Does a nursing home need a license? Profitable old age: how a private nursing home works. How to open a home for the elderly and disabled? What is needed for this

Enough a large number of people are interested in the topic of opening a private nursing home. An integral part of this interest are economic calculations, profitability, necessary investments, etc. This entire aspect of interest is covered by the business plan.

But independently drawing up a business plan is quite a labor-intensive task, primarily time-consuming and requiring certain knowledge in the field financial planning and calculations. Ordering a business plan from consulting organizations is quite an expensive undertaking.

Having been involved in the organization and opening of private nursing homes for quite a long time, I, based on my desire to have as many decent boarding houses for elderly people in our state as possible offering a high level of quality of life for elderly people, decided to make a gift for everyone who has the desire and opportunity to open . Below, via the red link, in PDF format, you can familiarize yourself with one of the business plans I ordered for a nursing home developed for Moscow. Business plan for a premium boarding house for elderly people. I chose this particular business plan because the standards must always be raised) And the premium segment is a good guideline for organizing the work of a private nursing home.

What's next?

And then important information will be knowledge of the hygienic requirements for the placement, design, equipment, maintenance of facilities of healthcare organizations and social services, intended for permanent residence elderly and disabled people, sanitary-hygienic and anti-epidemic regime of their work. Or simply put, Sanitary and Epidemiological Rules and Standards. More specifically, SanPiN 2.1.2.2564-09. Click on the red text below and you will have knowledge of the rules and regulations imposed by the state on the topic of interest to us.

The business plan for a nursing home is reflected on the website in pdf format and the estimated figures are reflected for a specific case. For your situation, I have an Excel file with specified formulas for calculating EBITDA, NPV, IRR, payback periods, sensitivity analysis and other financial calculations. Write to me at the email indicated in the Contacts section and I will send you this very necessary tool for financial calculation of the profitability of a private boarding house for the elderly.

The older generation needs care and special care. However, relatives are not always ready to surround an elderly person with attention. While young family members are at work, the pensioner is left to his own devices. The situation can worsen even more if, with age, a person develops a galaxy of diseases, including mental disorders.

A private boarding house or nursing home is the optimal solution for all parties: the elderly person receives the necessary care and medical supervision, relatives are no longer afraid to go to work, and the establishment receives a well-deserved profit.

Guaranteed social protection or private sector

Unfortunately, the percentage of citizens of retirement age in Russia is gradually growing, and existing state institutions for caring for the elderly can no longer cope with the influx of guests. It is also necessary to take into account the factor that social institutions Only single pensioners are accepted - the heirs must take care of the rest.

Family grandparents, more often their relatives, can only apply to a private institution, therefore this type business is considered the most competitive in the conditions modern economy. Stereotypes about poor living conditions and negative attitudes towards nursing home residents are gradually being erased. Confidence in nursing homes is returning due to objective reasons: modern private institutions are distinguished by a high level of comfort and professional staff.

How to open a nursing home

The practice of spending the rest of one's years in a nursing home, under constant surveillance medical supervision, is widespread in Europe and the USA: neither children nor their parents see anything reprehensible in it. Supply fully covers demand: this niche social business in European countries it is completely filled. However, in Russia, business is only gaining momentum - many businessmen are investing capital in the construction and improvement of nursing homes in order to receive a high and stable income in the future.

Any social entrepreneur can open a nursing home or a private boarding house for the elderly and disabled: registering a business is not particularly difficult (description below). But you will have to work very carefully on your business plan or enlist the help of a specialized specialist, otherwise the project may turn out to be unprofitable.

A business plan for opening a nursing home can be downloaded for free on the Internet, purchased as a personal project or franchise, or developed independently. Considered the most reliable individual projects– they are based on preliminary marketing and social research applicable to a specific region or city.

Before registering a business and looking for investors, you need to determine:

• Assessing the prospects of a project in a specific city/district: demand for services, presence of competitors, etc.
• Target Audience: Who are you planning to work with?
• Specifics of the institution: nursing home, boarding house.
• Number of guests.
• Selecting a location and building.
• Range of services provided.

And only then, based on the data received, you develop/order a business plan for a nursing home.

