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You don’t have the 865 hours it will take to manage your next dialysis unit project. One easy call provides every service you need to get your next state-of-the-art dialysis unit up and running in 43% of the average time, for 66% of the average cost and with none of the hassles. Feasibility
Studies for Expansion or New Locations - Do you need an entirely new unit or
should you just expand your existing unit? We’ve doubled capacity in the
same location—while maintaining existing operations—we’ve built
entirely new units from the ground up, and we’ve renovated existing
buildings into dialysis units. The difference isn’t always obvious, but we can tell you
which option is best for you. Not sure of how many stations to add or how
large to make the unit? Let us perform a Free
Size Analysis to help you get started. Site Search
and Selection - One of the biggest problems with Renal Dialysis Units
is that they are built in the wrong place or in the wrong building. TMA
has a 2,931 member national real estate team that helps find the ideal
location for your next unit. In
our full search we use a time-tested 141-point due diligence checklist to
ensure we have the best facility or location for your needs. Our Free
Site Search can have 4 options on your desk within 7 days. Lease
Negotiation - If you don’t know how to negotiate a lease you’ll
pay too much for the next 20 years, get a substandard building …and
you’ll never know it. Once
the primary sites for your facility are identified TMA will negotiate a
lease with at least two different owners.
These owners know they’re in competition against each other, and
we know what the prevailing lease rates and construction costs are from
our nation-wide database. We
start this process while we are still working on the site search in order
to help minimize the total time, and use the best negotiated lease as one
factor in deciding which site is best for your needs.
We recently saved one client $1.47 million just through effective
lease negotiation. (We’ve highlighted this case in our white paper 10
Critical Steps to Opening A Dialysis Unit—And How To Make Them All Work
For You.) Financing - One call will have 6,481 financial institutions vying for your project…that’s the power of TMA’s financial network. There are 3 common types of financing for new dialysis units: Leasing is the preferred method of financing for many clinics, where we locate a building owner, arrange financing with them and establish a long-term lease for you. Ownership is right for some clinics. Depending on how involved you want to be we can arrange direct financing for you and provide a professional property manager who will take care of interior and exterior building maintenance—anywhere in the country. JV
Ownership with a large Provider -
If
you’re wondering about partnering with a large Provider through a JV
arrangement—Gambro, Davita, Fresenius, or any other—we can give you
some industry ‘insider’ information on which of the ‘bigs’ is most
likely to be right for you based on how you want to operate.
We’ve worked directly for some of them, and through industry
connections know which ones are likely to be the right fit for you and
which ones you should stay away from. Project
Layout
is the key to a patient-friendly, staff-friendly, cost-effective dialysis
unit. TMA’s time-tested 61-Point Physician’s Dialysis Profile is the
starting point for a successful layout.
We used this to develop the prototype facilities for both Gambro
and Renal Care Group that they now use nation-wide. This takes a maximum
of 4 weeks, and can be done in as little as 1 week when needed. Architectural/Engineering Services - We will help you select the right architect/engineer for your project and work with them to completion. (See How To Select An Architect.) TMA uses a 204-item Drawing Review Checklist that has provided an average of 483 specific revisions to the architectural plans we’ve reviewed on behalf of our clients in the past 5 years—and this is from architects who were pre-qualified with more than 20 projects to their credit. Some of the things we change are big (inadequate water service) and some are small (no locks on the medical supply drawers) but they all make for a better dialysis unit in the end. Does that mean the architects are incapable? No, it means that there’s no substitution for our experience—that’s why our 231 projects have been completed with only 1.5% change orders compared to the national average of 8% for new construction and 12% for remodeled construction. This savings alone returns double the amount of our fee to the client. And the architects like our involvement—because they know the better the drawings are up front the less trouble there is during construction. Our pre-qualified list of architects will typically discount their fee to you by up to 50% when they know TMA is involved—because they know it will require up to 50% less time from them to provide a successful unit. And we use a
value engineering process that has saved an average of $76,000 in the
constructed project and $285,000 in life-cycle operational costs.
(For more on this see 10 Critical Steps to
Opening A Dialysis Unit—And How To Make Them All Work For You.) Permitting
the unit is confusing and time-consuming because it’s different in every
state, and each state is perpetually changing their requirements.
You absolutely must check the state’s regulations at the
beginning of every project to make sure you’re not missing anything new.
Failure to do this will result in your unit not being permitted or
licensed as you need it to be. Unfortunately, some renal facilities have
recently been the victims of project managers who failed to perform their
due diligence in this area and could not get their unit completed as
planned. Don’t let that
happen to you. The TMA 204-Point Drawing Review Checklist is designed to
catch all the things the states require BEFORE we submit the drawings to
them. Our track record is flawless for approved units—the FIRST
time. Construction Management - An average contractor will get 8% more money in change orders for new construction and 12% more for renovation of ANY dialysis unit. And they’ll use that excuse to drag the schedule out. TMA keeps change orders to less than 1 ½ % and meets the schedule every single time. Here’s how. TMA’s
project manager will visit the site at least 8 times in the 12-week
construction period, and meet with you on-site as you desire to review
progress. We will be in daily
contact with the site superintendent and general contractor’s project
manager—and we’re available by cell phone 24 hours a day.
We will resolve or see to the resolution of ALL construction
issues. The frequent visits
and daily contact enables the project to stay on-schedule and keep changes
to a minimum by resolving unforeseen conditions and problems as they
arise. TMA’s project
manager processes progress payments to the contractor and sends all
paperwork to you in one monthly easy-to-understand bundle.
All you have to do is review, acknowledge, sign and sleep easy at
night knowing your project will finish on-time and within the budget. Construction - Accept the wrong construction bid and you’ll pay 8% to 12% more, get less, finish late and wish you’d never started the project. You must pre-qualify general contractors before you allow them to bid your project. (See How To Select A General Contractor for Dialysis Unit Construction.) TMA can do this for you. TMA involves
these pre-qualified contractors in the drawing reviews and value
engineering process—which gives YOU lower bids, better construction and
fewer change-orders—because the contractors understand the job better
and have had an opportunity to guide the plan development where possible
to make the job easier to build. Contractors like our involvement, too,
because we are instantly available to them to resolve typical job-site
problems as they arise—which keeps the project on-schedule and in the
budget. Equipment
Ordering - TMA’s 96-point equipment checklist ensures that everything will be in place
when you’re ready to open. Our
national database of competitive pricing will make sure you don’t pay
too much. We can coordinate furniture and
equipment vendors for you by giving them the dimensioned layout and
furniture plan for pricing. We’ll
help you by analyzing their bids and recommending the right furniture and
equipment for your unit. Some
vendors will charge up to 4 times the price for identical items (like
water boxes) just because they know you don’t really know what to look
for. We’ll show you the
traps to avoid, and where it’s better value to invest more in the
up-front costs for total life-cycle value. Medicare/State/Local Licensing - Mess this up and you’ll be stuck for months waiting for a Medicare RE-inspection, won’t get all your stations certified and will have employees with nothing to do watching equipment you’re buying with no one to use it. Everything
from the Certificate Of Need, HCFA Form 855 right through scheduling the
Medicare inspection—we’ll manage it all for you. Taylor Management
Associates has never missed a Medicare inspection because of time overruns
in a project. Our project
documentation for the examiner is prepared in a 3-inch thick 3-ring binder
that allows the inspection to be performed in less than half a day—and
in our 231 projects there has NEVER been a return visit looking for
missing documentation. Ongoing
Building Maintenance - TMA will arrange local services for anything you
want - from changing light bulbs to lawn care. |
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