New policies and standards for applying for nursing homes in 2016
Basic principles
Deepen the system reform. Accelerate the transformation of government functions, reduce administrative intervention, increase policy support and guidance, stimulate the vitality of various service entities, innovate service supply methods, strengthen supervision and management, and improve service quality and efficiency.
Insist on ensuring the basics. The government should take the lead and give full play to the role of social forces to ensure the elderly care service needs of the elderly with special needs and ensure that everyone has access to basic elderly care services. Increase investment in grassroots and rural elderly care services, and give full play to the important role of community grassroots organizations and service agencies in home-based elderly care services. Support families and individuals to take their due responsibilities.
Focus on overall development. Coordinate the development of home-based elderly care, institutional elderly care and other forms of elderly care, and implement a combination of universal services and personalized services. Coordinate urban and rural elderly care resources and promote the balanced development of basic elderly care services. Coordinate the use of various resources to promote the interactive development of elderly care services and related fields such as medical care, housekeeping, insurance, education, fitness, tourism, etc.
Improve the market mechanism. Give full play to the basic role of the market in resource allocation, gradually make social forces the main body in the development of the elderly care service industry, create a market environment of equal participation and fair competition, vigorously develop the elderly care service industry, and provide various types of elderly care services that are convenient, accessible and reasonably priced. Elderly care services and products meet the diverse and multi-level needs of elderly care services.
Application conditions and precautions for applying for a nursing home in 2016
1. Application conditions
1. Application for setting up a social welfare service institution: with more than 60 beds. The Civil Affairs Bureau shall review and approve the hospital. If the number of beds is less than 60, it shall be reviewed and approved by the Civil Affairs Bureau of the county (city) district where it is located and reported to the Civil Affairs Bureau for filing.
2. Apply for a "Practice Certificate for Social Welfare Institutions": The civil affairs department that accepts the application will conduct an on-site inspection. If the applicant meets the conditions for practice application, a "Practice Certificate for Social Welfare Institutions" will be issued; if the applicant does not meet the conditions for practice application, A written rectification notice will be issued to the applicant, and the applicant shall complete the rectification within the specified period and resubmit a practice application.
3. To run a nursing home, you first need to fill in an application form and a feasibility study report. You must also have documents proving qualifications, sources of funds and a fixed location, as well as draft articles of association, including the above 6 After completing the following conditions, you can go to the civil affairs department in your jurisdiction to complete the procedures.
2. Procedures
The first step: The civil affairs department of the district (city) or county where the enterprise is located submits the application materials to the window of the Civil Affairs Bureau of the Municipal Affairs Service Center, and the window staff will conduct a preliminary review. Then accept;
The second step: The Civil Affairs Bureau will send people to conduct on-site investigation and verification of the new enterprise within the specified time limit. If the conditions are met, sign and seal the approval form;
< p>Step 3: The Municipal Civil Affairs Bureau will transfer relevant information to the Municipal Taxation Department for review and signature and then submit it to the Provincial Department of Civil Affairs;Step 4: Obtain the approval of the Provincial Department of Civil Affairs, the National Taxation Bureau, and the Local Taxation Bureau to apply for a certificate It will then be returned to the Civil Affairs Bureau, which will forward it to the district (city) or county civil affairs department for distribution to the new enterprise.
Additional explanation:
Now the state encourages private investment in welfare undertakings. You must first consult with the local civil affairs department. Specifically, you need to ask: land use, loans, taxation, industry and commerce, and what the state has Subsidy policies, etc., these are preferential policies that private investors should enjoy.
The country has now promulgated policies in this regard, but they are related to local local finance. Generally speaking, the country and local governments encourage , support private investment in setting up nursing homes!
What also needs to be explained is: the so-called qualification certificate means that you must have the conditions to operate a nursing home, and hardware and software are indispensable! Mainly reflected in the following aspects:
1) Building design specifications.
At present, the existing large-scale elderly care institutions in our country can generally be designed and constructed in accordance with the "Building Design Code for the Elderly" jointly promulgated by the Ministry of Construction and the Ministry of Civil Affairs, taking into account fire protection, ventilation, and interior design in a scientific and reasonable manner. Issues such as barrier-free transportation, as well as functional supporting facilities such as bedding, catering, entertainment, and medical care.
2) The advantages in medical care are obvious. Because large-scale nursing homes have scale advantages, it is easier to attract medical personnel with professional knowledge and experience to join them, thereby improving the service standards of medical care. Especially for the elderly with multiple diseases, it can provide them with a sense of security in medical coverage.
3) The leisure environment is better. When planning and designing large-scale elderly care institutions, they generally combine the actual conditions of their own land and space to build some places suitable for elderly activities and plant some flowers, plants and trees to create an elegant and relaxing environment. And all of this is of greatest concern to the elderly, especially those living in cities and their children.