The target audience

First of all, you should decide on your clientele. Will you work only with older people or are you willing to accept people with disabilities? Are you ready to work with seriously ill (bedridden) patients and do you agree to care for people with mental disorders that develop in old age?

For each group of guests you will need to create personal conditions, purchase specific medical equipment and staffing. Caring for bedridden patients and other groups of disabled people costs a considerable budget, which may not be recouped later, so many private institutions prefer to work in the narrow sphere of serving the elderly.

To choose from target audience influence:

• The presence of competitors in certain areas: social institutions for pensioners and disabled people, hospices, mental health centers;
• Sociological surveys: are relatives ready to entrust the care of elderly parents/disabled/severely ill to a third party organization;
• Marketing research: standard of living of the population, whether certain services will be in demand in this region and to what extent;

Specifics

All institutions can be divided into two broad categories:

• Residential nursing home;
• Boarding house for elderly people.

It is possible to combine both functions: some of the residents are in the institution permanently, some - in case of urgent need. But you should remember that the notorious “need” most often arises among relatives before a holiday or vacation. In fact, an elderly relative is placed under the care of medical staff when children and grandchildren go to resorts. As a result, the main peak of work in a boarding house occurs during summer time and New Year's holidays.

The specifics of the establishment include the entertainment program that you are going to offer to guests. One TV is not enough: it is advisable to organize several hobby groups, develop an active recreation program (exercise machines, vegetable garden, swimming pool - for health reasons).

Business project

A nursing home is a mutually beneficial arrangement. The entrepreneur assumes responsibility for the guests, and his relatives relieve themselves of this responsibility for a certain financial payment.

In order for the establishment to be profitable, all costs must be foreseen in advance - when the project begins to be implemented, you will have no time to look for investors. It is likely that during the implementation process the business plan will have to be adjusted several times. However, the higher the quality of the project, the closer the final cost will be to the estimate.

About how to open a private house for the elderly and what is required for this, you can consult with specialists working in this field. For a certain amount of money they will help you draw up quality business plan, they'll give you a few practical advice and will warn about the pitfalls that are hidden in the murky bureaucratic current.

Premises requirements

The choice of building and its placement plays a huge role. Can be built new object in strict accordance with SNiP standards or purchase a ready-made building and carry out reconstruction - the buildings of old boarding houses and sanatoriums are best suited for this. Hotels and hostels can also be used.

It is best to choose objects (buy a plot for construction) outside the city - in an ecologically healthy area. The best option– a landscaped area of ​​one or two hectares. So the guests will have beautiful view from the window and the opportunity to walk in the fresh air.

In the planning of the facility it is necessary to take into account:

• Single or double rooms for residents
• Bathrooms: private in rooms or shared on each floor
• Spacious dining room
• Rooms for doctor's appointments, procedures, etc.
• Premises for recreation and entertainment
• Required: the presence of ramps, railings and an elevator

Personnel requirements

All line personnel (medics, psychologists, orderlies, etc.) must have appropriate education and work experience. Without a qualified health worker on staff, you will not be allowed to open a nursing home. Depending on the number of guests, you may have one doctor on duty or an entire medical unit. It is advisable to organize round-the-clock duty so that the specialist on duty can see the patient at any time.

You can select housekeeping personnel at your discretion. You will need: security guards, cleaners, administrator, wardrobe maid, caretaker, gardener.

Particular attention must be paid to the choice of nannies. Staff working directly with guests should be friendly, tactful, polite and stress-resistant. It is recommended to select applicants for these positions with a medical or psychological education.

Equipment purchase

is the most client-oriented business possible: clients literally live with you for years. Therefore, you create decent living conditions for them, provide medical care, and organize leisure time. This will require a lot of special equipment and devices:

• Beds with adjustable backrest
• Mattresses to prevent bedsores
• Plumbing equipment taking into account the physical capabilities of users
• Personnel emergency call system (panic button)
• Required minimum of diagnostic and treatment equipment
• Equipment for cooking, taking into account the menu of all guests
• Disabled equipment
• Equipment for entertainment, recreation and sports

Essential equipment is listed here. If you want to improve the status of your establishment or attract clients from target groups, you will have to significantly increase your budget. After all, many of your residents require additional procedures to maintain health - physiotherapeutic, massage, therapeutic and preventive, etc.

