 5,000 6,000 70,000 70,000 35,000 35,000 35,000 30,000 40,000 35,000 35,000 40,000 18,000 30,000 20,000 45,000 10,000 21,000 14,000 35,000 12,000 8,40,000 8,40,000 4,20,000 4,20,000 4,20,000 3,60,000 4,80,000 4,20,000 4,20,000 4,80,000 2,16,000 3,60,000 2,40,000 5,40,000 1,20,000 2,52,000 1,68,000 4,20,000 1,44,000 Required 1 1 1 Salary/person Total Monthly /month expenses 85,000 85,000 60,000 35,000 60,000 35,000 Total Annual expenses 10,20,000 7,20,000 4,20,000
Health Staff Female Health Assistant
2008A44
1
7,000
7,000
84,000
Page 24
Extension Educator Paramedical Staff Lab Technician/Blood Bank Tech ECG Technician Pharmacist Sr. Radiographer CSSD Medical Records Ward boys TOTAL
1 2 1 1 1 1 1 6
7,000 7,000 6,000 7,000 7,000 6,000 8,000 2,500
7,000 14,000 6,000 7,000 7,000 6,000 8,000 15,000
84,000 1,68,000 72,000 84,000 84,000 72,000 96,000 1,80,000 1,06,44,000
SUPPORT STAFF Designation Engineering Staff Civil Mechanical Electrical IT Engineering Aid Other Staff Driver Carpenter Cooks Barber Class IV including chowkiders Gardener Plumber Administrative Staff Office Superintendent Head Clerk Cashier Stenographer UDC LDC TOTAL Required Salary/person Total Monthly expenses 10,000 10,000 10,000 10,000 12,000 9,000 3,000 6,000 2,000 50,000 15,000 2,000 12,000 12,000 10,000 7,000 7,000 12,000 Total Annual expenses 1,20,000 1,20,000 1,20,000 1,20,000 1,44,000 1,08,000 36,000 72,000 24,000 6,00,000 1,80,000 24,000 1,44,000 1,44,000 1,20,000 84,000 84,000 1,44,000 23,88,000
1 1 1 1 2 3 1 2 1 25 3 1 1 1 1 1 1 2
10,000 10,000 10,000 10,000 6,000 3,000 3,000 3,000 2,000 2,000 5,000 2,000 12,000 12,000 10,000 7,000 7,000 6,000
2008A44
Page 25
NOTE: 1. The above requirements of staff are according to the DCI Regulations 2006 *. 2. The DCI regulations cite the staff requirements for a 100 bedded hospital. Since, the current project is a 50 bedded hospital, all the staff requirements have been scaled down appropriately. The management starting the hospital should keep the same in consideration while tying up with another hospital, to have a 100 bed arrangement as per the guidelines for starting a dental college. 3. Dean, Director and Medical Superintendent are not a part of the DCI requirements, but have been included as they are an important part of the organization. 4. * Some extra support staff like ward boys, plumber and gardeners have also been included. Other Estimated Expenses Particulars Total Monthly expenses 50,000 10,000 25,000 3,000 2,000 5,000 20,000 25,000 5,000 20,000 10,000 1,000 15,000 Total Annual expenses 6,00,000 1,20,000 3,00,000 36,000 24,000 60,000 2,40,000 3,00,000 60,000 2,40,000 1,20,000 12,000 1,80,000 22,92,000
Electricity Water Telephone Cleaning Electricals Washing/sterilization Fuel for Ambulance Lab / medical supplies Generator Maintenance – Building Maintenance – Equipment Maintenance – Ambulance Miscellaneous TOTAL
Estimated Total Operating Costs Annually = Rs 1,53,24,000/-
** Note : ? The Expenses considered at the time of calculation of Operating Costs have been approximate estimations of the current market pricing for that particular Work Profile. ? The Salaries of Doctors may vary on case to case basis. ? The Salaries of Support staff are calculated on a generalised salary structure followed by the institutions.
2008A44 Page 26
? The other expenses are rough estimates for the same size of hospitals.
Dental College : Estimated Annual Operating Costs Of The Dental College
Staff Admin Staff Principal Office Superintendent Assistants Receptionist Teaching Staff Professor Reader Lecturers Nursing Staff Nurses Support Staff Librarian Dsa(Chair Side Attendant) Dental Mechanic Dental Hygenist Radiographer Data Entry Operator Lab Technician Total
No. 1 2 4 3 2 2 10 3 1 8 4 3 2 1 2
Salary 80000 10000 8000 4000 60000 35000 10000 6000 7000 3500 4500 4500 6000 3500 5000
Total salary PM 80000 20000 32000 12000 120000 70000 100000 18000 7000 28000 18000 13500 12000 3500 10000 1033000 Total salary PM 12000 15000 8000 40000 75000
Annual 960000 240000 192000 144000 1440000 840000 1000000 216000 84000 336000 216000 162000 144000 42000 120000 12396000
Staff Other Staff Sweepers/Scavengers Security Drivers Peons Total
No. 4 5 2 10
Salary 3000 3000 4000 4000
Annual 144000 180000 96000 480000 900000
1. The above requirements of staff are according to the DCI Regulations 2006 *. 2. These requirements are for a 50 student batch strength.
2008A44
Page 27
3. Engineering staff and some support staff like gardeners, etc are to be shared with the hospital. Other Estimated Expenses Particulars Electricity Telephone Cleaning Lab/medical supplies Diesel Maintanence - Building Maintanence - Bus Maintanence - Equipment Maintanence - Comp Lab Library Costs Staff Quarters /Hostel Maintanence Mess Festivals, Guest Lectures,Etc Comp Lab Net Connection Total Monthly Annual Cost Cost 40000 480000 10000 120000 5000 60000 25000 300000 20000 240000 10000 120000 3000 36000 5000 60000 5000 60000 3000 36000 10000 120000 200000 300000 2132000
136000
Estimated Total Operating Costs = Rs 1,54,28,000/Hence, Cost Incurred Hospital Main Staff Support Staff Other Expenses College Teaching Staff Non-teaching staff Other Expenses Total Amount 10644000 2388000 2292000 12396000 900000 2132000 30752000
Total Annual Estimated Operating Costs for the College as well as Hospital would be ~ Rs. 3,07,52,000/-.
2008A44
Page 28
Cash Flow Projections
Operating income of the Dental College
1st year Source of Income Fees Category Merit Management Total Students Number of Students 30 30 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 3000000 9000000
60
12000000
2nd year Source of Income Fees Category Merit Management Total Students Number of Students 60 60 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 6000000 18000000
120
24000000
3rd Year Source of Income Fees Category Merit Management Total Number of Students 90 90 180 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 9000000 27000000 36000000
2008A44
Page 29
4th Year Source of Income Fees Category Merit Management Total Students Number of Students 120 120 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 12000000 36000000
240
48000000
{ The above figures do not include the Donations accepted. }
If we include the donations and assume that the donation to be Rs. 5 Lac per seat (as per industry rate) then every year the income by fees will go up to: 5,00,000 x 30 = Rs. 1,50,00,000/Therefore, Amt. In first year will be = 1,20,00,000+1,50,00,000= Rs. 2,70,00,000/In second year= 2,40,00,000+1,50,00,000 = Rs. 3,90,00,000/In third year= 3,60,00,000+1,50,00,000 = Rs. 5,10,00,000/In fourth year= 4,80,00,000+1,50,00,000 = Rs.6,30,00,000/-
But here we are going to be conservative and assume that in the first – four years we would not be able to earn the donations and will only charge the management fees. Hence, after four years the income would be same as in the fourth year & would be operating to our maximum strength of student.