The focus of improving the supporting functions of nursing homes lies in two aspects:
(1) Supporting medical and nursing services. The civil affairs department stipulates that elderly care institutions must set up medical rooms, but can the medical rooms truly meet the disease treatment and special care requirements of the elderly? Obviously it is not enough. As far as large-scale nursing homes are concerned, most of the residents are senior citizens over 70 years old. Why are there so many elderly people? This is generally determined by the cost and difficulty of home care. Only when the cost of home care is comparable to the charges of a nursing home, or when the elderly person needs medical care due to his physical condition, will the children send the elderly person to a nursing home. This puts forward higher requirements for medical care in nursing homes, and a simple medical room cannot meet the needs. Imagine that there are more than 500 elderly people over 70 years old. At least 50% of their bodies have some diseases and need to take medicine and injections; at least 25% of the elderly need to be hospitalized for observation and treatment. With such a disease, the scale of medical consultation and hospitalization is, There should be first-class hospitals and supporting facilities. Therefore, large-scale elderly care institutions must cooperate or independently apply for geriatric hospitals in order to achieve supporting and perfect medical care functions.
(2) A scientific and reasonable diet.
The canteen of a nursing home must first be designed and decorated in accordance with the regulations of the health and epidemic prevention department to meet basic hygiene requirements and operating procedures. Secondly, according to the special requirements of common and frequently-occurring diseases in the elderly, such as hypertension, diabetes, etc., nutritional recipes should be scientifically formulated and the quantity and type of diet should be reasonably controlled.
Is this road easy to walk? It is not easy to walk. It is very difficult. The main problems are as follows:
1. Large investment and long payback period.
Since the industrialization direction of elderly care institutions is scale management and brand management, what is the input-output situation? One fact before us is that everyone believes that the elderly care industry is a sunrise industry with a bright future. Yes, the market is very huge, the competition pattern has not yet been formed, and the total demand is greater than the total supply. But why is no one willing to step into this industry, especially some powerful enterprise groups and individuals who are unwilling to invest? The reason is simple, because the investment is large, the payback period is long, and it is unprofitable. Let’s compare a nursing home project with a real estate project of the same size, and the result is obvious. Suppose there is a land of 100 million m2 in a certain city, with a volume of 3% and a construction area of ??30,000 m2. The construction cost of the nursing home project is about 1,770 yuan/m2, excluding the reduced or exempted land acquisition compensation fee. The total investment is about 53 million yuan, and the capital cost is an annual interest rate of 6%. The size of a nursing home is calculated based on 1,000 beds. The main source of income for recycling funds is one-time equipment purchase fees. The per capita charge is about 8,000 yuan. The turnover rate is 3 times in 10 years, totaling about 24 million yuan; bed fees per person 500 yuan per month, the 10-year occupancy rate is calculated at 100%, and the total is about 60 million yuan; other income can be deducted from operating costs. In this way, it will take 10 years for the nursing home project to recover the investment, and it will not be profitable. The construction cost of the real estate project is about 2,170 yuan/m2, the total investment is about 65 million yuan, the house sales price is 3,500 yuan/m2, and the recovered funds are about 105 million yuan. Including the construction period and sales period, it takes about 2 and a half to 3 years. time. As a result, the real estate project can not only recover the investment within 3 years, but also obtain a profit of about 40 million yuan.
2. Financing difficulties for leasing operations.
Due to the drive of economic interests, investing in the construction of elderly care institutions is not in line with my country’s current economic practices of input and output. Then, renting a house to operate a nursing home is a more ideal choice. This can convert a huge recent investment into installments of rental payments. However, if it is a complete real estate project, how can others sublet it to others? There is only one answer, and it must be an "unfinished building" for many years. To complete an "unfinished building" project, a relatively large investment is still required. Since it is a leased house, it only has operating rights but no ownership rights. The funds invested are bound to be occupied and cannot be used through mortgage loans or other methods to activate and recycle the funds. Therefore, financing difficulties for leasing operations are an inevitable result.
Let’s take the operation of Liangdian Nursing Home in Guangzhou as an example. Guangzhou Liangdian Nursing Home leased a 94-year-old nine-story hotel in 2002, with a construction area of ??20,000 m2 and a floor area of ??8,000 m2. The lease term was 20 years. It has more than 200 rooms and can accommodate 650 elderly care beds. The monthly rent is nearly 200,000 yuan. The total investment in renovation and expansion is about 15 million yuan. The investment payback period takes more than 6 years. Although the current operating conditions of the hospital are good, due to the limited investment capacity of shareholders, it has to give up other industries it originally operated. Since the operating rights cannot be mortgaged for loans, in order to raise liquidity for the nursing home, the shareholders had to borrow money from friends, and even used their homes as bank mortgages. This is a reflection of the industrialization process of elderly care institutions and a difficult financing issue in the industrialization process.