Legal registration

In order to legalize a nursing home, you will need to register and register a legal entity with the tax authorities, obtain a medical license, resolve issues with the Social Insurance Fund, the Pension Fund of Russia, Rosstat and the Department social protection. Many entrepreneurs are wondering how to open a nursing home without a license: according to current legislation, this is impossible.

For registration of all necessary documents you can use the services law firm or a hired lawyer - professional help will help you save time and money.

The regulations for the reception of guests are also prescribed at the legislative level. You will need:

• Statement from the person himself, his close relatives or guardian
• Passport, SNILS, INN
• Copies of your medical card and health insurance policy
• Documents confirming the assignment of a disability group (if available)
• Medical examination report (if necessary)

To protect the entrepreneur from unforeseen claims, the client must sign the material and household inspection report, as well as the rules for the reception, residence and discharge of the tenant.

Advertising

It is necessary to allocate a separate budget column for attracting clients. Advertising can be distributed through the media or via the Internet - individually for all groups of the target audience. Your own website will significantly increase your chances of success - here you can post photos of the establishment from the best angles, customer reviews and a list of services.

Profitable business or social project?

To open a nursing home you will need initial capital minimum 1,000,000 rubles. The higher the status of the establishment, more quantity services and the wider the staff, the more costs you will incur.

The payback period for the project is at least 1 year for different regions. The level of further profit depends on your pricing policy and the number of guests, but most entrepreneurs speak of the fairly high profitability of the business project.

However, against the backdrop of commercial benefits, we must not forget about the main task of social business - helping the elderly and disabled people. The reputation of such establishments takes years to earn and can be destroyed in an instant. You make a profit exactly as long as you honestly fulfill your obligations.

Study the demand for the services you are going to provide. The requirements of various authorities for the activities of private homes for the elderly and disabled are very high, and the legislative framework It's just being created. Study all legal and organizational issues.

Main risks

Despite insufficient funding and terrible conditions in government institutions, regulatory authorities pay close attention to private ones. The risk of “drowning” in litigation due to identified violations of sanitary standards, insufficient qualifications of personnel and other inconsistencies is extremely high. Strict adherence to regulations, exemplary service and a contract with a good law firm will help minimize these risks.

Private homes for the elderly and disabled are still a rarity for the CIS countries. The wary attitude of the population is reinforced by numerous cases of fraud against the elderly and disabled. There is only one way to change the opinion of society - to provide exemplary services, provide clients with maximum comfort and the opportunity to feel their social significance.

Location

The ideal premises for organizing a home for the elderly and disabled is the building of a health resort, recreation center, or private boarding house. The layout and communications of such institutions are already adapted for the stay of people in need of medical care.

The area of ​​the premises depends on the number of residents of the boarding house. No more than two people should live in a room. Also, examine the building for compliance with sanitary standards and the list of services you plan:

Sewerage.
- Fire safety.
- Air conditioning.
- Dining room.
- Possibility to organize bathrooms.
- Possibility to organize medical offices.

During the repair process, the most important point is the heating system.

Equipment

For organizing a private home for the elderly and disabled, the same rules apply as for state institutions.

It is necessary to purchase special beds and mattresses to prevent bedsores.

Bathrooms must be equipped in such a way that people with limited mobility have the opportunity to perform hygiene procedures. The floor is covered with anti-slip tiles.

An important point is the handrails, which ensure safe movement for people with disabilities. disabilities, wheelchairs, walkers, canes.

If a building has several floors, it must have an elevator. All rooms must be equipped with emergency personnel call systems.

A prerequisite is the presence of medical offices equipped with everything necessary to provide medical care and carrying out general strengthening procedures.

Providing adequate nutrition is also extremely important point, requiring significant investments and compliance with sanitary standards. The building must have a full-fledged dining room, providing 4 meals a day to the residents of the boarding house.

If your budget allows, you can place a TV in each room. As a last resort, it is necessary to create rest rooms on each floor and install televisions there. The boarding house should create a library and provide residents with the opportunity to engage in handicrafts and other forms of creative expression. Refrigerators should be installed in every room. Modern nursing homes provide the opportunity for residents' family and friends to be welcomed into their rooms.

To transport food and other things necessary for the full functioning of the boarding house, you should purchase a cargo bus.

