Project Profile For Multi-Specialty Hospital: Sarla Medical Centre Private Limited

SARLA MEDICAL CENTRE PRIVATE LIMITED
PROJECT PROFILE
For
MULTI-SPECIALTY HOSPITAL
1
TABLE OF CONTENTS
**********
Sr. DESCRIPTION PAGE NO.
1. Executive Summary 03-10
2. An Overview of the Indian Healthcare Sector 11-19
3. Uttar Pradesh State Profile 20-28
4. Project Outline 29-37
5. Project Development Plan 38-41
6. Projected Financials 42-44
2
Executive
Summary
3
1.1 Project Introduction
SARLA MEDICAL CENTRE PRIVATE LIMITED is desirous of setting up a multi-

specialty hospital in Noida. The company was running a nursing home in Sector 56
of Noida since its inception. The proposed hospital would bridge the gap in
accessibility to quality healthcare services in Noida and the nearby areas of Delhi,
Faridabad, Ghaziabad etc. The hospital would be equipped with state-of-the-art
diagnostic and clinical facilities to provide best in class treatment to the local
community. The hospital would be would be located on a 1006.20 sq. mtr land
allotted to the company by the competent authority, which is situated at NH-1,
Sector – 119, NOIDA. Land is allotted by NOIDA Authority in a special scheme as
per directives of honl. Supreme Court due to non availability of approved nursing
home and hospital land in NOIDA.
SARLA MEDICAL CENTRE PRIVATE LIMITED is incorporated in 1999, having its

registered office at A-1 SHOP NO.16 DURGA MARKET KONDLI NEW DELHI –
110091. The Directors of the company have extentive experience in healthcare and
construction sector. At present company has four directors.
1. Dr. PUNAM KUMAR: Dr. Punam Kumar is a dental surgeon (BDS) and have
more than 30 years of experience in the field in NOIDA.
2. Dr. BABIT KUMAR: Dr. Babit Kumar is one of the leading Radiologist (MD)
associated with leading superspeciality hospitals like, Delhi State Cancer
Institutes (Delhi), Mahatma Gandhi Medical College and Hospital (Jaipur) and
Max Super Specialty Hospital.
3. DHARAMVEER SINGH: Dharamveer Singh is having extensive experience in

construction and development. He is also associated with SUNWORLD
DEVELOPERS PRIVATE LIMITED, as Director, which is a leading real estate
development company developing approx. 120 acres of land in Noida and
Yamuna Expressway. He is also chairperson in Ascent International School,
Greater Noida, which is a Not for profit CBSE affiliated Senior secondary
school providing affordable quality education to children of greater Noida and
nearby areas for last 15 years.
4. RAHUL KUMAR: Rahul kumar is having more than 8 years of experience in

real estate development. He is associated with PROHOMES PROPMART
PRIVATE LIMITED.
4
1.2 Project at a glance
The proposed hospital would be multi-specialty tertiary care unit. The

hospital would have 100 bed spread over a total built up area of 52,889 sq.
ft.
Approved Land Area: 10,831 sq. ft.

Total Built-up area: 52,889 sq. ft.
Facility Spred: 2 Basement + Ground Floor + 9 Floor + 2 Service Floor
Total Number of Census Beds: 100 Beds
1.3 Facility Mix
The facilities to be offered by the proposed hospital are based on assessment

of the catchment area. The specialities to be offered in the hospital are as
follows:
Obstetrics & Gynecology
 Labour OT
 LDR( Labor – delivery –recovery) room
 Post operative room
 IVF unit
Medical
 General Medicine
 Dietetics & Nutrition
 Dermatology & Venerology (Skin & Allergy)
 Paediatrics
 Neonatology
 NICU (Neonatal Intensive Care )
 Nursery beds
Surgical Speciality
 General Surgery
 Urology
 ENT
 Dental
 Anaesthesia
 Surgical ICU
 Plastic surgery & Cosmetology
5
Diagnostic Services
 Radiology (X ray, DEXA, Ultrasound, Mammography, CAT Scan etc.)

 Labarotary Medicine ( Pathology and Microbiology )
 Cardiology ( Echo , ECG )
Support Services
 Ambulance (3) & Mortuary Van (1)

 Pharmacy ( Indoor & Outdoor)
 CSSD
 Dietary
 Laundry
 Housekeeping
 Nursing
 OPD ( Out Patient Department)
 IPD ( In Patient Department)
 OT ( Operation Theatre)
Other Services
 Medical Records
 Physiotherapy
 Bio Medical Maintenance
Bed Distribution
 Intensive Care areas (ICU, NICU): 25

 Well baby Nursery : 12
 General ward ( in various specialities ): 18
 Twin Sharing: 14
 Single Room: 15
 Others: 16
1.4 Projected Capex Estimates
The proposed hospital shall be developed in total 10,831 sq. ft. area having
total built
up area of 52,889 sq. ft. accommodating a total of 100 beds. The cost of
projected is expected to be Rs 30,00 lakh.
The detailed break up of costs shall be as follows:
( Land + Equipments + working capital+ Building)
6
LAND
1. Plot Number and Sector NH-1, Sector-119

