Nursing Home Development

From Green Field to First Resident - Seven Phases

Depending on the decisions made in regard to the target market and the operation of the nursing home the following tasks will be undertaken:

Phase (1): THE IDENTIFICATION OF A SUITABLE SITE FOR A NURSING HOME CENTERED ON A SOCIAL DEMOGRAPHIC AREA:

• Research social catchment area, identifying +65 age group, applying currently accepted norms for the number of persons seeking or requiring residential care.
• Identify existing nursing homes in the area and secure information on  bed numbers and, where possible giving age of building, the extent to which it may be possible an opinion on their future.
• Identify planning applications currently with the relevant Local Authorities.

▪         Research Local Development Plan for site zoning and objectives regarding provision of Community Facilities in the local area.

▪         Summarise services adjacent to site: ESB, Sewerage, Water, Footpaths and Services.

IDENTIFY SUITABLE LOCATION FOR NURSING HOME:

▪         Project future requirement for Nursing Home beds in the selected catchment areas.

▪         Project future requirement for specialist care facilities/beds including: Respite, Convalescent, High Dependency and End of Life.

▪         Depending on size and location of available site, the opportunity for additional care facilities to be operated in association with the nursing home.

Cost  ---

PHASE(2): PREPARATION OF A FINANCIAL FEASIBILITY STUDY FOR A NURSING HOME as in (1) OVER THE NEXT FIVE YEARS:

▪         Take bed projection and apply financial current values to calculate residential turnover.

▪         Project operating costs including direct, fixed and variable, and calculate operating overheads.

▪         Agree projected Operating Profit (loss), and positive (negative) contribution to yearly repayment of Capital Costs.

▪         Project positive (negative) cash flow.

▪         Project bed break even analysis.  

Cost ---

Phase (3): PREPARING AND PROGRESSING A PLANNING APPLICATION TO THE LOCAL AUTHORITY:

▪         Assist architects to identify design and planning concerns.

▪         Brief architects/engineers on regulatory requirements by HIQA and advise on interpretation of standards as they are likely to affect the design of the nursing home.

▪         Advise on detailed layout to maximise residents’ privacy.

▪         Review Health and Safety issues with the view to minimising operating costs.

▪         Review site security, green areas, garbage collection, resident services and accessibility to emergency services.

▪         Identify safety and emergency requirements for residents in the areas of security, comfort and food.

▪         Seek pre-clearance approval of nursing home from HIQA prior to lodgement of planning application with Local Authority.

▪         Prepare statement of purpose and function of Nursing Home as required by HIQA standards and define operators’ management policies.

▪         Where relevant identify site location of Day Care Centre and Sheltered Housing to nursing home to benefit from common services.

Cost ---

Phase (4): CONSTRUCTION AND WORK ACTIVITIES WITH BUILDING OF NURSING HOME:

▪         Agree internal nursing home fixtures with Quantity Surveyor.

▪         Agree internal nursing home fittings with operator.

▪         Draw up interior design scheme for areas frequented by residents.

▪         Agree open green areas layout with landscapers.

▪         Continuously review above as construction phase continues.

▪         Project Manage the internal and garden specifications to best meet the needs of residents by communicating continuously with Architects, Engineers, Constructor Company and Owners with advise relating to any deviation from design specification.

▪         Ensure the finished ambiance of the nursing home, other care facilities and its surrounds is in tune with the expectations of the target residents.

Cost ---

Phase (5): DISCUSSION ON FUTURE OPERATING STRATEGY:

▪         Whether to appoint an independent franchise operator or Developer to manage/ operate the Nursing Home.

▪         Instigate discussion with developer, accountants and tax advisers on future operator strategy to ensure that standards are achieved and maintained and that there is a return on investment.

▪         Research and provide, where possible, information on existing nursing home operators (whether local, national or international) who may be interested in operating the facility.

Cost ---

Phase (6): STAFF REQUIREMENT AND OPERATIONAL PLAN FOR THE CONSTRUCTED NURSING HOME:

▪         Recommend staff requirements based on HIQA Standards and anticipated care needs of residents.                                                    

▪         Recruit Nurse Manager in Charge and prepare job description.

▪         Recruit Business Manager and prepare job description.      

▪         Advice and assist Business Manager and Nurse Manager in the recruitment of nurses, care staff, catering and cleaning, administration and security staff.      

▪         Advice on the best arrangements for ensuring adequate care services are available from doctors, pharmacist, physiotherapists and other para-medical staff.                                                                                                                                   

▪         Assist in the preparation of a staff training program.

▪         Prepare staff operational plan to minimise operational costs.

Cost ---

Phase (7): Prepare AN OUTLINE OF THE RESIDENTIAL POLICIES AND CARE PLANS REQUIRED BY HIQA TO  SECRURE REGISTRATION FOR THE NURSING HOME:

This will include:

• Contracts of Care for Residents.       
• Residents’ safety including abuse prevention and restraint policy.
• Dealing with accidents and incidents involving residents.
• Medication management. 
• Infectious diseases policies.    
• Phasing of admissions and start up arrangements.
• Complaints policies for residents.