2008A44
Page 30
Revenues from the Hospital
Total population of Devrukh = 22000 Expected Number of patients Per month would be = 5% of 22000= 1100
Sources Of Income
Amount charged per patient
Number of Patients Expected per month 1100 100 50 50 30 400 100 10 10 300 80 75 75 75 8 6 4 1
Number Total of days Amount
Registration X-ray Minor operations Admit for 3 days or more CT- SCAN INVESTIGATION ULTRA SOUND MAJOR OPERATIONS GYANECOLOGY SCALING FILLING ROOT CANAL X-RAY COMPLETE DENTURE CROWN BRIDGE MINOR SURGERY MAJOR SURGERIES
30 100 200 400 1400 100 300 3000 1500 50 75 450 50 500 500 500 250 2500
3
33000 10000 10000 60000 42000 40000 30000 30000 15000 15000 6000 33750 3750 37500 4000 3000 1000 2500 376500
Total annual income
4518000
As the annual income of the hospital is not easy to predict as it works more on goodwill and goodwill is been developed over years and the only the income of the hospital would increase.
2008A44
Page 31
Total Revenue Of Hospital & College :
Year 1st Year 2nd Year 3rd Year 4th Year
Income From Hospital & College Rs. 1,65,18,000 Rs. 2,85,18,000 Rs. 4,05,18,000 Rs. 5,25,18,000
(Note these income does not include the Donations to be accepted at the time of admission which according to our calculation account to @ Rs. 1.5 Crores per Year on a conservative note)
As we know Annual Operating Costs for Hospital & college are Rs. 3,07,52,000/OPERATING LOSS / PROFIT for the upcoming years Year 1st Year 2nd Year 3rd Year 4th Year Income 1,65,18,000 2,85,18,000 4,05,18,000 5,25,18,000 Expenditure 3,07,52,000 3,07,52,000 3,07,52,000 3,07,52,000 Profit / Loss -1,42,34,000 - 22,34,000 97,66,000 2,17,66,000
{Note : The shaded portion in yellow colour shows that there is loss incurred for those particular years.} Since the loss for the first couple of years would have to be born therefore working capital would have to be increased by that amount for that couple of years.
2008A44
Page 32
Legal Requirements
The Below mentioned requirements are needed to get the necessary DCI approval. As we are starting with batch strength of 30, these norms will suffice. Approvals from the local district level, regarding the deed of the land, registration of the trust, building authorities, etc along with the necessary approvals from the State health department and the university would be required. The financial and tax formalities will be looked after by the CA in its audited report.
? ? ? ? ?
?
?
? ? ?
Registration of the trust State government permission University Affiliation (initially provisional will do) DCI permission 100 bedded general hospital ? CMO’s permission ? Permission from the issuing authority, In this case department of Health, State Govt. ? For dental hospital, atleast 25 new patients per day must be treated. Faculty standard ? Faculty ID card issued by DCI. ? Faculty strength as per DCI norms. (shown in the operating cost sheet) ? Experience of faculty: Professors should have minimum 8 years experience. Only full time employment to be considered. ? Composition of Lecturers : 25 % MDS & 75 % BDS ? Faculty should be selected as per the norms of the State University Act. Library: ? Journal Mix: International, National, Back volumes ? Seating capacity: Minimum 50% student strength ? List of books as per DCI recommendations (Minimum 3 copies per title) Administrative staff: As per DCI norms. (shown in the operating cost sheet) Dental chairs: ? Minimum requirement 20 Hostel for staff and students
2008A44
Page 33
Infrastructure & Functional Requirements Infrastructure Administrative block Library Lecture Halls – 4 Central Stores Maintenance room Photography and artist room Medical Stores Amenities area Compressor and room for gas plant Cafeteria Examination hall Auditorium (To accommodate at least 400 people) Laboratories (Dental Subjects) Pre-clinical Prosthodontics and dental material lab Pre-clinical conservative lab Oral biology and oral pathology lab Laboratory for orthodontics and Pedodontics 1500 sq. ft. Requirement 2000 sq. ft. 4500 sq. ft. 3200 sq. ft. 400 sq. ft. 600 sq. ft. 250 sq. ft. 250 sq. ft. 2000 sq. ft. 200 sq. ft. 800 sq. ft. 1800 sq. ft.
1300 sq. ft. 1300 sq. ft. 800 sq. ft.
2008A44
Page 34
Laboratories (Medical Subjects) (only for independent dental colleges) Anatomy dissection hall with storage for cadavers, osteology, demonstration room etc. One laboratory for physiology and pathology and microbiology with stores and preparation rooms for individual subjects attached to it. Laboratory for biochemistry and pharmacology with store and preparation rooms separately for both subjects Laboratories (Clinical) Prosthodontics Conservative Dentistry Oral pathology for histopathology Haematology and clinical biochemistry 1300 sq. ft. 300 sq. ft. 400 sq. ft. 200 sq. ft. 4500 sq. ft. 1500 sq. ft.
1500 sq. ft.
1500 sq. ft.
? ? ? ?
Land size: Minimum 5 acres Building should be complete and certified Pollution Control norms fulfilled Bio waste management as per Pollution control board of India
2008A44
Page 35
Tabulated Details of the Required Investment in the 1st year
Details
Amount (In Rupees)
Infrastructure 1. Hospital 2. College Building 3. Hostel 1,97,23,440 3,36,94,272 3,14,90,208
Equipments 1. Hospital 2. College ( Phase I) College (Phase II) 1,65,34,000 38,88,600 72,66,000
Operating Cost 1. Hospital 2. College 1,53,24,000 1,54,28,000
Total Investment
143348520
(Note : This table shows the Investment required in the first year, the revenues accounting to Rs. 1. 65 Crores in the First year have not been reduced from first years expenditure. Reducing Which the Entire Project Cost Would be
Approximately Rs. 12,68,30,520/-
2008A44
Page 36
Expansion Plans (MBBS College)
Highlights of a Medical College: The minimum land requirement: 1. Metro – 5 acres 2. Rural area – 25 acres 300 bedded hospital (up and running at the point of establishment) with 5 functional Departments: 1. Medicine 2. Surgery 3. Orthopaedics 4. Obstetrics 5. Gynaecology and paediatrics The College, at the time of application, should also have the teaching departments: 1. Anatomy 2. Physiology 3. Bio- Chemistry 4. Community Medicine The other requirements like Strength and experience of the Staff goes in the same line as that of the dental and nursing college. Infrastructure requirements should be sufficient for a minimum of 50 students. For further expansion, it is to done according to the slabs prepared according to: MEDICAL COUNCIL OF INDIA NOTIFICATION New Delhi, dated 30th July, 1999
2008A44
Page 37
Following is the detailed plan of the Setup of a Medical College. ELIGIBILITY CRITERIA: The following organisations shall be eligible to apply in Form-1 for permission to set up a medical college, namely :1. A State Government/Union territory; 2. A University; 3. An autonomous body promoted by Central and State Government by or under a Statute for the purpose of medical education; 4. A society registered under the Societies Registration Act, 1860 (21 of 1860) or corresponding Acts in States; or 5. A public religious or charitable trust registered under the Trust Act, 1882 (2 of 1882) or the WAKFS Act, 1954 (29 of 1954). QUALIFYING CRITERIA: The eligible persons shall qualify to apply for permission to establish a medical college if the following conditions are fulfilled :1. that medical education is one of the objectives of the applicant in case the applicant is an autonomous body, registered society or charitable trust. 2. that a suitable single plot of land measuring not less than 25 acres is owned and possessed by the person or is possessed by the applicant by way of 99 years lease for the construction of the college. 3. that Essentiality Certificate in Form 2 regarding No objection of the State Government/Union Territory Administration for the establishment of the proposed medical college at the proposed site and availability of adequate clinical material as per the council regulations, have been obtained by the person from the concerned State Government/ Union Territory Administration. 4. that Consent of affiliation in Form-3 for the proposed medical college has been obtained by the applicant from a University. 5. that the person owns and manages a hospital of not less than 300 beds with necessary infrastructural facilities capable of being developed into a teaching institution in the campus of the proposed medical college. 6. that the person has not admitted students to the proposed medical college.