2. Total Area of Plot (in Sq. Mtr.) 1006.20
3. Total cost of the allotted plot Rs. 5,46,36,660
Medical Equipment & Surgical Instrument and Working Capital

Cost of Medical Equipment :- Rs. 2,20,26,638
Cost of Surgical Instrument:- Rs. 2,29,65,565
Requirement of Working Capital:-2,99,30,507
7
8
1.5 Project Timelines
The project timelines shall be as below. It is envisaged that the statutory

clearances and licenses required prior to commencement of construction
shall be worked upon and put in place before commencement of the
construction at site. Necessary, approvals are taken from authority.
Structure work is already completed and electricity, HVAC, Fire, plumbing
work is going on. Expected time of operational readiness is 180 days from
present date.
1.6 Staffing Plan
The proposed hospital shall be staffed in line with industry standards. Each
specialty would have a super-specialist at the level of a senior consultant.
Further, the staffing strategy would envisage having visiting consultants at a
minimum of one per specialty to drive volumes and utilization initially.
The broad numbers for the man power grid (administrative and para-medical
staff) is as follows:
Staff category Number

Medical Staff
Senior Doctors 15
Doctors - Mid Level 10
Junior Doctors 10
Nurses 100
Medical Technician 10
Bio Medical 2
Pharmacy 8
Physiotherapy 2
9
Dietetics 2
Medical Records 3
Total Medical Staff 162
Management and Administration

Management ( Senior) 2
Managers( Mid Level) 4
Engineering staff 3
General Admin 10
F&B 10
House Keeping 40
Front Office 6
Security 10
Information Technology 1
Human Resources 2
Finance 3
Marketing & promotion 4
Total Staff - Non Medical 95
TOTAL STAFF 257
10
An Overview
of the
Indian healthcare
Sector
11
2.1 Indian Healthcare scenario
As per statistics published by the WHO, in 2008, the death-rate due to

noncommunicable diseases was approx. 55% in the age group of 15 – 60
years. Lifestyle related diseases such as cardio-vascular, cancer, gastro
intestinal and respiratory diseases contributed a major portion totaling to
almost 85% of all deaths in this category.
12
A large part of this observation can be attributed to either the lack of access to
tertiary healthcare or to the unaffordable nature of tertiary care.
The life-expectancy of Indians has been steadily increasing over the years and this
combined with a slow and steady migration of young workforce to the cities
andurban agglomerations has resulted in the increasing share of lifestyle disease
incidence. The projected life expectancy will be 70 years by the years 2025.
On the other hand, the infant mortality rate is on a steady downward trend thanks
to the improvements in medical technology and accessibility to primary care.
However, it needs to be noted that the secondary and tertiary healthcare
accessibility is still largely restricted to the metro and the larger Indian cities.
In short, Indians are living longer, steadily migrating to urban areas and are
becoming more and more prone to lifestyle related diseases at a much earlier age
than before.
On the other hand, the cost of healthcare has risen steeply over the years. The
public spending on health by the Indian Government is one of the lowest in
comparison to other nations, amounting to only 20%. 80% of the healthcare
expenditure is borne by the public.
13
The per-capita expenditure on health has seen a CAGR of 15% in the period 2005
2010. The cost of healthcare has grown at a pace greater than the inflation,
thereby making access unaffordable to the common man.
2.2 Indian Healthcare vs. Global Standards
Indian healthcare has grown rapidly in the last three decades. Corporate groups
have revolutionized the delivery of healthcare, by continuously benchmarking with
global standards and striving to achieve international and national accreditation
14
such as Joint Commission International, NABH etc.
However, a lack of Government will to promote the growth of healthcare coupled

with the presence of high entry barriers such as steep set up costs, shortage of
medical professionals etc. have ensured that the reach of the corporate healthcare
groups have remained largely confined to the metros and Tier I cities. India
currently has approximately 0.9 beds per 1000 population compared to the global
standards of 3.5 beds per 1000 population. This translates to an additional 0.81
million beds at an estimated investment of INR 2.1 Trillion by 2018.
The Indian middle class is expected to grow the most with the workforce in the age
group of 15 – 59 years of age set to reach 325 million by the year 2050. The
demand
for health services aided by higher disposable income, greater insurance
penetration and improved awareness levels are factors which are set to be the main
drivers of the healthcare boom.
15
One other factor aiding the growth of healthcare is that India currently boasts of
the
largest number of US FDA approved drug manufacturing facilities outside of the US.
While these facilities currently focus on serving the lucrative US and European
markets, eventually it can be expected that the strong domestic demand would be
met by the production from these facilities. The prevalence of generics supported
by mass market production strategies would aid to lower the cost of medicines and
consumables for the Indian patient.
16
2.3 Industry Challenges
In 2011, India had about 313 medical colleges across the country offering about
34,000 under-graduate seats and approximately 16,000 post-graduate seats. The
acute shortage of medical professionals has resulted in a skewed distribution with
concentration of healthcare workers and doctors in the main cities. For e.g. Bihar
had a patient to doctor ratio of 3400:1 as compared with the Indian average of
1700:1.
The figure below illustrates the fact that an estimated 100 new medical colleges if
opened every year for the next five years would result in India achieving the global
patient to doctor ratio standard of 500:1 by 2025.
The medical colleges across the country are skewed in distribution and offer
inadequate number of admissible seats, leading to alienation of students from
states in the East and North-Eastern part of the country due to widespread
disparities in the standard of education and uneven competing landscape for these
students.
The Eastern part of the country has only 12% of all medical colleges present in
India.
17
Poor healthcare delivery infrastructure and human resource constraints have

