Why banks say NO to great healthcare practitioners. Five reasons why banks reject loans to quality small-business owners and what you can do about it.

If you have a dream of opening or expanding a practice, then bank lending is probably an option you've considered. However, many practitioners are under the false assumption that banks are currently not lending. Untrue! Between 2008 and 2012, banks have loaned an average of $216 billion to small businesses throughout the United States each year. There are two aspects to a bank loan package: (1) your loan application with tax information, asset information, etc.; and (2) your business plan. This article delves into the five reasons banks say "no" to a great healthcare practitioner and what you should include in your business plan to not only have the bank say "yes" to financing your business but also to create a situation where multiple banks are offering to lend you money.

Federal Housing Administration (FHA): Section 232 Healthcare Facility Insurance Program--Strengthening Accountability and Regulatory Revisions Update Final Rule Amendment--revision of date of applicability. Final rule amendment.

On September 7, 2012, HUD published a final rule that revised the regulations governing the insurance of healthcare facilities under section 232 of the National Housing Act (Section 232). HUD's Section 232 program insures mortgage loans to facilitate the construction, substantial rehabilitation, purchase, and refinancing of nursing homes, intermediate care facilities, board and care homes, and assisted-living facilities. The amendments made by the September 7, 2012, final rule updated the Section 232 regulations to reflect current policy and practices, improve accountability and strengthen risk management in the program. The final rule provided an applicability date of April 9, 2013, for certain of the updated requirements. This final rule amendment changes the applicability date to July 12, 2013, for the purpose of allowing more time to transition to the new requirements.

Land rent and housing policy: a case study of the San Francisco Bay area rental housing market.

In the San Francisco Bay Area, where residential rent is among the highest in the United States, an analysis of data from several sources demonstrates that high rent cannot be accounted for by higher quality, higher operating costs, or higher construction costs. At least one-third of the total rent paid is land rent. Despite increases in real incomes, very-low-income tenants in the Bay Area today have less income remaining after payment of rent than tenants did in 1960. High land rent is a long-term feature of the Bay Area rental market that results mostly from its geography, the density of its urban centers, and a strong economy, rather than from regulatory barriers to new multifamily construction. Deregulation is not a sufficient response to the effects of land rent on low-income tenants. Government should subsidize non-profit housing organizations, particularly land trusts that remove residential land from the market. Taxes on land rent would be a particularly appropriate funding source.

The role of the public sector in the provision of housing supply in Turkey, 1950­2009.

This study examines the changing role of the public sector in Turkey with regard to housing provision since 1950, and particularly since 2000, and seeks to clarify how public intervention has affected housing provision and urban development dynamics in major cities. Three periods may be identified, with central government acting as a regulator in a first period characterized by a 'housing boom'. During the second period, from 1980 to 2000, a new mass housing law spurred construction activity, although the main beneficiaries of the housing fund tended to be the middle classes. After 2000, contrary to emerging trends in both Northern and Southern European countries, the public sector in Turkey became actively involved in housing provision. During this process, new housing estates were created on greenfield sites on the outskirts of cities, instead of efforts being made to rehabilitate, restore or renew existing housing stock in the cities. Meanwhile, the concept of 'urban regeneration' has been opportunistically incorporated into the planning agenda of the public sector, and ­ under the pretext of regenerating squatter housing areas ­ existing residents have been moved out, while channels for community participation have been bypassed.

Vertical landscraping, a big regionalism for Dubai.

Dubai's ecologic and economic complications are exacerbated by six years of accelerated expansion, a fixed top-down approach to urbanism and the construction of iconic single-phase mega-projects. With recent construction delays, project cancellations and growing landscape issues, Dubai's tower typologies have been unresponsive to changing environmental, socio-cultural and economic patterns (BBC, 2009; Gillet, 2009; Lewis, 2009). In this essay, a theory of "Big Regionalism" guides an argument for an economically and ecologically linked tower typology called the Condenser. This phased "box-to-tower" typology is part of a greater Landscape Urbanist strategy called Vertical Landscraping. Within this strategy, the Condenser's role is to densify the city, facilitating the creation of ecologic voids that order the urban region. Delineating "Big Regional" principles, the Condenser provides a time-based, global-local urban growth approach that weaves Bigness into a series of urban-regional, economic and ecological relationships, builds upon the environmental performance of the city's regional architecture and planning, promotes a continuity of Dubai's urban history, and responds to its landscape issues while condensing development. These speculations permit consideration of the overlooked opportunities embedded within Dubai's mega-projects and their long-term impact on the urban morphology.

[Construction-cost assessment of a program designed to promote physical and sports activities and prevent doping behaviors: PN-APSD - on 2002-2007]. / Coûts de construction du programme de "promotion de la santé par les activités physiques et sportives et de prévention des conduites dopantes : PN-APSD - 2002-2007".

BACKGROUND: According to the framework legislation promulgated as part of the reform of finance laws in France, quality is a mandatory feature of all governmental actions. In this context, this work was conducted to assess the construction cost of a national health program designed to promote physical and sports activities and prevent doping behaviors. This program was considered to have the characteristic features of a successful governmental health intervention. METHODS: Four cost categories were evaluated: cost of the activity itself, transportation costs, communication costs and promotion costs. RESULTS: It was found that the program costs for 2002-2007 were 100,000 euro, with 15% of the costs in the communication category. CONCLUSION: Economic elements could be associated with factors of successful health service interventions in order to help decision makers responsible for the public interest and the consistency of public health actions.

Calculating the cost of a healthcare project.

Nearly $200 billion of healthcare construction is expected by the year 2015, and nurse leaders must expand their knowledge and capabilities in healthcare design. This bimonthly department prepares nurse leaders to use the evidence-based design process to ensure that new, expanded, and renovated hospitals facilitate optimal patient outcomes, enhance the work environment for healthcare providers, and improve organizational performance. In this article, the author introduces important project budget terms and a method of calculating an estimation of probable cost for a building project.

Housing policy, aging, and life course construction in a Canadian Inuit community.

The provisioning and administration of social housing has been a continuous problem in the Canadian North since the 1960s, when the Canadian government began taking an active role in the welfare of Inuit. Some of these problems are quite basic and include high costs for construction and maintenance of units. An examination of the development and evolution of Canadian housing policy in the North demonstrates that changes to the administration of social housing programs and, since the mid-1980s, development of formal privatization schemes have steadily shifted housing costs onto local residents. These shifting costs, however, are borne unequally, with Inuit born and raised in the context of permanent communities (the Settlement Generation) facing the greatest burdens.

Cost analysis of the built environment: the case of bike and pedestrian trials in Lincoln, Neb.

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated. Trail length averaged 3.6 miles (range = 1.6-4.6 miles). Annual cost in 2002 dollars ranged from 25,762 to 248,479 (mean = 124,927; median = 171,064). The cost per mile ranged from 5735 to 54,017 (mean = 35,355; median = 37,994). The annual cost per user was 235 (range = 83-592), whereas per capita annual medical cost of inactivity was 622. Construction of trails fits a wide range of budgets and may be a viable health amenity for most communities. To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users should be considered.