2008A44 Page 38
7. That the person provides two performance bank guarantees from a Scheduled Commercial Bank valid for a period of five years, in favour of the Medical Council of India, New Delhi, one for a sum of rupees one hundred lakhs (for 50 admissions), rupees one hundred and fifty lakhs (for 100 admissions) and rupees two hundred lakhs (for 150 annual admissions) for the establishment of the medical college and its infrastructural facilities and the second bank guarantee for a sum of rupees 350 lakhs (for 400 beds), rupees 550 lakhs (for 500 beds) and rupees 750 lakhs (for 750 beds) respectively for the establishment of the teaching hospital and its infrastructural facilities : Provided that the above conditions shall not apply to the persons who are State Governments/Union Territories if they give an undertaking to provide funds in their plan budget regularly till the requisite facilities are fully provided as per the time bound programme.
8. Opening of a medical college in hired or rented building shall not be permitted. The
Medical college shall be set up only on the plot of land earmarked for that purpose as indicated.
2008A44
Page 39
References
? ? ? ?
DCI Guidelines for Dental College Set up. MCI Guidelines for Medical College Set up. www.mciindia.com 2001 Indian Census Report
2008A44
Page 40
doc_236253833.pdf
document is to build a scalable and sustainable business model for a 50 bedded Multi Specialty hospital and a Dental College.This business plan is about building a 50 bedded multi speciality hospital along with a BDS College at Ratnagiri (Maharashtra). 1st step was doing the feasibility study of the proposed location. Competitor study and disease pattern analysis along with the socio economic study was also done.
To build a scaleable and sustainable business model for a 50 bedded Multi Specialty hospital and a Dental College.
COE Marketing
MBA program Batch 2008-2010 Semester IV
Dr Vishal Bhatia
2008A44
2008A44
Page 1
Acknowledgement
A research/project is a combined effort of the researcher, his inspiration, the respondents/resources and all those people who contribute directly or indirectly towards the project. And this project is no different in that aspect. First I would like to thank my college for giving me an opportunity to prepare a challenging and interesting business plan like this. Then I would like to thank Dr Harsh Chopra and Mr Abhishek Kamle for their guidance and support throughout this project. I would also like to thank Pratima Ma’am, for she has been such an inspiring and wonderful marketing faculty for the past 2 years, and also Anita Ma’am for her constant help and support. In the end I would like to thank all the doctors, patients and other respondents who have helped me in this research directly or indirectly.
2008A44
Page 2
Table of Contents
Executive Summary .............................................................................................................................. 4 Feasibility Study .................................................................................................................................... 5 Geography:.......................................................................................................................................... 5 Demographics : ................................................................................................................................... 5 Market Analysis & Competition: ......................................................................................................... 5 Infrastructure Requirements ............................................................................................................... 8 Hospital (50 Beds): .............................................................................................................................. 8 Dental College (50 Seats Per Year): ..................................................................................................... 9 Dental Hostel (200 Seated): .............................................................................................................. 10 Equipment Requirements .................................................................................................................. 12 Medical Hospital Equipments (50 bedded hospital) : ..................................................................... 12 Equipment Dental College: ............................................................................................................... 14 Governance Plan ................................................................................................................................. 20 DENTAL COLLEGE .............................................................................................................................. 20 MEDICAL HOSPITAL ........................................................................................................................... 21 DEPARTMENTS: ................................................................................................................................. 22 Operating Cost .................................................................................................................................... 24 Hospital: Estimated Annual Operating Costs Of The Hospital .......................................................... 24 Dental College : ................................................................................................................................. 27 Cash Flow Projections ........................................................................................................................ 29 Legal Requirements ............................................................................................................................ 33 Expansion Plans (MBBS College)...................................................................................................... 37 ELIGIBILITY CRITERIA: ........................................................................................................................ 38 QUALIFYING CRITERIA: ...................................................................................................................... 38 References ............................................................................................................................................ 40
2008A44
Page 3
Executive Summary
This business plan is about building a 50 bedded multi speciality hospital along with a BDS College at Ratnagiri (Maharashtra). 1st step was doing the feasibility study of the proposed location. Competitor study and disease pattern analysis along with the socio economic study was done. Infrastructure requirement (excluding land) came out to be 2 crore for Hospital, 3.37 crore for Dental College and 3.14 crore for Hostel, totalling to 8.5 crores. Equipment cost for medical college is 1.65 crores and for dental college is 39 lakhs. Equipment cost was estimated taking into account that no super speciality interventions would be done in the hospital as it is assumed to be a secondary care facility.
Operating cost for the medical hospital and dental college was calculated separately. For the hospital and college a governance plan was made to estimate medical staffing requirements. After taking each possible expenditure into account the operating cost for hospital came out to be 1.5 crores annually. For the dental college also, annual operating cost came out to be 1.5 crores. So the total operating cost came out to be 3 crores annually.
In the end cash flow projections were done to estimate the breakeven point. These were done taking into mind that in the first few years only 30 students will be given admission in dental college. Then over the time seats can be increased up to 100 with approval from DCI. Positive cash flow was reached in the 3rd year of operation. Also the legal requirements of MCI and DCI are given at the end for reference.
2008A44
Page 4
Feasibility Study
As per the requirements Devrukh (Ratnagiri) is selected as the location for the setup of 50 bedded hospital and a BDS college. Following are the outcomes of our research and the location study. DEVRUKH : Geography:
Latitude Lat (DMS)
17.0500 17° 3' 0N
Longitude Long (DMS)
73.6167 73° 37' 0E
Altitude (feet) Altitude (meters)
616 187
Devrukh stands on an open plain or table-land about twelve miles south of Sangameshvar, between Kundi and Amba passes, at the foot of the Sahyadri range and below the fort of Mahipatagad. The headquarters of the taluka was moved from Sangameshvar to Devrukh in 1878. Devrukh lies on the motorable road between Sakharpe at the foot of Amba pass and Sangameshvar. It is healthy, well-wooded and picturesque. The nearest railway station is Kolhapur, 61 miles to the south-east. Vegetables, grocery and cloth are brought from Kolhapur. Demographics :
Nearby airports: Code VARG FR3205 VAKP IATA RTC Name RATNAGIRI KARAD KOLHAPUR Distance 30 Km W 63 Km E 82 Km E
Market Analysis & Competition: ? Private hospitals in Devrukh – Matrumandir General Hospital
2008A44 Page 5
Matrumandir is a registered NGO(R.E. 68) & established in 1954 by Late Smt. Indirabai Halbe. This NGO works in the field of Child Welfare, Women Development & rural development in last 50 year in the area of Ratnagiri & Sindhudurg District. Details of Matrumandir General Hospital : ? No. of beds – 40 ? No. of patients availing services: ? General Consultancy above 50 patients/day ? Rates Charged : ? @ Rs.10/- for services provided by NGO # Medicines are included with consultation fee for patients through NGO and are charged no extra cost. ? @ Rs. 30/- to Rs.100/- by private Kind of Patients visiting this Hospital and the rates they are charged : ? ? ? ? ? Minor OT around 50 patients/month at Rs. 500/- to Rs.1000/? Minor Accident cases ~ 15-20 patients/month. 20 major operations/month at an average of Rs. 5000/- to Rs.10000/Ultrasound machine ~ 70 patients/month at Rs.250/For delivery ~ 30 cases/month at Rs. 1400/No CT scan facility available but provide recommendation to 30-50 patients/month to Ratnagiri. Cost in Ratnagiri at Rs. 1000/- to Rs.1200/-
Major Diseases ? Common Cold ? Fever/ Seasonal Fevers ? Malaria ? Water Bourne diseases ? Accidents mainly related to incident like construction/manufacturing not car/traffic related. Doctors present: ? 3 visiting doctors ? 2 resident doctors ? 2 MD’s, 2 Doctors (MBBS), 1 ONCO present at the hospital on daily basis. ? New eye care facility coming up.