prevented State Governments from replicating successful affordability
empowerment models such as the Yeshaswini.
18
The Indian Government spending on Healthcare is 0.9% of the GDP, accounting for
just 20% of the total spend on healthcare. Despite the large contribution of private
spending, successful models such as the community based micro-health insurance
scheme in Karnataka ‘Yeshaswini’ have emerged. Launched in 2008, the scheme
initially collected approximately 5 cents per month from each person. This coupled
with the State Government contribution have successfully ensured access to about
1700 surgical procedures. However, the absences of healthcare delivery
infrastructure and human resource constraints have prevented State Governments
from replicating the scheme.
19
Uttar Pradesh
State Profile
20
3.1 Health Status across the States
Status of health at national as well as across the state has improved during the
course of time but still it is far from satisfactory if we compare it from other
countries. Across the state we find that states which have higher level of per capita
income are spending more on health expenditure and they have better health
indicators and HDI ranks (Table1). Kerala tops the HDI rank as their health
indicators i.e. birth rate (15per thousand), death rate (7 per thousand), infant
mortality rates (15 per thousand) are low and life expectancy 74 years are very
much improved.
21
As far as backward states are concerned specially UP and Bihar their health
indicators are very poor and thus their HDI ranks are very low. Over all the analysis
reflects that high income states are enjoying better health outcomes and low
income states are deprived of good health. This in turn reflects the state
government’s policy, efforts and concern in this direction.
3.2 Health Care Infrastructure in Uttar Pradesh
Uttar Pradesh has made significant investment in health infrastructure in the last
few decades. UP has a large public as well as private health care infrastructure. At
present, seven Medical Colleges at Agra, Jhansi, Meerut, Gorakhpur Kanpur,
Allahabad, a medical university at Lucknow and a Super Specialty hospital, SGPGI,
Lucknow are being run by the state government(Table 2). In addition to these, two
medical colleges are also functional which are owned by the government of India.
The state has also one King George Dental University at Lucknow (Govt.)
The state is also in process of developing four more Super Specialty Hospitals viz.
Balrampur Hospital, Civil Hospital, and Dr. Ram Manohar Lohiya Hospital at
Lucknow and Saifai Hospital at Etawah.
Besides that the state has also 53 district hospitals, 13 combined hospitals, 388
community health centres, 823 block PHC’s,2817 additional PHC’s apart from 20521
sub centers.
In the private sector, the state has three full fledged private medical colleges and
Hospitals, more than twenty dental colleges and 4193 male /female hospitals/
nursing homes at district level. However there are large numbers of registered and
non- registered medical practicenors in the state and they play an important role in
providing medical service to the rural and urban populations.
22
Note;*1 super specialty Hospital SGPGI, is functional at Lucknow,3 more institute