3. Difficulty in introducing medical talents
The focus of large-scale elderly care institutions is medical care services, and it is more difficult to introduce experienced, mid-level and senior professional medical personnel. There is a relatively complete promotion mechanism for professional and technical titles in hospitals. If a professional medical staff goes to work in the medical rehabilitation room of a nursing home, it is almost impossible to be promoted from a junior professional title to an intermediate or senior professional title. Therefore, not only are large nursing homes unable to attract professional medical staff to join them, it is also difficult to cultivate their own medical teams. For example, Guangzhou Liangdian Nursing Home introduced a chief physician as the director. Due to the management of the medical and health system, he was forced to resign from public office and give up nearly 30 years of service and corresponding benefits.
4. The business risk is high.
With the gradual enhancement of people’s legal awareness, extensive medical care is no longer suitable for the development needs of large-scale operation of nursing homes. Due to the large scale of large-scale elderly care institutions, people believe that they have certain financial strength and compensation capabilities. Therefore, children of the elderly are often not easy to tolerate and understand mistakes and inappropriateness in the medical care process, and even intentionally intensify the conflicts. Advancing into the legal process of medical malpractice disputes, ultimately leading to compensation from nursing homes. Of course, people's increased legal awareness has its positive side, but elderly care institutions are often in a weak position due to medical conditions and personnel quality. From a subjective point of view, large-scale elderly care institutions are willing to open geriatric hospitals that match their scale. However, the rules and regulations and approval procedures of the health department cannot support this, which objectively increases the operational risks of large-scale elderly care institutions.
3. The government’s guidance and support in the industrialization process of elderly care institutions
Old care institutions have long been considered to be welfare institutions, a matter of the government and collectives, and of charitable institutions. thing. It is not easy to operate it as an enterprise and take the road of industrialization. In particular, scale operation and brand development are inseparable from the government's advocacy, the positioning of industry development direction and the support of preferential policies. We sincerely hope that the government can do more work in the following aspects:
1. Publicity to change the concept of elderly care.
For thousands of years in our country, Confucianism has always advocated: "Raising children to prevent old age, accumulating grain to prevent hunger", "Filial piety governs the world", etc. Under the guidance of these ideologies, people generally believe that only those who have no children or wives will enter nursing homes or nursing homes. If someone's parents or elders enter a nursing home, they will be considered unfilial, and the elderly will feel disgraced if they enter a nursing home. With the further refinement of the social division of labor, the shrinking of family structures, and the increasing pressure on children to work and study, objectively there has been a trend that elderly care must be socialized. This is no longer a question of filial piety, but a manifestation of social progress. Sending the elderly to elderly care institutions is a reflection of children's filial piety, and the government's support for the development of elderly care institutions is a sign of care for the people. Therefore, the government should vigorously publicize the benefits and inevitability of caring for the elderly in elderly care institutions through the news media, and guide and cultivate the development of the elderly care consumer market.
2. Actively cultivate and support the main force of elderly care institutions.
Leaders at all levels of government must fully realize that the problem of elderly care is not only a family problem, but a universal social problem
. It directly affects people's work and study, family harmony, and social stability. Only by taking precautions, cultivating and supporting the standardized development of a number of large-scale elderly care institutions, forming elderly care groups, and becoming the main force guiding the elderly care consumer market can arbitrary charges and unreasonable behaviors be stopped. The focus of the government's work is to supervise and inspect whether the country's existing preferential policies are implemented in place, and to coordinate and solve some practical difficulties to create a good business environment and investment environment.
3. Expand funding channels for the development of elderly care institutions.
Given the insufficient financial resources of existing governments at all levels, efforts should be made to broaden funding channels for the development of elderly care institutions. Two aspects can be considered: First, the civil affairs department should establish a special development fund. It is allocated by the finance and managed by the civil affairs department, but is not directly used for elderly care institutions. Instead, banks are entrusted to issue working capital loans to institutions that have the conditions and the potential to develop into key elderly care enterprises, and the banks help control capital risks. The second is to set up a pension foundation among charitable institutions led by the civil affairs department to raise funds through solicitations from the society. The pension foundation will serve as an investment representative and participate in or control a number of large-scale elderly care institutions. This can not only solve the financial needs for the development of elderly care institutions, but also control and guide the elderly care institutions through the shareholder meetings and boards of directors of the elderly care enterprises, so that they can develop steadily in accordance with relevant national regulations and policies.
4. Coordinate and solve the construction problems of the medical staff team.
The construction of a team of medical staff is a major issue that restricts the development of elderly care institutions. Failure to solve it will not only cause a lot of medical disputes, but also scare away many investors and affect the industrialization development process of elderly care institutions. This article proposes to amend the regulations on medical supporting facilities and clearly point out that nursing homes of different sizes should have medical service departments of different specifications, namely infirmaries, medical rehabilitation centers, and geriatric hospitals. It also stipulates that the civil affairs department enjoys a certain degree of authority in the establishment of some institutions, and the health department must cooperate and provide professional guidance and supervision. Only in this way, medical staff will devote themselves to the elderly care industry if they have suitable jobs. At the same time, it is also recommended to establish and improve a nursing professional title system and promotion mechanism with industry characteristics in the elderly care industry.
5. Reform the tax policy for the elderly care industry.
The difference between for-profit and non-profit elderly care institutions lies in whether the profits are distributed. Those that are distributed are for-profit, while those that are not distributed are non-profit. Do non-profits really have no distribution? We will not discuss it here. However, it seems inappropriate to treat for-profit elderly care institutions on an equal footing with enterprises in other industries and uniformly implement a corporate income tax rate of 33%. First of all, individuals and companies engaged in the elderly care industry have a sense of social responsibility, love and patience. What they do is good deeds, and society needs more people to join. The suffering of walking on thin ice and waiting for a long payback period are not something everyone is willing to do. Secondly, today, as the problems and contradictions of aging become increasingly prominent, it cannot be solved by families and cannot be handled by government finances. All we have to do is mobilize social forces and private capital. Without certain preferential policies and support, it is difficult to attract capital investment. Although the government has introduced tax policies to reduce business tax, it is not enough. The elderly care industry should be treated differently from other industries in terms of corporate income tax. We can follow the example of supporting high-tech enterprises and implement income tax reduction and exemption for two years and half reduction for three years after the pension enterprises generate profits. We can also consider implementing a differentiated tax system for corporate income tax, and levy corporate income tax on the elderly care industry at 15%. Reduce the tax burden on elderly care institutions and give them a chance to recuperate, thereby encouraging investment and promoting the industrialization process of elderly care institutions.
What are the preferential policies for private nursing homes
Social welfare institutions established by social forces (hereinafter referred to as social welfare institutions) have developed rapidly and have become an important part of my country's social welfare undertakings. It further mobilizes the enthusiasm of social forces to participate in social welfare undertakings, safeguards the legitimate rights and interests of social welfare institutions, and promotes the socialization process of social welfare.
According to Article 7 of the "Measures for the Administration of Social Welfare Institutions" of the Ministry of Civil Affairs, organizations established in accordance with the law or individuals with full capacity for civil conduct (hereinafter referred to as applicants) may propose to set up a hospital if they meet the corresponding conditions. Apply. Submit an application for the establishment of a social welfare institution to the civil affairs department of the people's government at or above the county level where the social welfare institution is located. The state strongly supports all sectors of society and individuals to invest in the establishment of elderly care service institutions.
What information is required when applying for a social welfare institution?
Application form, feasibility study report; documents proving the qualifications of the applicant; documents proving the source of funds for the proposed social welfare institution; Documents proving the fixed location of the social welfare institution. The applicant shall, with the above materials, submit an application to the civil affairs department of the people's government at or above the county level where the social welfare institution is located, and the civil affairs department that accepts the application will review and approve the application. There are bed subsidies and one-time building subsidies, which are tax-free.
Preferential policies for private nursing homes
In 2000, the General Office of the State Council forwarded the "Opinions on Accelerating the Socialization of Social Welfare" (Guobanfa [2000] No. 19) from 11 ministries and commissions including the Ministry of Civil Affairs. It stipulates that social welfare institutions shall enjoy the same treatment as government-run social welfare institutions in terms of planning, construction, tax exemption, land use, water use, electricity, etc. The relevant policies are interpreted as follows:
Implement fiscal subsidies and include them in fiscal budgets at all levels. Adopt a paid method to use the land, but appropriately reduce the charging standards. Reduce or reduce land management fees and unify planning. Charges for social welfare projects and facility projects will be reduced or exempted as appropriate, and preferential policies will be given to corresponding taxes. At the same time, financial institutions are required to increase loans for the construction of social welfare facilities and public welfare undertakings. Taxes and fees on donations within the limits of units, groups and individuals at all levels can be exempted. The best prices for water and electricity should be adopted and relevant departments should take care of them. Pay attention to and protect the legitimate rights and interests of vulnerable groups and provide them with high-quality legal services. Public welfare enterprises are temporarily exempted from income tax.