2008A44
Page 6
Facilities available: ? Pathology ? Operation theatre ? X-ray ? Ambulance facility etc. for poor & weaker section of society Courtesy# Dr. Dhar (Resident Doctor) ? Government hospitals in Devrukh ? No. of beds 50 ? No. of in-patients and out-patients every day is between 30-50 ? Facilities available – Basic Facilities required for a General Hospital. ? Other Health related organisations ? 7 NGO’s in Ratnagiri District ? Population: around 22,000 ? Female population: 53% ? Male Population : 47% ? Literacy 65.13% # Approximations: Based on the consensus (2001) of Ratnagiri District Possible disadvantages/risks of location ? Population is very low.
2008A44
Page 7
Infrastructure Requirements
Infrastructural & Functional Requirements: Hospital (50 Beds): The Infrastructural required for Hospital for a BDS college is Pre-specified by the DCI. Minimum immediate requirement for the hospital has been calculated. Few architects were consulted to do the costing part. Infrastructural & Functional Requirements Of 50 Beded Hospital LENGTH WIDTH PARTICULARS BEDS AREA(m2) (mts) (mts) Surgery 8 Beds 12.00 18.00 216.00 Medicine 8 Beds 12.00 18.00 216.00 Gyn. & Obs 8 beds 12.00 18.00 216.00 Paediatric 8 Beds 12.00 18.00 216.00 Dental 4 Beds 9.00 6.00 54.00 ICU 3 Beds 9.00 6.00 54.00 Nephrology 3 Beds 9.00 6.00 54.00 Mis.- ENT + OPD 15.00 24.00 360.00 Radiological (X-Ray) 9.00 15.00 135.00 Pathology 9.00 6.00 54.00 Physiotherapy 9.00 6.00 54.00 Pharmacy 9.00 6.00 54.00 Administrative 9.00 15.00 135.00 Emergency & Trauma 15.00 21.00 315.00 2 16 Operation Theater 9.00 9.00 81.00 Tables 17 Minor Operation Theater 9.00 6.00 54.00 TOTAL 2,268.00 Sl. No. 1 2 3 4 5 6 7 8 9 10 11 13 14 15 TOTAL AREA OF ROOMS 2,268.00
Total Construction reqd. (In Sq. Feet) Rate per sq. ft for construction Cost Of Builtup Can be taken as Electrical & Sanitation as @ 10% TOTAL COST OF Hospital
2008A44
22,413 sq. ft 800 1,79,30,400 17,93,040 1,97,23,440
Page 8
* Area for Toilet, Store, Wash rooms, Corridor, Garden and Parking are assumed and can be changed as per requirement at the site.
Dental College (50 Seats Per Year): Infrastructure & Functional Requirements Of Dental College S.No QT LENGTH( WIDTH( PARTICULARS AREA(M2) . Y. M) M) 1 Administrative block 1 12.50 15.00 187.50 2 Library 1 15.00 28.00 420.00 3 Lecture Halls 4 7.00 11.00 308.00 4 Central Stores 1 4.00 9.00 36.00 5 Maintenance room 1 5.00 11.00 55.00 6 Photography and artist room 1 4.00 6.00 24.00 7 Medical Stores 1 4.00 6.00 24.00 8 Amenities area 1 10.50 18.00 189.00 Compressor and room for gas 9 1 3.50 5.50 19.25 plant 10 Cafeteria 1 7.50 10.00 75.00 11 Examination hall 1 11.00 15.50 170.50 12 Auditorium ( For 400 people) 1 12.50 30.00 375.00 13 Laboratories (Dental Subjects) 1 9.00 12.00 108.00 Pre-clinical Prosthodontics and 14 1 10.00 14.00 140.00 dental material lab 15 Pre-clinical conservative lab 1 10.50 12.00 126.00 Oral biology and oral pathology 16 1 10.50 12.00 126.00 lab Laboratory for orthodontics and 17 1 7.00 11.00 77.00 Pedodontics 18 Laboratories (Medical Subjects) 1 14.00 30.00 420.00 Anatomy dissection hall with 19 storage for cadavers, osteology, 1 10.00 14.00 140.00 demonstration room etc. One laboratory for physiology and pathology and microbiology 20 with stores and preparation 1 10.00 14.00 140.00 rooms for individual subjects attached to it. Laboratory for biochemistry and pharmacology with store and 21 1 10.00 14.00 140.00 preparation rooms separately for both subjects 22 Laboratories (Clinical) 1 9.00 12.00 108.00 23 Prosthodontics 1 10.50 12.00 126.00
2008A44 Page 9
Conservative Dentistry Oral pathology for 25 histopathology Haematology and clinical 26 biochemistry TOTAL TOTAL AREA OF ROOMS Total Construction reqd. (In Sq. Feet) Rate per sq. ft for construction Cost Of Builtup Can be taken as Rs Electrical & Sanitation as @ 8% TOTAL COST OF PROJECT
24
1 1 1
4.00 5.00 3.50
7.00 8.00 6.00
28.00 40.00 21.00 3,623.25 3,623.3 38998 sq.ft 800.0 3,11,98,400 24,95,872 3,36,94,272
Dental Hostel (200 Seated): INFRASTRUCTURAL AND FUNCTIONAL REQUIREMENTS OF 200 SEATED HOSTEL Width S.No. Department Qty. Length (m) (m) Area (m2) 1 4 Beded Rooms 30 5.00 6.00 900.00 2 2 Beded Rooms 25 3.00 4.00 300.00 3 1 Beded Rooms 30 3.00 4.00 360.00 4 Toilet Wings 50 2.00 3.00 300.00 5 Recreation Rooms 3 12.00 21.00 756.00 6 Dining Hall / Mess 2 15.00 24.00 720.00 7 Warden Office / Living 1 5.00 10.00 50.00 TOTAL 3,386.00 TOTAL AREA OF ROOMS Total Construction reqd. (In Sq. Feet) Rate per Sq. ft. Cost Of Builtup Can be taken as Rs Electrical & Sanitation as @ 8% TOTAL COST OF HOSTEL 3,386.0 36447 Sq. Ft 800.0 29157600 23,32,608 3,14,90,208
2008A44
Page 10
Total Expenditure Required on Infrastructure for the Project : Details Hospital College Building Hostel Area (Sq. Feet) 22,413 38,998 36,447 Total Cost of Development 1,97,23,440 3,36,94,272 3,14,90,208 8,49,07,920/-
Requirements As Per Government Guidelines: Hospital Building Requirements: ? Department wise requirement of beds: Department General Ward – Medical including allied specialities General Ward –Surgical including allied specialities Private Ward (A/C & Non A/c) Maternity Ward Paediatric Ward Intensive Care Services (4% of bed strength) Critical Care Services (6% of bed strength) ? Area Requirements (As per Bureau of Indian Standards): Particulars Required Covered Area 20 sq.m./ bed Inpatient Services 40% Outpatient Services 35% Department and supportive services 25% DENTAL COLLEGE BUILDING: ? Total Constructed Area Required: 30,000 sq. ft. ? Staff quarters should be separate from hostel.