at Lucknow and one at Safai, Etawah are in process of Development.
Despite all these, the Physical Health Infrastructure in the state is still below the
country‘s average. For instance the population covered by sub centre in state is
7080 and the average distance is 3.4 Km. While the country average is 5109 and
1.3 Km. It is estimated that 11% of the people in Uttar Pradesh are not able to
access medical care due to locational reasons. Further, even when accessed, there
is no guarantee of sustained care. Several other factors such as bad roads,
unreliability of findings of health providers, cost for transport and wage loss etc.
make it cheaper for a villager to get some treatment from local quacks.
Uttar Pradesh is known for several healing techniques, which form part of alternate
medicines such as Ayurveda, unani &homeopathic. There are 24650 medical
centers, 2108, Ayurvedic centers, 253 unani centres & 1483 homeopathic centres.
3.3 Medical Education in U.P.
Most of the quantitative increase in hospitals/ dispensaries took place in the 1970’s
and 1980’s where as PHC and sub centers expended rapidly in 1980’s. Although
impressive on most counts it was barely able to keep pace with the increase in the
population. There are only 11 medical colleges in U.P. – 7 in Public Sector and 3 in
Private Sector (as mentioned above). Based on the norm of one medical college for
every 50 lakhs population, there ought to be 35 medical colleges in the State. Thus,
there is deficit of 24 medical colleges in the state in order to address this deficit,
the State Government is opening a new medical college at Saifai and it is proposed
to establish another Rural Post-Graduate Medical Institute at Azamgarh.
23
It may be noted that all the four better performing states in the sphere of health,
i.e., Kerala, Andhra Pradesh, Tamil Nadu and Karnataka have more than the
required number of medical colleges. Against the norm of 11, Karnataka has 31
medical colleges, Andhra Pradesh has 27 against norm of 16; Tamil Nadu has 20
against requirement of 13 and Kerala has 14 medical colleges against requirement
of 7. U.P. has only 1262 medical seats .There are 801 MBBS seats in the
Government Medical Colleges and another 350 MBBS seats in the four medical
colleges in the State. There are 21 private Dental Colleges in the State and the total
numbers of BDS seats in these colleges are 1940. In addition, there are 583 post-
graduate seats in the Government Medical Colleges.
Under the Indian system of medicines and homeopathy, there are altogether 17
medical colleges in the state. There are eight Ayurvedic Medical Colleges in the
State and the total number of BAMS seats in these colleges is 320. Like-wise there
are two Unani Medical Colleges in the State and there are 76 BUMS Seats for the
students of the state. In addition, there are seven State Homeopathic Medical
Colleges and these have 285 BHMS seats.
3.4 Human Resources
Severe shortage of manpower at all levels in the public health delivery system,
stands out as another challenge. Every health functionary is under a lot of pressure
on account of large numbers that he/she is expected to serve. This has a direct
bearing on the quality of services rendered and uptake services. The ratio of
doctors per thousand populations for U.P. is much below the national figure of 1
and although the ratio of beds is almost the same as the all-India figure of 0.7,
their geographical distribution is highly skewed in favour of urban areas (Table 3).
24
In UP this ratio is 1:4202 and 1: 10796 respectively whereas all India average
is1:1855 and 1:1455. In Kerala doctor –population ratio is 1:1141 and Nurse -
Population ratio is 1:542 only. This shows the heavy population pressure on doctors
and nurses in UP. In Bihar situation is worst among all states.
The current position of doctors and paramedical staffs in UP is shown in Table 4.

The
table depicts that despite the sanctioned posts health personnel are not available to
the government sector which again create pressure in the health care delivery
system in the government sector whereas they are very much available in the
private sector.
25
The situation is grave in terms of requirement of medical personnel vis-à-vis their

availability specially doctors and specialists. Although the state also has a large
presence of private health providers, it is mostly concentrated in urban areas and is
largely focusing on curative aspects. A survey of hospitals in the private sector,
commissioned by the Government of U.P. revealed that there are 2,592 private
hospitals with the total bed capacity of 47,269. There are 2,321 general hospitals
that account for 92.4 per cent of beds in the private sector, 201 nursing home with
2,506 beds that offer maternal and child health services exclusively and 70
hospitals with 1,010 beds that offer specialty services.
26
The problem of shortages is further compounded by the absenteeism of public

sector health personnel in the state. A World Bank study captures the overall
percentage of absenteeism and reasons for absence in different stages of the
country. Shortage of manpower is only one dimension of the problem. 45 per cent
of the doctors were found absent from duty in U.P. Interestingly 14 per cent out of
this 45 per cent were on leave; 8 per cent of them were absent without reasons;
and 22 per cent (i.e. almost half of the total absenteeism) of doctors were absent
from the post because they were on the official duty. It raises questions regarding
the work schedule which forces absence of doctors in doctor scarce state. It also
apparently raise question regarding compromised system of accountability of the
health functionaries where absence can be camouflaged as field visit, etc.
3.5 Noida: Overview
Noida is a systematically planned Indian city under the management of the New
Okhla Industrial Development Authority (also called NOIDA). It is part of National
Capital Region of India. Noida came into administrative existence on 17 April 1976.
It was set up as part of an urbanisation thrust during the controversial Emergency
period (1975–1977). The city was created under the UP Industrial Area
Development Act by the initiatives of Sanjay Gandhi. The city has the highest per
capita income in the whole National Capital Region. The Noida Authority is among
the richest civic bodies in the country.
As per provisional reports of Census India, the population of Noida in 2011 is