Personnel

Personnel should be selected with particular care. The success of your nursing home depends on the professionalism of these people and their attitude towards the older generation. To work in such an institution you need a medical education. It is no secret that working with this category of patients is extremely difficult. Patience and respect for residents are mandatory criteria for hiring.

The owner or administrator of the boarding house must personally conduct interviews and carefully check the candidate's personal file.

Except medical workers cooks needed. Your clients will suffer from many diseases, the work of the canteen is designed to prepare special dishes. This means that a nutritionist is needed on staff who can formulate a nutritious diet depending on the diagnosis of each nursing home resident.

You will have to work constantly and hard to comply with sanitary standards. The number of support staff depends on the area of ​​the premises and other features of your establishment.

To handle financial affairs, you need to hire a full-time accountant.

Documents and licenses

The process of registering a home for the elderly and disabled is very troublesome and lengthy. To comply with all regulations and speed up registration, it is better to hire law firm, which specializes in this area.

The organizers or managers of the boarding house must have the appropriate medical education and a license to provide wide range medical services.

Registration with the tax office is only part of the process. Each region requires additional registration and obtaining a number of permitting documents. Fire and sanitary services, the local health department will grant permission to operate only after the boarding house building is brought into compliance with the standards of each of these authorities.

To organize and obtain permits, it is necessary to provide contracts and certificates of conformity from all suppliers.

A separate issue is the settlement of many legal and financial issues with Pension Fund and the Department of Social Protection. Issues of transferring pensions of residents of nursing homes and disabled people to the institution’s account are resolved by local authorities.

Marketing

Advertisements for looking for a caregiver for the elderly and disabled can be seen literally at every turn. Advertising in local media will definitely bring results. Then everything depends on the quality of service in your establishment. This niche in our country is still absolutely free. A high level of service will provide you with a constant flow of clients.

Collaborate with medical institutions. If in hospitals relatives of disabled and elderly people are offered your booklets and recommend your establishment, the problem of finding clients will disappear instantly.

Summary

Minimum amount starting capital for organizing a private home for the elderly and disabled is about 40 million rubles. If events develop successfully, you should expect payback in 5-6 years. The main thing to achieve success in this direction is strict compliance with standards, qualifications of personnel and high level service.

To assess the level of demand for a service, you need to take into account:

• size of the settlement, degree of urbanization of the region;
• mentality and solvency of the population;
• the presence of competitors and the state of infrastructure (hospitals, rehabilitation centers, nursing homes of various forms of ownership, specialized organizations providing medical services at home).

State and municipal nursing homes, as a rule, cannot compete with private institutions due to inadequate living conditions and patient care. There are exceptions. It happens that a government agency is taken under the guardianship of a charitable organization or a large business entity. If, at the expense of the sponsor, a state institution has created sufficient material resources and tolerable living conditions, potential clients will not overpay to a private owner.

Organizational aspects

It is desirable that the establishment is located outside the city in a picturesque area. There are many reasons for this:

• older people want peace, they benefit from walks in the air;
• distance from the city reduces labor costs (the claims of cooks, cleaners, janitors and security guards from the nearest village will be less than those of city residents);
• the relatives who have placed the elderly person in a private boarding house are wealthy enough to visit him by personal transport.

Selection of premises

The more the layout of the building (rooms for 1-2 people, a corridor system, the presence of a dining room, a sufficient number of showers and restrooms) corresponds to the profile of the future boarding house, the less will subsequently have to be invested in its arrangement.

Best option:

• recreation center;
• hospital;
• sanatorium;
• Kid `s camp.

Such organizations are departmental or located in municipal property. In both cases, the conclusion of the lease agreement may be delayed. State property can be leased only on a competitive basis.

The business plan for a nursing home must contain an estimate for putting the selected premises in order. In most cases, cosmetic repairs are not enough. You will have to change the plumbing, wiring, windows, doors, and re-roof. In the worst case scenario, we need to install communications, install a heating system, and negotiate the allocation of an electrical line. If the business is planned on a large scale, it is better to start with one building (floor), and finish the remaining premises as financial receipts come in.

You need to be extremely careful when executing lease relationships. It is worth involving a lawyer in the transaction process. The contract must be long-term. Otherwise, there is no point in investing in the reconstruction of someone else's building.