No. of Beds 30 30 9 15 6 4 6
Available
2008A44
Page 11
Equipment Requirements
Medical Hospital Equipments (50 bedded hospital) : ? ? ? ? The attached sheet contains the list of all the major equipment required in the hospital with their approximate cost. Apart from these some minor instruments and other medical goods would be required but they form a very small part of the total cost. As it is a scalable model so as and when more beds will be added more equipment will be required. The costs given in the sheet are Approximate and negotiable and not exact because a lot of variability exists between various models of equipments and that from vendor to vendor. Tenders can be floated for equipments required and bids can be invited for the same to get the instruments at effective cost.
?
Hospital equipment cost Price Range Available in market
Dept Medicine Surgery ot
Equipment Nebulizers Ot tables Cautery Anaesthesia gas machine +ventilator Suction Autoclave Monitor Labour room setup
Number Cost 2 2500 2 50000 1
Total Cost
5000 2000-5000 100000 20000-100000 70000 50000-150000 4 LAKHS - 10 600000 LAKHS 7000 7000 1.5 LAKHS-4 200000 LAKHS
1 1 1 1
Gynae
2008A44
50000
Page 12
ICU
Ventilator Defibrilator
1 1
3 LAKHS TO 8 500000 LAKHS 70000 50000-200000 1.5 LAKHS- 3 200000 LAKHS 4 LAKHS- 10 700000 LAKHS NEW FROM 80 LAKHS TO 2 10000000 CRORES REFURBISHED 60 LAKHS 8 LAKHS TO 15 1000000 LAKHS APPROXIMATE 1300000 COST APPROXIMATE 500000 COST APPROXIMATE 500000 COST APPROXIMATE 150000 COST APPROXIMATE 25000 COST
Radiology
X-Ray(Digital) Ultrasound
1 1
CT Scan
1
Nephrology
Dialysis machine
1
Blood Bank Setup Pathology and Biochemistry lab
Semiautoanalyser Blood Gas Machine
1 1
Eye
Slit Lamp
1
Paeds Air Conditioning for surgery ot, icu, labour room
Incubator
1
APPROXIMATE 250000 COST APPROXIMATE 300000 COST Total 1,65,34,000
Generator
2008A44
Page 13
Equipment Dental College: The setup of dental college could be said be done in two phases to reduce the expenditure costs at the initial level. Phase 1 Setup - The Equipment costing as mentioned in the table below is for the Departments (prosthodontics and endodontics) which are required for the first two years of the college, as per DCI guidelines. Because the first two years are Non Clinical 1) 2) 3) 4) PROSTHODONTICS Ceramic and Cast Partial Lab CONSERVATIVE DENTISTRY AND ENDODONTICS Chemical Lab 1. PROSTHODONTICS EQUIPMENT REQ DCI 17 PER UNIT 80,000 TOTAL REFERENCE
Dental Chairs and Units 40 Semi articulator 2 adjustable
1360000
60000-80000(confident) 2lac-5lac(cavo) Hanau) –wide vue 70000 H250000 Whipmix Artex(amangirpach)6080000 height800-2500 gothic arch 8000-15000 8000-15000 1500-3000 10000-20000 10000-20000 30000 5000 2500-20000 2500 8000-15000 10000
2
80,000
160000
Extra oral/intra oral tracer 2 Dewaxing unit5-7 Curing unit5-7 Dental casting machine1 Wax burnout furnace1 Pre heating furnace Surveying unit Heavy duty hand piece Autoclave 2 Needle burner with syringe cutter Plaster Dispenser Model Trimmer with Carborandum Disc
2008A44
2 1 1 1 1 1 1 3 1 1 2 1
2000 11000 11000 3000 15,000 15,000 30,000 5,000 12,000 2,500 12,000 10,000
4000 11000 11000 3000 15000 15000 30000 15000 12000 2500 24000 10000
Page 14
Model Trimmer with Diamond Disc Acrylizer Lathe Flask press Mechanical Press Sand blasting unit5-7000 Ultrasonic cleaner5-7000 Model Trimmer Hot water sterilizer Geyser Heavy duty lathe
1 2 1 4 1 2 1 2 1 1 2
10000 10,000 10,000 200 1000 7000 7000 10000 2500 8000 10000 Total
10000
500/disc
20000 8000-15000 10000 5 TO 15 800 200 1000 1000 14000 7000 20000 2500 8000 20000 17,85,800
2. CERAMIC AND CAST PARTIAL LABORATORY EQUIPMENT Plaster Dispensor Duplicator Pindex System Circular saw Sandblasting machine Model Trimmer with Carborandum disc Model Trimmer with Diamond disc Induction casting machine Heavy duty lathe with suction Preheating furnace Ultrasonic cleaner Micro surveyor PRE-CLINICAL PROSTHETICS LABORATORY REQ DCI 2 1 1 1 1 1 1 1 1 1 1 1 60 PER UNIT 7000 2500 12000 10000 7000 10000 10000 3000 10000 15000 7000 5000 3000 TOTAL 14000 2500 12000 10000 7000 10000 10000 3000 10000 15000 7000 5000 180000 REFERENCE
TOTAL 2,85,500
2008A44 Page 15
3. PLASTER ROOM FOR PRE-CLINICAL WORK Plaster dispenser Lathe Model Timmer Carborandum Disc Diamond disc 2 2 1 1 12000 10000 10000 10000 TOTAL 24000 20000 10000 10000 64,000
2. CONSERVATIVE DENTISTRY AND ENDODONTICS EQUIPMENT Name Dental Chairs and Units Autoclaves Ultrasonic cleaner Needle burner with syringe cutter Plaster dispensers Casting machine Intra-oral X-ray Unit Radiovisiography 17 2 1 3 2 1 1 1 80,000 12000 7000 2500 12000 3000 30,000 200000 TOTAL 1360000 24000 7000 7500 24000 3000 30000 200000 16,55,500 REQ DCI PER UNIT TOTAL REFERENCE Quantity Available 60-80000 2500-20000 5-12000 2500 8-15000
3. CHEMICAL LAB EQUIPMENT Plaster Dispenser Model TrimmerCarborandum disc Diamond disc Heavy Duty Lathe Ultrasonic cleaner Burnout furnace Porcelain furnace Sandblasting Machine
2008A44
REQ PER TOTAL REFERENCE DCI UNIT 2 12000 24000 1 10000 10000
1 1 1 1 1 1
10000 10,000 7000 15000 10000 7000
10000 10000 7000 15000 10000 7000
5-15000 5000 to 7000 10-20000 10000 5000 to 7000
Page 16
Casting machine Motor cast/induction casting preferred
1
3000
3000
TOTAL
96000
Total Expenditure Required For Phase I Set Up Of Dental College = Rs. 38,88,600/-
Phase II Requirements : The following departments will be added second year onwards as these are mandatory third year onwards; approximate costing for them is mentioned below. This is the cost that will be incurred after 2 years of starting the college. This is the list of departments that must be added 2nd year onwards. 1) 2) 3) 4) 5) ORAL PATH AND MICROBIO ORAL & MAXILLOFACIAL SURGERY PERIODONTOLOGY ORTHODONTICS PAEDIATRIC AND PREVENTIVE DENTISTRY (PEDO LAB) 6) ORAL MEDICINE AND RADIOLOGY. 7) PUBLIC HEALTH DENTISTRY
COST PER 1) ORAL PATH AND PROPOSED UNITS UNIT TOTAL MICROBIOLOGY PROPOSED DENTAL CHAIRS 4 80000 320000 MICROSCOPES 10 5000 50000 MISCELLANEOUS EQUIPMENTS 20,000
COST PER 2) ORAL & MAXILLOFACIAL PROPOSED UNITS UNIT TOTAL SURGERY DENTAL CHAIRS 17 80,000 1360000 AUTOCLAVE 1 12,000 12000 ULTRASONIC CLEANER 1 7000 7000 COMPUTER 1 25000 25000 MISCELLANEOUS EQUIPMENTS 20000
2008A44
Page 17
3) PERIODONTOLOGY DENTAL CHAIRS AUTOCLAVE ULTRASONIC CLEANER MISCELLANEOUS EQUIPMENTS
PROPOSED COST PER UNITS UNIT TOTAL 17 80,000 1360000 1 12,000 12000 1 7000 7000 50000
4) ORTHODONTICS DENTAL CHAIRS AUTOCLAVE ULTRASONIC CLEANER MISCELLANEOUS EQUIPMENTS
PROPOSED COST PER UNITS UNIT TOTAL 17 80,000 1360000 1 12,000 12000 1 7000 7000 250000
COST PER 5) PAEDIATRIC AND PROPOSED UNITS UNIT TOTAL PREVENTIVE DENTISTRY DENTAL CHAIRS 10 80,000 800000 AUTOCLAVE 1 12,000 12000 ULTRASONIC CLEANER 1 7000 7000 COMPUTER 1 25000 25000 MISCELLANEOUS EQUIPMENTS 300000 PEDO LAB 70,000
6) ORAL MEDICINE AND PROPOSED COST PER RADIOLOGY. UNITS UNIT TOTAL DENTAL CHAIRS 10 80,000 800000 Panoramic X-Ray with Cephalometric 1 150000 150000 Intra Oral X-ray Unit 1 30000 30000 General X-ray Unit 1 150000 150000 COMPUTERS 2 25000 50000 MISCELLANEOUS EQUIPMENTS 200000