642,381 of which male and female are 352,577 and 289,804 respectively. Roads in
Noida are lined by trees and it is considered to be India's greenest city with about
50% green cover, the highest of any city in India.
Noida is located in Gautam Buddh Nagar district of Uttar Pradesh state. The
district's administrative headquarters are in the nearby town of Greater Noida.
However, the district's highest government official, the District Magistrate (DM),
has its official camp office in Noida Sector-27. The city is a part of the Noida Vidhan
Sabha (state assembly) constituency and Gautam Buddha Nagar (Lok Sabha
constituency).
27
Noida was ranked as the Best City in Uttar Pradesh and the Best City in Housing in
all of India in awards conducted by abp news in 2015 (Best City Awards 2015).
Noida replaced Mumbai as the second-best realty destination, according to an
analyst report. Noida has emerged as a hot spot for IT and IT-enabled services
industry with many large companies setting up their businesses here. It is
becoming the preferred destination for companies offering IT, ITeS, BPO, BTO and
KPO services in various domains such as banking, financial services, insurance,
pharma, auto, fast-moving consumer goods and manufacturing. According to a
study by Assocham the major advantages include an excellent power supply, a
salubrious climate eminently suited to information technology (IT) industries, a
capability to increase the pool of skilled manpower, the availability of engineering
colleges and other educational institutions, the low cost of setting up an IT unit as
well as low recurring costs (including cost of living).
3.6 Health Services in Noida
Noida has many private healthcares like Jaypee Hospital and Fortis Healthcare with
1200-bed tertiary care multi-specialities but Noida lags far behind in government
health care. All three of its government hospitals, Dr Bhimrao Ambedkar Multi-
Specialty Hospital, Super Specialty Paediatric Institute and ESIC Hospital, lack
super-specialists and only provide secondary medical care. There is huge
requirement for health facility given the population density of the area. The area
still lacs in all paramenteres of health services. Private health care has huge
opportunity given the high income and connectivity of noida to Delhi, Gaziabad &
Faridabad through express highways.
The unavailability of sufficient number of beds and advanced diagnostic imaging

facilities, prima-facie lend strong support to establishing a tertiary care hospital in
Noida.
28
Project Outline
29
4.1 Introduction
SARLA MEDICAL CENTRE PRIVATE LIMITED is desirous of setting up a multi-

specialty tertiary care hospital in Noida. The hospital would bridge the gap in
accessibility to tertiary healthcare services in Noida and the nearby areas of Delhi,
Gaziabad, Faridabad etc. The hospital would be equipped with state-of-the-art
diagnostic and clinical facilities to provide best in class treatment to the local
community.
The hospital would be would be located on a 10.831 sq. ft. land allotted for the
purpose by NOIDA Authority to the company.
SARLA MEDICAL CENTRE PRIVATE LIMITED is incorporated in 1999, having its

registered office at A-1 SHOP NO.16 DURGA MARKET KONDLI NEW DELHI –
110091. The Directors of the company have extentive experience in healthcare and
construction sector. At present company has four directors.
1. Dr. PUNAM KUMAR: Dr. Punam Kumar is a dental surgeon (BDS) and have
more than 30 years experience in the field in NOIDA.
2. Dr. BABIT KUMAR: Dr. Babit Kumar is one of the leading Radiologist (MD)
associated with leading superspeciality hospitals like, Delhi State Cancer
Institutes (Delhi), Mahatma Gandhi Medical College and Hospital (Jaipur) and
Max Super Specialty Hospital.
3. DHARAMVEER SINGH: Dharamveer Singh is having extensive experience of

more than 30 years in construction and development. He is also associated with
SUNWORLD DEVELOPERS PRIVATE LIMITED as Director, which is a leading real
estate development company developing approx. 120 acres of land in Noida and
Yamuna Expressway. He is also chairperson in Ascent International School,
Greater Noida, which is a Not for profit CBSE affiliated Senior secondary school
providing affordable quality education to children of greater Noida and nearby
areas for last 15 years.
4. RAHUL KUMAR: Rahul kumar is having more than 8 years of experience in

real estate development. He is associated with PROHOMES PROPMART
PRIVATE LIMITED.
4.2 Hospital Structure
The proposed hospital would be multi-specialty tertiary care unit. The

hospital would have 100 beds, spread over a total built up area of
approximately 52,248 sq. ft. The facility would consist of the following
medical (core) and support (non-core services):
30
 General Medicine
 Dietetics & Nutrition
 Dermatology & Venerology (Skin & Allergy)
 Paediatrics
 Neonatology
 NICU (Neonatal Intensive Care )
 Well baby nursery
 General Surgery
 Urological Suegery
 ENT Surgery
 Dental Procedure
 Anaesthesia
 Surgical ICU
 Plastic surgery & Cosmetology
 Labour OT
 Ante-natal ward
 Post-natal ward
 Postpartum ward
 Labour room
 Radiology (Ultrasound Mammography, CAT Scan)
 Labarotary Medicine ( Pathology and Microbiology )
 Cardiology ( TMT , Echo , ECG )
 Ambulance & Mortuary Van facilities
 Pharmacy ( Indoor & Outdoor)
 CSSD
 Dietary
 Medical Records
 Physiotherapy
 Bio Medical Maintenance
 Medical Education & Training
Supporting infrastructure facilities for the hospital like:
 Substation
 EB Metering Yard
 Sump & Pump room
 Medical Gas Manifold room
 Mortuary & Bio-Medical Waste Segregation room
 Sewage Treatment Plant – Sump & Pump room
The rationale of proposing a multi-specialty unit is based on the fact that an

