How to open a nursing home: a business plan step by step
You asked, we tell: this article will talk about how to open a nursing home. What is needed for this, what start-up costs will be, how is it regulated by law and how to start a business.
How the market works
On the market for boarding houses for the elderly, there are private and public organizations that provide care services for the elderly or full board – accommodation, meals, medical support. In this case, public ones include those that were not created by the state, but by various associations and monasteries.
Private boarding schools operate at their own expense, state budgeting is not provided. The only exception may concern monasteries, but in this case, the region may rather be a donation, rather than a full-fledged subsidy.
The main budget of such organizations is equity and credit capital. The cost of services is high – from 50,000 rubles per month. Therefore, the maintenance of an elderly relative in a private boarding school is not affordable for every citizen of our country.
Some private guesthouses accept senior citizens on a subsidy basis. In this case, the pensioner will pay up to 75% of his pension for his residence, and the state pays the rest for it. For example, in the capital it is 2,500 rubles per day, in the regions the amount is less.
In general, the topic of nursing homes in Russia is not particularly advertised, because it is believed that handing over your relative to someone in the care is a shame, it is not family-like, they just want to get rid of him. In fact, this is far from the truth. Not everyone is able to fully care for an elderly relative, and most do not have the necessary skills. And being in a boarding house, a grandfather or grandmother receives full-fledged medical care, round-the-clock care of specialists, and, moreover, they do not sit alone within four walls while the rest of the family is busy with their own affairs.
An individual entrepreneur will not work in this case, you need to register an LLC.
A license is not required here if medical services will not be provided. But, in this case, you need to take into account: the location of a nursing home should be a maximum of 10 minutes drive from a medical institution, where a person can be received at any time of the day.
It is recommended that the boarding house be registered with the register of social services. What this gives: it will be possible to participate in government tenders, receive more contracts, purchase equipment and other goods using government support measures.
According to the legislation, services can be provided in the territory of residence of an elderly person, then we are talking about patronage care. If an elderly person is taken to an institution and left for permanent residence, then we are talking about a private boarding house.
The activities of such institutions are regulated by the following regulatory legal acts:
- Federal Law No. 442 of 28.12.2013 “On the Basics of Social Services for Citizens of the Russian Federation”.
- Resolution of the Chief State Sanitary Doctor dated 23.10.2009 No. 71.
- Order of the Ministry of Labor and Social Protection of the Russian Federation of November 24, 2014 No. 940n.
Additional regulations may also apply in your area. You can get acquainted with them on the city website or by contacting the territorial office of the social protection body.
Forms of cooperation
The easiest way: register an LLC, rent a room, equip it and start accepting people. But, you can start your own business with the help of the state. In this case, there will be such forms of cooperation:
- Concession. The state gives land or a building for a boarding house. The investor carries out repairs, equips it and begins to operate. But the state remains the owner. That is, the entrepreneur rents premises or land from the municipality.
- Public-private partnership agreement. Everything is the same as above, but only a legal entity or a private investor can act as an owner.
- Lease with investment obligations in accordance with the Civil Code of the Russian Federation.
- Strategic investment contract within the framework of regional legislation.
Not all business models are universal. It all depends on how much money you need to invest at the start and what payback periods the company will have.
What else you need to pay attention to before starting
The average check for boarding services is higher than the average salary of citizens of our country in the regions. Therefore, it is not a fact that it is in your region that the enterprise will be profitable. It’s another matter if you are going to work not exclusively in the commercial field, but to conduct social entrepreneurship.
But, there is definitely an unmet demand for such services.
The payback of such a business does not come earlier than in five years, the average profitability varies from 5% to 18%.
What nuances you need to pay attention to before the start:
- At the stage of developing a business model, you need to decide on which category of the population your boarding house will be designed for: for the disabled, for those who are able to take care of themselves, for those who are completely lying, with certain diseases, with dementia or of a mixed type.
- Your income will depend on the occupancy of the boarding house. In the first year, the work will go towards building a reputation, advertising, so you won’t have to think about big revenue.