7) PUBLIC HEALTH DENTISTRY DENTAL CHAIRS MOBILE DENTAL VAN
2008A44
PROPOSED UNITS
COST PER UNIT TOTAL 5 80,000 400000 1 800000 800000
Page 18
MISCELLANEOUS EQUIPMENTS TOTAL Expenditure Required for the Phase II set up of Dental College would be = Rs. 72, 66,000/This expenditure is to be incurred after first two years of the Dental college. 7266000
2008A44
Page 19
Governance Plan
The following document contains the governance plan for the whole institute. Management: Chairman and Director Chairman (1): ? ? ? Overall in charge of the whole institution. Owner of the institute, responsible for financing and overall administration of the institution. Looks after the admission process of the management seats
Director (1): ? ? ? ? Administrative In charge of the Institution, To deal with the DCI and other legal requirements with Directorate of Medical education, Maharashtra health department. The conduct of admission test Looks after the admissions from the university side.
DENTAL COLLEGE 1. HEAD OF INSTITUTE (DEAN/PRINCIPAL) (1) Qualification: MDS ? ? ? ? Administration of college and Dental hospital. Responsible for the implementation of academic schedule in the institute Looks after confirmation of DCI norms In charge of dental hospital supplies
2008A44
Page 20
2. Head of the department Qualification: MDS ? ? ? ? ? In charge of the respective department All the staff in the dept. to report to HOD Duty rosters for entire department Implement and design academic schedule Clinical dental work and consultation
# Initially at the time of set up as per requirements two functioning departments are needed: Prosthodontics and Conservative dentistry.
MEDICAL HOSPITAL
1. MEDICAL SUPRITENDENT (1) – Qualification: MBBS/MD ? ? ? ? ? ? ? ? Head of medical hospital. Responsible for ensuring the medical supplies To look after the duties of resident doctors Plans schedules of visiting consultants Ensure adherence to bed occupancy rates as recommended by the DCI Coordinates with the matron and other staff in charges for paramedical to ensure smooth running of hospitals General administration of hospital sanitation, medicine supply, equipment maintenance Plans health camps and programs for publicity of hospital
2. Nursing Supdt. ? To look after staff nurse, ANM and ward boys
Page 21
2008A44
?
In charge of ward maintenance
DEPARTMENTS: (a) Medicine Department ? 2 Specialist Doctors (MD) ? 1 Doctor (MBBS) ? 1 Staff Nurse ? 1 Ward boy (b) Obstetrics & Gynecology ? 1 Specialist Doctor (MD Gynecology) ? 1 Doctor (MBBS) ? 1 staff nurse ? 1 Ward boy (c) Pediatrician ? 1 Specialist Doctor (MD Pediatrics) ? 1 Doctor (MBBS) ? 1 Staff Nurse ? 1 Ward boy (d) Emergency ? 1 Doctor (MBBS) ? Ward boy
(e) Pulmonary Medicine ? 1 Specialist Doctor (MD Respiratory medicine) (f) Radiology
2008A44 Page 22
? 1 Radiologist ? 1 Radiographer
(g) Surgery department ? 2 surgeons MS general surgery with 3 years post MS residency ? 1 Doctor (MBBS) ? 1 staff nurse (h) ENT department ? 1 MS ENT (i) EYE ? 1 MS eye (j) Consultant Anaesthetist - On call from Ratnagiri. (k) Nursing staff ? Nursing head is the matron ? ? ? 4 staff nurse 6 ANM 6 ward boys
(l) Paramedical staff ? 1 Pathologist 1 Lab technician
? 1 Pharmacist
2008A44
Page 23
Operating Cost
Hospital: Estimated Annual Operating Costs Of The Hospital Main Staff Designation Dean Director Medical Superintendent Medical staff General Surgery General Medicine Obstetrics & Gynaecology ENT Paediatrics Anaesthesia Orthopaedics Ophthalmologist Pulmonary Medicine Radiologist GDMO Community Medicine Hospital Administration Emergency Doctors Nursing Staff Matron Sister In charge O.T. Nurses General Nurses Labour Room Nurses 2 2 1 1 1 1 1 1 1 1 1 1 1 3 1 3 2 7 2 35,000 35,000 35,000 35,000 35,000 30,000 40,000 35,000 35,000 40,000 18,000 30,000 20,000 15,000 10,000 7,000 7,000 5,000 6,000 70,000 70,000 35,000 35,000 35,000 30,000 40,000 35,000 35,000 40,000 18,000 30,000 20,000 45,000 10,000 21,000 14,000 35,000 12,000 8,40,000 8,40,000 4,20,000 4,20,000 4,20,000 3,60,000 4,80,000 4,20,000 4,20,000 4,80,000 2,16,000 3,60,000 2,40,000 5,40,000 1,20,000 2,52,000 1,68,000 4,20,000 1,44,000 Required 1 1 1 Salary/person Total Monthly /month expenses 85,000 85,000 60,000 35,000 60,000 35,000 Total Annual expenses 10,20,000 7,20,000 4,20,000
Health Staff Female Health Assistant
2008A44
1
7,000
7,000
84,000
Page 24
Extension Educator Paramedical Staff Lab Technician/Blood Bank Tech ECG Technician Pharmacist Sr. Radiographer CSSD Medical Records Ward boys TOTAL
1 2 1 1 1 1 1 6
7,000 7,000 6,000 7,000 7,000 6,000 8,000 2,500
7,000 14,000 6,000 7,000 7,000 6,000 8,000 15,000
84,000 1,68,000 72,000 84,000 84,000 72,000 96,000 1,80,000 1,06,44,000
SUPPORT STAFF Designation Engineering Staff Civil Mechanical Electrical IT Engineering Aid Other Staff Driver Carpenter Cooks Barber Class IV including chowkiders Gardener Plumber Administrative Staff Office Superintendent Head Clerk Cashier Stenographer UDC LDC TOTAL Required Salary/person Total Monthly expenses 10,000 10,000 10,000 10,000 12,000 9,000 3,000 6,000 2,000 50,000 15,000 2,000 12,000 12,000 10,000 7,000 7,000 12,000 Total Annual expenses 1,20,000 1,20,000 1,20,000 1,20,000 1,44,000 1,08,000 36,000 72,000 24,000 6,00,000 1,80,000 24,000 1,44,000 1,44,000 1,20,000 84,000 84,000 1,44,000 23,88,000
1 1 1 1 2 3 1 2 1 25 3 1 1 1 1 1 1 2
10,000 10,000 10,000 10,000 6,000 3,000 3,000 3,000 2,000 2,000 5,000 2,000 12,000 12,000 10,000 7,000 7,000 6,000
2008A44
Page 25
NOTE: 1. The above requirements of staff are according to the DCI Regulations 2006 *. 2. The DCI regulations cite the staff requirements for a 100 bedded hospital. Since, the current project is a 50 bedded hospital, all the staff requirements have been scaled down appropriately. The management starting the hospital should keep the same in consideration while tying up with another hospital, to have a 100 bed arrangement as per the guidelines for starting a dental college. 3. Dean, Director and Medical Superintendent are not a part of the DCI requirements, but have been included as they are an important part of the organization. 4. * Some extra support staff like ward boys, plumber and gardeners have also been included. Other Estimated Expenses Particulars Total Monthly expenses 50,000 10,000 25,000 3,000 2,000 5,000 20,000 25,000 5,000 20,000 10,000 1,000 15,000 Total Annual expenses 6,00,000 1,20,000 3,00,000 36,000 24,000 60,000 2,40,000 3,00,000 60,000 2,40,000 1,20,000 12,000 1,80,000 22,92,000
Electricity Water Telephone Cleaning Electricals Washing/sterilization Fuel for Ambulance Lab / medical supplies Generator Maintenance – Building Maintenance – Equipment Maintenance – Ambulance Miscellaneous TOTAL
Estimated Total Operating Costs Annually = Rs 1,53,24,000/-
** Note : ? The Expenses considered at the time of calculation of Operating Costs have been approximate estimations of the current market pricing for that particular Work Profile. ? The Salaries of Doctors may vary on case to case basis. ? The Salaries of Support staff are calculated on a generalised salary structure followed by the institutions.