increasing number of population in nearby areas, both urban and rural, are
exhibiting co-morbidity and require the intervention of multiple specialists to
provide holistic treatment. Moreover, multiple specialties would allow the hospital to
better utilize expensive diagnostic facilities. For e.g. CT Scan and MRI serve cardiac
surgery, neuro-surgery, orthopedic surgery and gastro-intestinal surgery. ECHO
and Ultrasound are useful
31
for diagnosing urology, gynecology, vascular and cardiology related problems in

patients.
The hospital would consist of three cores:
Outer core – OPD Zone
The OPD zone is the first approach for any patient to this hospital. Patients entering
the OPD entry will be exposed to a series of consultation rooms catering to different
departments, treatment rooms and diagnostic facilities. An out-patient waiting area
for the OPD facility is planned in OPD block with separate toilet facilities.
The emergency facilities & maternity wards are planned as a separate arm and it
has
the following facilities.
 Examination Lobby
 Help desk
 Triage
 Treatment room
 Observation beds
 Labor ward
 Delivery rooms
 NICU
 Neonatal Resuscitation
 Duty doctor room
The diagnostic facilities planned are as follows:
 Ultrasound
 ECG
 Echo
 Treadmill
 Pulmonary lab
 Audiometry
 EEG
 EMG
 Lithotripsy
 Uro-dynamics
 Endoscopy
 Mammography
Clinical Laboratories are also planned very close to OPD and IPD areas for easy
access.
32
Intermediate Core – Radiology and Critical Care Zone
The intermediate core accommodates the radiology diagnostics and the critical care
areas such as the intensive care units, operating rooms, pre and post-op holding
bays
etc. Since, the radiology unit serves the out-patients, emergency department and
the in-patients; the location of the radiology wing is of particular importance and is
located so as to enable optimal access from all three areas. Inter-dependent
departments / diagnostics would be located next to each other to facilitate efficient
use of resources. Radiology department would also be planned in such a manner so
that it is away from maternity department and patient waiting areas to ensure
patient
safety.
The diagnostic facilities include
 X-Ray
 MRI
 CT Scan
The Intermediate zone would have the following facilities:
 Operation Theatres
 Pre / Post Op beds
 ICU beds
 OT & ICU support services
 Change rooms for Male & Female
 Equipment & Sterile Store
 Anesthetist room
 Duty doctor rooms
 Console & wash
 CSSD
Suitable zoning shall be planned to minimize crisscross of fresh and used material,
manpower and patients.
Inner Core – In-Patient Departments
The inner IPD zone would consist of wards and holding areas for recuperation of
medical and surgical in-patients. The zoning shall be so planned to minimize traffic
and provide a peaceful environment for the patients to recover.
The wards would be further categorized as general wards, semi-private rooms,

private rooms and deluxe rooms to provide service differentiation and address the
specific requirements of various classes of patients.
Wards would be supported with the following facilities:
33
 Treatment room
 Nurses’ station
 Clean Utility & Drug Store
 Dirty Utility
 Duty Doctor rooms
4.3 Projected Capex Estimates
The proposed hospital shall be developed in total 10,831 sq. ft. area having
total built
up area of 52,889 sq. ft. accommodating a total of 100 beds. The cost of
projected is expected to be Rs 30,00 lakh.
The detailed break up of costs shall be as follows:
34
4.4 Staffing Plan
The proposed hospital shall be staffed in line with industry standards. Each
specialty would have a super-specialist at the level of a senior consultant.
Further, the staffing strategy would envisage having visiting consultants at a
minimum of one per specialty to drive volumes and utilization initially.
The broad numbers for the man power grid (administrative and para-medical
staff) is as follows:
35
Staff category Number

Medical Staff
Senior Doctors 15
Doctors - Mid Level 10
Junior Doctors 10
Nurses 100
Medical Technician 10
Bio Medical 2
Pharmacy 8
Physiotherapy 2
Dietetics 2
Medical Records 3
Total Medical Staff 162
Management and Administration

Management ( Senior) 2
Managers( Mid Level) 4
Engineering staff 3
General Admin 10
F&B 10
House Keeping 40
Front Office 6
Security 10
Information Technology 1
Human Resources 2
Finance 3
Marketing & promotion 4
Total Staff - Non Medical 95
TOTAL STAFF 257