- The average check will be influenced by the region and the paying capacity of the population in it. If in your city the average salary is 20,000 rubles, and the day of stay in a boarding house is from 5,000 rubles, then you are unlikely to find clients.
- You should not skimp on advertising and on what can make you a good reputation.
- Finding experienced and qualified employees at the same time will be difficult. So it makes sense to take with specialized education and with little work experience. Nurture your staff yourself.
- A nursing home is, first of all, about the social. So it will be a good tool for building a positive reputation if some of the places in your boarding house are social – for single old people who are not solvent at all.
It is imperative to conduct market analysis, analysis of your target audience and analysis of competitors, if any in your region. This provides a wealth of useful information for building a business model.
Business project: requirements for premises, purchase of equipment, recruitment
We’ve come to the heart of the matter: how to go from paper to action. Let’s say you’ve put together a business model. Now you need to turn everything into numbers and stage-by-stage execution of work. And in order to calculate this, you need to understand what the premises should be like, what needs to be purchased and what kind of personnel with a salary fund to recruit.
Requirements for the premises
You can build a building from scratch, in accordance with the requirements of SanPin. But, this will significantly increase both the costs and the timing of the project. Therefore, it is more profitable to consider renting a room with its subsequent adaptation to a boarding house. Ideal for this premises, where there were already nursing homes, geriatric centers. A former hostel or hotel would also work well.
Good location – outside the city, but not too far. So in this direction, you can still consider the former sanatoriums.
What is important in the planning of the facility:
- Rooms must be single, double and triple.
- Bathrooms should be on the floor and in the room.
- The dining room should be spacious.
- Doorways throughout should be wide enough for a wheelchair to pass. All other rooms should also be adapted for disabled people, entrance groups should be with ramps.
- Passenger and freight elevators are required.
If the boarding house will accept elderly people with psychiatric diseases, then also consider this:
- Windows must be locked so that they cannot be opened without problems. In this case, frames are placed where the doors are locked with a key.
- The rooms in which the sick will be located should not have objects that can harm themselves. These are mirrors, glassware, some structural elements of furniture that can be easily removed.
Since most of the clients will be staying at the boarding house for the rest of their days, care must be taken to ensure that they are comfortable. The minimum set of equipment for this:
- Beds with adjustable headboards.
- Anti-decubitus mattresses.
- Electronic personnel call systems.
- Means of social adaptation for people with disabilities.
- Remedial gymnastics and leisure supplies.
All personnel (with the exception of cleaners and nurses, handymen in the kitchen and the territory) must have specialized education and medical books.
There must be a medical worker on the staff, even if, according to your OKVED, you will not provide medical services.
Depending on the number of guests, there may be 2 health workers on duty or a whole medical unit.
Registration of activities
The legal entity must be registered with the Federal Tax Service and the FSS, the Pension Fund of the Russian Federation, Rosstat and the Department of Social Protection. If you will provide medical services, then the Ministry of Health will need to obtain an appropriate license.
There is also a regulation for the registration of guests. You will need to receive from them such a package of documents:
- Application – from the guest himself or from his close relative (guardian), if the first is incapacitated.
- Passport, SNILS, TIN.
- A copy of the medical record.
- If there is a disability, then a copy of the group assignment decision.
- If necessary, an act of medical examination.
Based on the application, an agreement is drawn up, which spells out the conditions of detention, cost, terms, obligations and responsibilities of the parties, the actions of the parties in case of unforeseen circumstances. Such a contract must be drawn up by the boarding school’s lawyer. In no case should you use templates from the Internet, because there may be errors that will cost dearly if something happens.
Advertising tools like these will work well:
- Guest posts, articles on local city sites and in publics.
- Targeted and contextual advertising.
You need to choose a channel for advertising based on where your target audience lives. Central Asia, in this case, will not be the elderly themselves, but their close relatives: children, grandchildren, daughters-in-law and sons-in-law.