It is worth insisting that all or at least part of the cost of repair work be included in the rent. Improvements to the property are inherent and remain the default of the landlord at the end of the lease without any compensation. Since the contract is long-term, it will need to be registered in the Unified State Register of Real Estate.

Registration and permissions

A business plan for a private nursing home must take into account the need to register the organization. Least burdensome. As of 2016, the minimum authorized capital is 10 thousand rubles, the state duty for entering into the Unified State Register of Legal Entities is 4 thousand rubles. Registration of a turnkey LLC in Moscow will cost 35 thousand rubles. If you delegate only the drafting of the charter to a law firm and deal with bureaucratic procedures yourself, you can get by with 1.5 thousand rubles.

– 87.90 “Other care activities with provision of accommodation.” It is worth immediately adding as additional codes of all potentially possible types of activity. It's free.

A business plan for organizing a home, boarding house or boarding school for the elderly must include the cost of obtaining a license. The state fee for issuing a document is 7.5 thousand rubles. But the main costs will be incurred in connection with the previous sanitary and hygienic examination, preparation of certified copies, and extracts from registers.

The licensing conditions are:

• premises that meet the requirements of SanPiN;
• availability of an agreement for water supply, sewerage, heating, lighting, ventilation, fire alarm;
• the presence of medical personnel employed at their main place of work.

It will take up to 3 months to obtain a license, since passing through the authorities (Ministry of Emergency Situations, State Sanitary Supervision Service, Roszdravnadzor) can only be done sequentially. Each government agency needs conclusions from the previous one.

Many people are faced with the issue of caring for elderly relatives. Not everyone has the opportunity to devote enough time to the elderly. Constant work and household chores take up all my free time.

Elderly relatives require attention, care, and, most often, constant medical supervision. Therefore, modern nursing homes are an excellent option for permanent, comfortable living for elderly people.

In this article we will talk about how to open a private nursing home.

This business is quite attractive in terms of profitability and low competition. Therefore, it is profitable even in a crisis.

Business plan for a nursing home

Before starting a business, it is worth determining the level of competition. If, for example, you live in small town, and there is already a nursing home in it, then most likely your business will not be profitable. After all, a relatively small part of the population uses the services of shelters for elderly relatives.

If you live in a big city, then opening a private home for the elderly makes sense. And this business idea can become profitable if you approach its organization correctly.

How to open a home for the elderly and disabled? What is needed for this?

Unfortunately, in our country the attitude towards shelters for the elderly is negative; many believe that sending relatives to such institutions is inhumane. But this is a misconception; in fact, everything is not so. Modern nursing homes are well-equipped premises for living, staffed by excellent qualified staff who will provide care and special treatment to each resident.

Business registration

Before you start this activity, you need to formalize all the nuances in accordance with the law. First, you should register with the tax service as a legal entity.

For reference of this business a medical license is required. To do this, you must have employees with appropriate education. Or the owners themselves must have a medical education confirmed by a diploma.

Premises for opening a private nursing home

Choosing a room is a responsible task. For a shelter, a room, for example, a former recreation center or sanatorium, is suitable. The area should be large; it is also desirable that the boarding house be located in a quiet, environmentally friendly place, because old people love peace and a beautiful view from the window.

One or two people can be accommodated in one room, no more. Old people should be comfortable so that they feel at home.

There must be a large dining room. It is best to have 3-4 meals a day.

Bathrooms. You can equip separate bathrooms in each room or make a shared toilet and shower on the floor. I recommend the first option, it will be more comfortable for older people.

Mandatory presence of a medical office. Elderly people get sick often, so your shelter should have solid medical care and care.

It is also desirable to diversify the gray everyday life of old people. Organize a dance studio, it has a beneficial effect on your general condition. You can also equip a living room for spending time together.

Staff for a private nursing home

If you are planning to open a private nursing home, then it must be modernly equipped for the comfort and convenience of its guests.

Particular attention should be paid to personnel selection. It is important that the people who will care for the elderly are patient, honest, friendly, friendly, sensitive and attentive. Under no circumstances should you be rude or upset older people, always fulfill their requests, and do everything to make the residents comfortable.

Also pay attention to the education of your employees. It is advisable to select people with medical education and psychologists.