4.5 Marketing plan
The marketing plan for the hospital shall have two main objectives – creating
awareness of the hospital services and ensuring a steady patient load from across
the district.
During the initial roll out phase, an intense awareness campaign of the hospital
services would be initiated. The awareness campaign would include teaser
campaigns, free health check-up camps, media involvement in creating awareness
36
about preventive health checkups and lifestyle related modifications to avoid

diseases such as diabetes, hyper-tension, obesity etc. The marketing teaser and
awareness campaign shall be rolled out to include corporates, schools, Government
and public offices, shopping areas etc.
The objective of the outreach programs and camps shall be to reach out to
maximum number of people in the drainage area. Free health checkup and
screening camps shall be conducted with the help of hospital doctors. Diagnostics
such as ECG, Ultrasound, ECHO, physical screening etc. shall be conducted to
screen patients and identify problems in time and advice people on the correct
medical intervention necessary to prevent buildup of the problem. Community
health workers shall conduct door to door campaigns to ensure that the people
utilize the facilities made available to them during these outreach programs.
The marketing team shall also organize Continuous Medical Education programs for
doctors in the district and in the State of UP to facilitate greater knowledge sharing
and to create an awareness of the facilities available and the medical work being
carried out in the hospital amongst the medical fraternity in Noida and NCR.
37
PROJECT
DEVELOPMENT
PLAN
38
5.1 Project Management
The current Project management team, which includes all directors of the
Companay enjoys a proven track record of designing, developing construction
projects. The team has a also vast experience of working closely with the medical
professionals at leading hospitals and enjoys the advantage of tapping into medical
planning resources of senior medical professionals.
The project management set up at the company includes architects, design

engineers, project managers and site execution experts who are well versed in the
nuances of designing and building.
5.2 Planning, design and construction
The planning, design and construction phase is the one of the most important
phases in setting up a multispecialty hospital. This phase lays the basis for an
operationally efficient hospital capable of serving patients in the most optimal way.
5.3 Architectural & MEP design
Medical departments and allied services require comprehensive provisioning of

support services for seamless functioning. The scope of services under this head
would include
Schematic design stage
 Review of architectural plans for adequacy and for provisioning of support

Services
 Propose design concepts in line with the project brief
 Ensure adequate space provision for accommodation of allied services and
support functions
 Review final schematic drawings with recommendation to promoter for final
Approval
Design development stage

 Coordinate with the promoter, architects, structural and MEP consultants for
coordinated design development drawings
 Review and recommend for approval, the design development drawings and
specifications including
 building elevations, incorporating all building elements such as doors,
windows, shafts, materials, signage’s etc.
 structural design report indicating type of structure, loading patterns and
design parameters
 preliminary engineering design report for all engineering disciplines indicating
type of system proposed along with justifications (technical and financial),
basic engineering scheme, preliminary costs, suggested vendors etc.
 specialist services like, IT, laundry, kitchen, CSSD, medical graphics &
signage, medical gas systems and medical equipments.
39
5.4 Construction stage
The construction stage can be broadly divided into pre-construction, construction

and post-construction phases.
Pre-Construction Phase
 Visit the site and or assess the scope of development, which may be required
for planning the total development of site.
 At completion of schematic design phase verify & confirm the budgeted cost
of
construction of the project as prepared by the Architect/Design Consultants.
 Conduct pre-bid conferences to familiarize the Vendors with the Tender
Documents, management techniques and with any special systems, materials
and methods.
 Evaluate the quotes received and help the promoter in contract negotiations
leading to selection of contractor(s) for the various tender packages and make
recommendations for award of contracts.
Construction Phase
 Recommend course of actions when the contractual requirements are not

being met and co-ordinate the work with the activities and responsibilities of
the promoter, Architect/Design Consultants to complete the project in
accordance with the promoter’s objectives of cost, time and quality.
 Develop the procedure for the review and processing of applications for
payment by the contractors for progress and final payments, in consultation
with the promoter.
 Review shop drawings (as may be required), co-ordinate with the
Architect/Design Consultants with comments for their approval.
 Review mock-ups and samples as submitted by contractors / suppliers
 Determine when a project is substantially complete, and take necessary
steps
that are required before the certificate to this effect can be issued.
 Final inspection, checking/monitoring of testing, and commissioning of the
system.
5.5 Equipment & Surgical Instruments planning and procurement
 Promoter would take help of consultant in preparing detailed BOQs and

specifications for the medical equipments and surgical instruments.
 The procurement team would assist in getting quotes from the vendors and
would also participate in negotiations with the vendors to obtain the best
possible rates.
5.6 Medical furniture planning and procurement
Promoter would plan the bill of quantity and finalize the stainless steel furniture
such as medicine trolleys, crash carts, OT furniture, CSSD furniture etc.
40
5.7 Contractual services finalization
Below listed services would be outsourced and will be finalized on contractual basis.
Food & beverage services: planning, design, preparation of patient menu

and identifying F&B vendors
Laundry services: evaluating the laundry load and negotiating best possible
rates for the various types of hospital laundry such as OT linen, soiled linen,
patient linen etc.
House-keeping services: assist in negotiating & finalizing house-keeping