2008A44 Page 26
? The other expenses are rough estimates for the same size of hospitals.
Dental College : Estimated Annual Operating Costs Of The Dental College
Staff Admin Staff Principal Office Superintendent Assistants Receptionist Teaching Staff Professor Reader Lecturers Nursing Staff Nurses Support Staff Librarian Dsa(Chair Side Attendant) Dental Mechanic Dental Hygenist Radiographer Data Entry Operator Lab Technician Total
No. 1 2 4 3 2 2 10 3 1 8 4 3 2 1 2
Salary 80000 10000 8000 4000 60000 35000 10000 6000 7000 3500 4500 4500 6000 3500 5000
Total salary PM 80000 20000 32000 12000 120000 70000 100000 18000 7000 28000 18000 13500 12000 3500 10000 1033000 Total salary PM 12000 15000 8000 40000 75000
Annual 960000 240000 192000 144000 1440000 840000 1000000 216000 84000 336000 216000 162000 144000 42000 120000 12396000
Staff Other Staff Sweepers/Scavengers Security Drivers Peons Total
No. 4 5 2 10
Salary 3000 3000 4000 4000
Annual 144000 180000 96000 480000 900000
1. The above requirements of staff are according to the DCI Regulations 2006 *. 2. These requirements are for a 50 student batch strength.
2008A44
Page 27
3. Engineering staff and some support staff like gardeners, etc are to be shared with the hospital. Other Estimated Expenses Particulars Electricity Telephone Cleaning Lab/medical supplies Diesel Maintanence - Building Maintanence - Bus Maintanence - Equipment Maintanence - Comp Lab Library Costs Staff Quarters /Hostel Maintanence Mess Festivals, Guest Lectures,Etc Comp Lab Net Connection Total Monthly Annual Cost Cost 40000 480000 10000 120000 5000 60000 25000 300000 20000 240000 10000 120000 3000 36000 5000 60000 5000 60000 3000 36000 10000 120000 200000 300000 2132000
136000
Estimated Total Operating Costs = Rs 1,54,28,000/Hence, Cost Incurred Hospital Main Staff Support Staff Other Expenses College Teaching Staff Non-teaching staff Other Expenses Total Amount 10644000 2388000 2292000 12396000 900000 2132000 30752000
Total Annual Estimated Operating Costs for the College as well as Hospital would be ~ Rs. 3,07,52,000/-.
2008A44
Page 28
Cash Flow Projections
Operating income of the Dental College
1st year Source of Income Fees Category Merit Management Total Students Number of Students 30 30 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 3000000 9000000
60
12000000
2nd year Source of Income Fees Category Merit Management Total Students Number of Students 60 60 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 6000000 18000000
120
24000000
3rd Year Source of Income Fees Category Merit Management Total Number of Students 90 90 180 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 9000000 27000000 36000000
2008A44
Page 29
4th Year Source of Income Fees Category Merit Management Total Students Number of Students 120 120 Amount / Student 1,00,000 3,00,000 Total Amount ( In Rupees) 12000000 36000000
240
48000000
{ The above figures do not include the Donations accepted. }
If we include the donations and assume that the donation to be Rs. 5 Lac per seat (as per industry rate) then every year the income by fees will go up to: 5,00,000 x 30 = Rs. 1,50,00,000/Therefore, Amt. In first year will be = 1,20,00,000+1,50,00,000= Rs. 2,70,00,000/In second year= 2,40,00,000+1,50,00,000 = Rs. 3,90,00,000/In third year= 3,60,00,000+1,50,00,000 = Rs. 5,10,00,000/In fourth year= 4,80,00,000+1,50,00,000 = Rs.6,30,00,000/-
But here we are going to be conservative and assume that in the first – four years we would not be able to earn the donations and will only charge the management fees. Hence, after four years the income would be same as in the fourth year & would be operating to our maximum strength of student.
2008A44
Page 30
Revenues from the Hospital
Total population of Devrukh = 22000 Expected Number of patients Per month would be = 5% of 22000= 1100
Sources Of Income
Amount charged per patient
Number of Patients Expected per month 1100 100 50 50 30 400 100 10 10 300 80 75 75 75 8 6 4 1
Number Total of days Amount
Registration X-ray Minor operations Admit for 3 days or more CT- SCAN INVESTIGATION ULTRA SOUND MAJOR OPERATIONS GYANECOLOGY SCALING FILLING ROOT CANAL X-RAY COMPLETE DENTURE CROWN BRIDGE MINOR SURGERY MAJOR SURGERIES
30 100 200 400 1400 100 300 3000 1500 50 75 450 50 500 500 500 250 2500
3
33000 10000 10000 60000 42000 40000 30000 30000 15000 15000 6000 33750 3750 37500 4000 3000 1000 2500 376500
Total annual income
4518000
As the annual income of the hospital is not easy to predict as it works more on goodwill and goodwill is been developed over years and the only the income of the hospital would increase.
2008A44
Page 31
Total Revenue Of Hospital & College :
Year 1st Year 2nd Year 3rd Year 4th Year
Income From Hospital & College Rs. 1,65,18,000 Rs. 2,85,18,000 Rs. 4,05,18,000 Rs. 5,25,18,000
(Note these income does not include the Donations to be accepted at the time of admission which according to our calculation account to @ Rs. 1.5 Crores per Year on a conservative note)
As we know Annual Operating Costs for Hospital & college are Rs. 3,07,52,000/OPERATING LOSS / PROFIT for the upcoming years Year 1st Year 2nd Year 3rd Year 4th Year Income 1,65,18,000 2,85,18,000 4,05,18,000 5,25,18,000 Expenditure 3,07,52,000 3,07,52,000 3,07,52,000 3,07,52,000 Profit / Loss -1,42,34,000 - 22,34,000 97,66,000 2,17,66,000
{Note : The shaded portion in yellow colour shows that there is loss incurred for those particular years.} Since the loss for the first couple of years would have to be born therefore working capital would have to be increased by that amount for that couple of years.
2008A44
Page 32
Legal Requirements
The Below mentioned requirements are needed to get the necessary DCI approval. As we are starting with batch strength of 30, these norms will suffice. Approvals from the local district level, regarding the deed of the land, registration of the trust, building authorities, etc along with the necessary approvals from the State health department and the university would be required. The financial and tax formalities will be looked after by the CA in its audited report.
? ? ? ? ?
?
?
? ? ?
Registration of the trust State government permission University Affiliation (initially provisional will do) DCI permission 100 bedded general hospital ? CMO’s permission ? Permission from the issuing authority, In this case department of Health, State Govt. ? For dental hospital, atleast 25 new patients per day must be treated. Faculty standard ? Faculty ID card issued by DCI. ? Faculty strength as per DCI norms. (shown in the operating cost sheet) ? Experience of faculty: Professors should have minimum 8 years experience. Only full time employment to be considered. ? Composition of Lecturers : 25 % MDS & 75 % BDS ? Faculty should be selected as per the norms of the State University Act. Library: ? Journal Mix: International, National, Back volumes ? Seating capacity: Minimum 50% student strength ? List of books as per DCI recommendations (Minimum 3 copies per title) Administrative staff: As per DCI norms. (shown in the operating cost sheet) Dental chairs: ? Minimum requirement 20 Hostel for staff and students
2008A44
Page 33
Infrastructure & Functional Requirements Infrastructure Administrative block Library Lecture Halls – 4 Central Stores Maintenance room Photography and artist room Medical Stores Amenities area Compressor and room for gas plant Cafeteria Examination hall Auditorium (To accommodate at least 400 people) Laboratories (Dental Subjects) Pre-clinical Prosthodontics and dental material lab Pre-clinical conservative lab Oral biology and oral pathology lab Laboratory for orthodontics and Pedodontics 1500 sq. ft. Requirement 2000 sq. ft. 4500 sq. ft. 3200 sq. ft. 400 sq. ft. 600 sq. ft. 250 sq. ft. 250 sq. ft. 2000 sq. ft. 200 sq. ft. 800 sq. ft. 1800 sq. ft.
1300 sq. ft. 1300 sq. ft. 800 sq. ft.
2008A44
Page 34
Laboratories (Medical Subjects) (only for independent dental colleges) Anatomy dissection hall with storage for cadavers, osteology, demonstration room etc. One laboratory for physiology and pathology and microbiology with stores and preparation rooms for individual subjects attached to it. Laboratory for biochemistry and pharmacology with store and preparation rooms separately for both subjects Laboratories (Clinical) Prosthodontics Conservative Dentistry Oral pathology for histopathology Haematology and clinical biochemistry 1300 sq. ft. 300 sq. ft. 400 sq. ft. 200 sq. ft. 4500 sq. ft. 1500 sq. ft.
1500 sq. ft.
1500 sq. ft.
? ? ? ?
Land size: Minimum 5 acres Building should be complete and certified Pollution Control norms fulfilled Bio waste management as per Pollution control board of India
2008A44
Page 35
Tabulated Details of the Required Investment in the 1st year
Details
Amount (In Rupees)
Infrastructure 1. Hospital 2. College Building 3. Hostel 1,97,23,440 3,36,94,272 3,14,90,208
Equipments 1. Hospital 2. College ( Phase I) College (Phase II) 1,65,34,000 38,88,600 72,66,000
Operating Cost 1. Hospital 2. College 1,53,24,000 1,54,28,000
Total Investment
143348520
(Note : This table shows the Investment required in the first year, the revenues accounting to Rs. 1. 65 Crores in the First year have not been reduced from first years expenditure. Reducing Which the Entire Project Cost Would be
Approximately Rs. 12,68,30,520/-
2008A44
Page 36
Expansion Plans (MBBS College)
Highlights of a Medical College: The minimum land requirement: 1. Metro – 5 acres 2. Rural area – 25 acres 300 bedded hospital (up and running at the point of establishment) with 5 functional Departments: 1. Medicine 2. Surgery 3. Orthopaedics 4. Obstetrics 5. Gynaecology and paediatrics The College, at the time of application, should also have the teaching departments: 1. Anatomy 2. Physiology 3. Bio- Chemistry 4. Community Medicine The other requirements like Strength and experience of the Staff goes in the same line as that of the dental and nursing college. Infrastructure requirements should be sufficient for a minimum of 50 students. For further expansion, it is to done according to the slabs prepared according to: MEDICAL COUNCIL OF INDIA NOTIFICATION New Delhi, dated 30th July, 1999
2008A44
Page 37
Following is the detailed plan of the Setup of a Medical College. ELIGIBILITY CRITERIA: The following organisations shall be eligible to apply in Form-1 for permission to set up a medical college, namely :1. A State Government/Union territory; 2. A University; 3. An autonomous body promoted by Central and State Government by or under a Statute for the purpose of medical education; 4. A society registered under the Societies Registration Act, 1860 (21 of 1860) or corresponding Acts in States; or 5. A public religious or charitable trust registered under the Trust Act, 1882 (2 of 1882) or the WAKFS Act, 1954 (29 of 1954). QUALIFYING CRITERIA: The eligible persons shall qualify to apply for permission to establish a medical college if the following conditions are fulfilled :1. that medical education is one of the objectives of the applicant in case the applicant is an autonomous body, registered society or charitable trust. 2. that a suitable single plot of land measuring not less than 25 acres is owned and possessed by the person or is possessed by the applicant by way of 99 years lease for the construction of the college. 3. that Essentiality Certificate in Form 2 regarding No objection of the State Government/Union Territory Administration for the establishment of the proposed medical college at the proposed site and availability of adequate clinical material as per the council regulations, have been obtained by the person from the concerned State Government/ Union Territory Administration. 4. that Consent of affiliation in Form-3 for the proposed medical college has been obtained by the applicant from a University. 5. that the person owns and manages a hospital of not less than 300 beds with necessary infrastructural facilities capable of being developed into a teaching institution in the campus of the proposed medical college. 6. that the person has not admitted students to the proposed medical college.
2008A44 Page 38
7. That the person provides two performance bank guarantees from a Scheduled Commercial Bank valid for a period of five years, in favour of the Medical Council of India, New Delhi, one for a sum of rupees one hundred lakhs (for 50 admissions), rupees one hundred and fifty lakhs (for 100 admissions) and rupees two hundred lakhs (for 150 annual admissions) for the establishment of the medical college and its infrastructural facilities and the second bank guarantee for a sum of rupees 350 lakhs (for 400 beds), rupees 550 lakhs (for 500 beds) and rupees 750 lakhs (for 750 beds) respectively for the establishment of the teaching hospital and its infrastructural facilities : Provided that the above conditions shall not apply to the persons who are State Governments/Union Territories if they give an undertaking to provide funds in their plan budget regularly till the requisite facilities are fully provided as per the time bound programme.
8. Opening of a medical college in hired or rented building shall not be permitted. The
Medical college shall be set up only on the plot of land earmarked for that purpose as indicated.
2008A44
Page 39
References
? ? ? ?
DCI Guidelines for Dental College Set up. MCI Guidelines for Medical College Set up. www.mciindia.com 2001 Indian Census Report
2008A44
Page 40
doc_236253833.pdf