Equipment for nursing home

It is very important to provide elderly people with comfortable living conditions, as close as possible to their home environment.

• Beds. Buy special beds with a position changing function, this will provide the vacationer with a comfortable sleep;
• Mattresses. They must have the function of protecting against bedsores. This is important, because people with disabilities often live in boarding houses;
• Bathrooms. Equip bathrooms and toilets according to all rules. The floor must be anti-slip and insulated. Also, bathrooms should be equipped with everything necessary for comfortable carrying out all procedures, because many old people cannot move independently;
• Handrails. Be sure to install special handrails around the entire perimeter of the premises for safe movement around the boarding house;
• Elevators. Mandatory presence of an elevator. It is difficult for elderly people to move up stairs, especially since disabled people can live in the boarding house;
• Emergency personnel call system. Be sure to equip special signal buttons in guest rooms, as well as in bathrooms. Old people may often need help, so they can always get it on time.

In addition to all this, it is necessary that there is a 24-hour pharmacy on the territory of the nursing home, because old people often get sick. Read more about this on our portal.

Entertainment for the elderly

Organizing leisure time for residents of a nursing home is a responsible matter that cannot be neglected. Despite their advanced age, old people, like children, want to have fun. Therefore, arrange for them a variety of entertainment courses. For example, checkers and chess tournaments, watching entertaining TV shows. Abroad, frequent dance schools located on the premises of nursing homes are very popular. You can adopt this interesting idea. Here, you will find detailed.

Advertising

It is very important to correctly build an advertising concept. This is necessary in order to attract customers. You can place advertisements in the media or on the Internet. It is also advisable to create your own website, which will indicate the address of the nursing home, prices and living conditions. You can additionally provide a photo.

How to register parents or relatives into a nursing home?

In order for people to be able to live in your boarding house, you will need to provide a package of necessary documents:

• Application from close relatives;
• Copy of passport, SNILS, INN;
• For disabled people - a certificate of assigned disability group;
• A certified copy of the medical record and insurance policy;
• Additionally, you need to sign a material and household inspection report and internal regulations.

Payback periods and costs

• Rental of premises and repairs;
• Purchase of necessary equipment;
• Costs for registration and obtaining licenses;
• Staff salaries;

Approximately opening a private nursing home will cost you from 100 thousand dollars.

But after a few years, you will recoup all costs and receive your profit from the business.

I wish you success!

hospice Vladimir

In the Welcome section to the question of how hospice stands for, asked by the author Vladimir Teplov, the best answer is I don’t know how it stands for, but it is:

Hospice (from English.

hospice) is a medical institution in which patients with a predicted unfavorable outcome of the disease receive decent care and service. Hospice patients are surrounded by ordinary “home” things, with free access to them for relatives and friends. Medical staff provides palliative medical care: patients can receive oxygen, painkillers, tube feeding, etc.

The word “hospice” came into English from Old French (“hospice”). There it, in turn, was formed from the Latin words hospes and hospitium (“hospitality”). This term has been used since the 6th century AD. e. designated resting places for pilgrims. The first hospices were usually

The word “hospice” came into English from Old French (“hospice”). There it, in turn, was formed from the Latin words hospes and hospitium (“hospitality”). This term has been used since the 6th century AD. e. designated resting places for pilgrims. The first hospices were usually located along roads along the main routes of Christian pilgrims. These were, in a certain sense, houses of charity for tired, exhausted or sick travelers. However, hospices also helped local residents. From in English the word found its way into other European languages ​​in the 19th century.

How to open a hospice

Hospice (from the English hospice) is a medical institution in which patients with a predictable unfavorable outcome of the disease receive decent care and service. Hospice patients are surrounded by ordinary “home” things, with free access to them for relatives and friends. Medical personnel provide palliative medical care: patients can receive oxygen, painkillers, tube feeding, etc. Minimum doctors and maximum middle and junior medical personnel. The main purpose of staying in a hospice is to brighten up the last days of life and alleviate suffering. This is humane and, in addition, more cost-effective than treating terminal patients in an intensive care unit. In the post-Soviet space, this problem has not been solved, since it still requires significant investments, obtaining a license to work with controlled drugs, etc.