Vendors
Maintenance: evaluate various facility management providers for the

expertise in operating equipments like chiller, DG sets, AHUs, transformers,
electrical panels, cooling towers etc., review man power deployment chart etc.
for seamless operation of the hospital services
Security: evaluate the security agencies and prepare the security personnel
deployment requirement
41
Projected
Financials
42
6.1 Projected Financials
General Assumptions
1. 300 working days has been considered for revenue calculations.
2. The capacity utilization matrix has been benchmarked based on Sarla
Medical Centre and directors experience at its nursing home and hospitals
elsewhere and the market dynamics. The same has been considered as per the
matrix below –
Year Capacity Utilization
Year-1 30%
Year-2 50%
Year-3 65%
Year-4 75%
Year-5 78%
Year-6 Onwards 80%
3. Price increment year on year has been considered at 5%
Profit and Loss Snapshot
(Figure in INR in Lacs)

Particulars Construction Year- Year- Year- Year- Year- Year-
Period 1 2 3 4 5 6
Occupancy 30% 50% 65% 75% 78% 80%
Revenue
Surgical 525 936 1302 1607 1789 1963
revenue
Non Surgical 56 100 139 172 191 210
Revenue
OPD Diagnostic, 313 557 775 957 1065 1169
Pharmacy & Lab
Revenue
TOTAL 893 1593 2217 2736 3045 3341
REVENUE
Avg. revenue 30 32 34 36 39 42
Per Occupied
bed
COST
Varible Cost
43
Fees to Doctors 393 542 665 766 761 835

Medicines and 357 478 665 766 853 935
Consumables
Other Variables 89 127 177 219 183 201
Cost
Fixed Cost
Salaries & 357 478 599 739 791 869
Administrative
Expenses
TOTAL COST 1197 1625 2105 2489 2588 2840
EBIDTA -304 -32 111 246 457 501
EBIDTA Margin -34% -2% 5% 9% 15% 15%
(%)
Some key points to be noted are as below –

 EBITDA break even period – Year 2
 Cumulative cash break even period – Year 4
44

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SARLA MEDICAL CENTRE PRIVATE LIMITED

Sr. DESCRIPTION PAGE NO.

1. Executive Summary 03-10

2. An Overview of the Indian Healthcare Sector 11-19

3. Uttar Pradesh State Profile 20-28

4. Project Outline 29-37

5. Project Development Plan 38-41

6. Projected Financials 42-44

1.1 Project Introduction

SARLA MEDICAL CENTRE PRIVATE LIMITED is desirous of setting up a multi-

SARLA MEDICAL CENTRE PRIVATE LIMITED is incorporated in 1999, having its

3. DHARAMVEER SINGH: Dharamveer Singh is having extensive experience in

4. RAHUL KUMAR: Rahul kumar is having more than 8 years of experience in

1.2 Project at a glance

The proposed hospital would be multi-specialty tertiary care unit. The

Approved Land Area: 10,831 sq. ft.

1.3 Facility Mix

The facilities to be offered by the proposed hospital are based on assessment

Obstetrics & Gynecology

 Radiology (X ray, DEXA, Ultrasound, Mammography, CAT Scan etc.)

 Ambulance (3) & Mortuary Van (1)

 Intensive Care areas (ICU, NICU): 25

1.4 Projected Capex Estimates

The detailed break up of costs shall be as follows:

( Land + Equipments + working capital+ Building)

1. Plot Number and Sector NH-1, Sector-119

Medical Equipment & Surgical Instrument and Working Capital

1.5 Project Timelines

The project timelines shall be as below. It is envisaged that the statutory

1.6 Staffing Plan

Staff category Number

Management and Administration

TOTAL STAFF 257

2.1 Indian Healthcare scenario

As per statistics published by the WHO, in 2008, the death-rate due to

2.2 Indian Healthcare vs. Global Standards

such as Joint Commission International, NABH etc.

However, a lack of Government will to promote the growth of healthcare coupled

2.3 Industry Challenges

Poor healthcare delivery infrastructure and human resource constraints have

3.1 Health Status across the States

3.2 Health Care Infrastructure in Uttar Pradesh

Note;*1 super specialty Hospital SGPGI, is functional at Lucknow,3 more institute

3.3 Medical Education in U.P.

3.4 Human Resources

The current position of doctors and paramedical staffs in UP is shown in Table 4.

The situation is grave in terms of requirement of medical personnel vis-à-vis their

The problem of shortages is further compounded by the absenteeism of public

3.5 Noida: Overview

As per provisional reports of Census India, the population of Noida in 2011 is

3.6 Health Services in Noida

The unavailability of sufficient number of beds and advanced diagnostic imaging

SARLA MEDICAL CENTRE PRIVATE LIMITED is desirous of setting up a multi-

SARLA MEDICAL CENTRE PRIVATE LIMITED is incorporated in 1999, having its

3. DHARAMVEER SINGH: Dharamveer Singh is having extensive experience of

4. RAHUL KUMAR: Rahul kumar is having more than 8 years of experience in

4.2 Hospital Structure

The proposed hospital would be multi-specialty tertiary care unit. The

Supporting infrastructure facilities for the hospital like:

The rationale of proposing a multi-specialty unit is based on the fact that an

for diagnosing urology, gynecology, vascular and cardiology related problems in

Outer core – OPD Zone

The diagnostic facilities planned are as follows: