Advantage Healthcare Systems is pleased to offer Turnkey development services. This service allows the client to have Advantage be the Project Manager and responsible party for all activities during the development process. As our business has evolved and the development of surgery centers has become more complicated, requiring more and more planning and professional execution and oversight, we strongly recommend that Advantage be retained as Project Manager via the Turnkey service. We have found that, with this control and responsibility, we are more able to deliver a project on time and within budget and without small items “falling between the cracks”. This also allows the physician(s) to concentrate on what they do best – treat patients – while we provide them with complete, experienced guidance. The price of our fee is generally saved multiple times over by the time-savings we can provide.
- Perform as Project Manager responsible for all activities relating to the preparation of the Center for operations, state licensure, Medicare certification and accreditation.
Pre-Development Activities
- Make recommendations for selection of an architect and general contractor.
- Make recommendations for selection of an appropriate site including review of existing conditions (e.g., fire rating of building, parking allowances, city variances).
- Assist in the preparation of the surgery center space plan with the approved architect to ensure complete compliance with all applicable regulations created by the agencies which will survey the facility. Submit the plan to the appropriate authorities for review prior to construction commencing, if appropriate
Creation of a complete business plan/feasibility study to determine the if the project is viable. Activities include interviews with prospective physician investors and users, preparation of a project timeline, site analysis, space requirements, and recommendations for legal structure. No matter if the project includes a single group, several groups or a joint venture between hospitals and physicians, a Business Plan/Feasibility Study is an absolute prerequisite. Single groups need this component in order to obtain favorable financing. Multiple groups or joint ventures need the Business Plan to promulgate information and ensure that all parties have adequate information to make an investment decision based on realistic, conservative figures. The Plan/Study provides an objective document for all parties to review. Advantage’s Business Plan/Feasibility Study includes narrative addressing reimbursement issues, surgical and/or procedural volume, competitive factors and critical success factors. The financial portion of the study provides 12 month cash flow analysis, Uses and Sources of proceeds, pre-development costs, supply and staffing costs per case by specialty with three scenarios. For projects involving non-aligned groups our feasibility studies are sound economic and financial tools that are a requirement for any serious project. Advantage’s Pre-Development package is an essential business tool.
Development Responsibilities and Tasks
- Perform as Project Manager responsible for all activities relating to the preparation of the Center for operations, state licensure, Medicare certification and accreditation.
Pre-Development Activities - Prepare construction specifics for the surgical facility including specifications to the architect and engineers indicating placement of equipment, power requirement of equipment, which equipment to be on emergency power (someone must perform this task in order to ensure proper systems are in place and meet specific codes), ceiling finishes, wall finishes, flooring finishes, HVAC requirements, location of Life Safety Code devices-, types of doors required, etc.
Work with the architect and general contractor selected to perform the work.- Perform on-site visits to the construction site during development, meeting with the general contractor and architect to assist in the prompt and complete performance of work.
- Arrange, organize and attend periodic meetings of the designated Steering Committee, or similar while providing minutes of meeting to participants and chosen representatives
- Equipment planning and acquisition: Advantage will:
- Arrange presentations by equipment purveyors when appropriate
- Review the equipment needs of the facility and prepare a list of equipment.
- Prepare a budget
- Obtain bids, compare bids, make recommendations
- Order and ensure receipt
- Arrange Inservices for equipment purchased
- Prepare equipment specifications for the surgical facility for the architect and engineers of all equipment to be utilized.
Obtain bids for financing for the purchase of any needed equipment, operating capital and construction or for any purpose deemed necessary. The pro forma financials prepared by Advantage (providing payor mix, volume and CPT codes) will complete the financial package required by lenders – and investors.- Supervision of Nurse Manager prior to opening of the Center. [Recruitment, screening, interviewing and hiring of the on-site Nurse Manager/Clinical Supervisor provided at no extra charge, if required.]
- Orient the nursing and administrative staff to the appropriate regulations and the general operations of the Center.
- Develop a fee schedule and obtain third party payor contracts with the top three payors as identified by Center physicians.
- Coordination of agreements with ancillary services such as pharmacy, radiology, medical waste pick-up, linen, laboratory/pathology, transcription, transfer, environment, and office equipment maintenance.
- Develop the Center’s personnel policies, credit policies, billing system, patient and paper flow, appointment procedures and initial operating budget.
- Plan and acquire medical and office supplies and instrumentation for the Center as well as coordinate affiliation with a group purchasing plan, if advantageous.
- Act as liaison with the appropriate certifying/licensing organization throughout the survey process and coordinate all activities relating to licensure and certification including preparation of the appropriate application materials and assembling of any additional documentation required by the reviewing organization.
- Prepare the Policies & Procedures Manual, Quality Improvement Program and Risk Management program specific to the facility.
- Provide templates for site specific medical records, logs and checklists for operational, organizational and credentialing purposes. Create a site-specific sample medical record and site-specific logs.
Create physician credential package and:
- Arrange enrollment with required verification agencies (AMA, NPDB)
- Request and assemble required documents (peer references, copies of licenses, DEA, malpractice, etc.)
- Ensure that credential packages meet appropriate regulations
- Provide training to staff regarding the credentialing process
- Prepare all initial log books, provide individual logs, orient staff to the use and purpose of the logs
- Prepare appropriate minutes for initial Governing Body and Quality Improvement Committee meetings
- Meet with staff periodically to provide direction regarding activities they must undertake including written task lists. Advantage will orient staff to the appropriate standards of the reviewing organization. Staff must be available without interruptions during these meetings.
- Attendance at the survey for initial accreditation. We will make our best effort to be present at the Life Safety Code and Medicare certification surveys which are unannounced. AAAHC policies do not allow the presence of a consultant at the survey but the surveyor may allow our presence. Advantage will follow through with the surveying organization until written approval has been given.
- Coordination with Center’s legal counsel and/or legal direction provided by in-house counsel.
Assist with preparation of additional documentation requested by surveyors or the reviewing organization.- Provide templates for legal documentation which will govern the facility including documents submitted to the State such as formation documents (articles of incorporation, articles of organization, limited partnership agreements) which include important information such as buy/sell agreements and non-compete clauses, Subscription Agreements which include price per share, minimum and maximum purchase amounts, time frame for purchases, etc.
- Guidance with preparation of marketing materials including facility brochures and yellow pages ads and other marketing activities such as opening ceremonies and establishing an internet presence.