Word " hospice" came into English from Old French ( "hospice") There it, in turn, was formed from the Latin words hospes and hospitium (“hospitality”). This term has been used since the 6th century AD. designated resting places for pilgrims. From English the word came to other European languages ​​in the 19th century.

Basic principles of the hospice concept

The hospice provides care to terminally ill patients in the final stages of the disease. In the CIS countries, hospice care is provided mainly to cancer patients with severe pain syndrome in the last stage of the disease, confirmed medical documents.

The primary object of medical, social and psychological care in a hospice is the patient and his family. Patient care is provided by specially trained medical and service personnel, as well as relatives of patients and volunteer assistants who have undergone preliminary training in hospices.

Hospice provides outpatient and inpatient care to patients. Outpatient care is provided at home by teams from the hospice field service (“hospice at home”). Inpatient care, depending on the needs of the patient and his family, is provided in a 24-hour, day or night hospital stay.

The principle of “diagnosis openness” can be implemented in a hospice. The issue of informing patients of their diagnosis is decided individually and only in cases where the patient insists on it.

The entire range of medical, social and psychological assistance to the patient should be aimed at eliminating or reducing pain and fear of death while preserving his consciousness and intellectual abilities to the maximum possible extent.

Each patient in a hospice should be provided with physical and psychological comfort. Physical comfort is achieved by creating conditions in the hospital that are as close to home as possible. Providing psychological comfort is carried out on the basis of the principle of an individual approach to each patient, taking into account his condition, spiritual, religious and social needs.

The sources of financing for hospices are budgetary funds, funds charities and voluntary donations from citizens and organizations.

Basic principles of hospice activities

Hospice services are free. You can't pay for death, just like you can't pay for birth.

Hospice is a house of life, not death.

Controlling symptoms allows you to qualitatively improve the patient’s life.

Death, like birth, is a natural process. It cannot be rushed or slowed down. Hospice is an alternative to euthanasia.

Hospice is a system of comprehensive medical, psychological and social assistance sick.

Hospice - schools and support for relatives and loved ones of the patient.

Hospice is a worldview of humanism.

Prospects for the development of palliative care for cancer patients in Russia

The future development of palliative care is associated with the need to solve a number of problems of an organizational, scientific, medical, social and economic nature.

At the first stage, it is advisable to use the existing finite fund of urban oncology hospitals, which will make it possible to create a network of palliative care departments in a short time and without large financial costs to improve the quality of life of patients in need. At the second stage, along with the existing palliative care departments, the construction of hospices will be carried out. On the third stage - (as hospices are put into operation) - expand the functions of palliative care departments to multidisciplinary units of the system palliative medicine, where patients with disabilities will receive the necessary care various forms chronic diseases (neurological, endocrinological, pulmonological, etc.) in the terminal stage of development, i.e. patients whose specialized treatment has already exhausted its capabilities and/or is impossible due to the severity of the patient’s general somatic condition. As a result, the system of palliative care for cancer patients created in Russia can be used as a model of palliative medicine service, the basis of which is territorial centers of palliative medicine.

2.1. Opening of a hospice. Hospice Regulations

The hospice provides assistance to patients in the Central District of the city.

The organization of the work of the PMH is carried out in accordance with the Regulations on this institution, approved by the Moscow Department of Health and which is the fundamental document for the organization of the work of hospices in Moscow, including the First Moscow Hospice. Below is the full text of this provision.

1. General Provisions

1.2. The hospice is created in the manner prescribed by regulations legal acts Moscow.

1.3. Hospice officials and staff are guided in their activities by legislation Russian Federation and this Regulation.

1.4. Hospice is legal entity, has an independent balance sheet, current and other accounts in banking institutions, a round seal with its name, a corner stamp with the name of the institution, forms.

1.5. The hospice operates in accordance with the Charter and on the basis of a license obtained in the prescribed manner.

1.6. A hospice can be a clinical and educational base for medical educational institutions and research institutes.

1.7. The hospice acts as a plaintiff and defendant in court, arbitration, and arbitration courts in accordance with the legislation of the Russian Federation.

1.8. Hospice performs state events on mobilization preparation in accordance with current legislation And regulations Moscow Government.

1.9. In order to implement state, social, economic and tax policies, the hospice is responsible for the safety of documents (managerial, financial and economic, personnel, etc.); ensures the transfer of documents to state storage.

The hospice provides services to the population of the assigned area, numbering up to The capacity of the hospice is determined by the number of beds.

2.2. The selection of patients for hospice is carried out by hospice doctors based on:

– the presence of terminal cancer, confirmed by medical documents from the referring institution;

– presence of pain syndrome that cannot be relieved at home;

– the presence of socio-psychological indications (depression, reactive states, conflict situations at home, inability to care for the patient).

2.3. Hospice provides outpatient and inpatient care to patients, which, depending on the needs of the patient and his family, can be provided in the form of intermediate forms - day hospital, mobile service.

2.4. Providing psychological comfort is carried out on the basis of the principle of an individual approach to each patient, taking into account his condition, spiritual, religious and social needs.

2.5. Medical care and qualified care for patients in a hospice are provided free of charge. Subsidies (payment) from relatives or patients are prohibited.

2.6. The hospice does not engage in commercial or other activities that contradict its charitable nature and violate the principle of equal access to the institution and equal opportunities for medical and social care for all incurable patients.

2.7. The hospice provides medical, social and legal protection for patients registered with the hospice.

2.8. Hospice provides social protection for hospice staff.

2.9. The hospice carries out organizational and methodological work on primary training of personnel: doctors, paramedics, junior medical staff, volunteers and training relatives in patient care skills.

2.10. Approves the structure and staffing of the hospice chief physician hospice, based on the number of the assigned contingent and the volume of medical and social assistance provided (within the limits of the wage fund).

2.11. The hospice provides organizational, methodological and practical assistance to institutions and specialists on palliative treatment issues, takes part in meetings and conferences on topical issues palliative treatment.

2.12. Hospice provides:

– emergency medical care;

– specialized medical care;

– selection and implementation of the necessary analgesic and symptomatic therapy;

– qualified medical and social assistance to patients, provision of psychotherapeutic assistance to the patient and his relatives;

– nutrition, including dietary, in accordance with medical recommendations and the wishes of the patient;

– organizing and conducting supportive palliative treatment of incurable patients;

– organizing the necessary advisory assistance;

– carries out the development and implementation of new methods of palliative treatment and patient care into practice;

– analyzes the effectiveness of the medical and social activities of the hospice;

– carries out mobilization preparation and civil defense activities;

– carries out operation and repair of hospice property;

– maintains statistical and accounting records and provides reports on the activities of the hospice in the prescribed manner.

3. Hospice objectives

– formation new form medical and social security, based on the compassionate and humane attitude of the public and the state to the problems of incurable cancer patients;

– increasing the availability of inpatient medical care for terminally ill patients and improving medical care at home;

– providing socio-psychological assistance to patients and their relatives, training relatives in the skills of caring for seriously ill patients;

– ensuring the selection and implementation of the necessary analgesic therapy;

– organizing the necessary advisory assistance.

3.2. In accordance with these tasks, the hospice is entrusted with:

– creation of a service of volunteer assistants providing free care for patients at home and in hospitals, training them;

- communication with religious organizations of all religions for the performance, if necessary, of religious rites during the period of stay in the hospital and at home;

– communication and active work with charitable organizations, both domestic and foreign;

– communication with other hospices, both domestic and foreign;

– communication with social protection authorities;

– communication with the media.

4. Hospice structure

1. Reception department.

2. Hospital beds.

3. Day hospital.

4. Field service.

5. Administrative and economic service.

6. Support services (sterilization room, pharmacy, disinfection unit, laundry, catering department).

5. Hospice property and finances

5.2. The source of formation of property and financial resources hospice services are:

– city health care budget;

– other sources, in accordance with the legislation of the Russian Federation.

5.4. When exercising the right operational management The hospice is obliged to:

– use property effectively;

– ensure the safety and use of property strictly for its intended purpose;

– prevent deterioration of the technical condition of the property. This requirement does not apply to deterioration associated with standard wear and tear of property during operation;

– carry out capital and Maintenance property;

– charge depreciation charges on the worn-out part of the property.

5.5. The property of the hospice, assigned to it under the right of operational management, may be seized either in whole or in part exclusively in the following cases:

– during liquidation or reorganization of a hospice;

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