Private finance initiative hospital architecture: towards a political economy of the Royal Liverpool University Hospital.

Sociological analysis has done much to illuminate the architectural contexts in which social life takes place. Research on care environments suggests that the built environment should not be understood as a passive backdrop to healthcare, but rather that care is conditioned by the architecture in which it happens. This article argues for the importance of going beyond the hospital walls to include the politics that underwrite the design and construction of hospital buildings. The article assesses the case of the yet-to-be-realised Liverpool Royal University Hospital, and the private finance initiative (PFI) funding that underpins the scheme, which is suggested as a salient 'external' context for understanding architecture's role in the provision of healthcare of many kinds for many years to come. PFI has major implications for democratic accountability and local economy, as well as for the architecture of the hospital as a site of care. Critical studies can illuminate these paradoxically visible-but-opaque hospital spaces by going beyond that which is immediately empirically evident, so as to reveal the ways in which hospital architecture is conditioned by political and economic forces.

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.

A financing model to solve financial barriers for implementing green building projects.

Along with the growing interest in greenhouse gas reduction, the effect of greenhouse gas energy reduction from implementing green buildings is gaining attention. The government of the Republic of Korea has set green growth as its paradigm for national development, and there is a growing interest in energy saving for green buildings. However, green buildings may have financial barriers that have high initial construction costs and uncertainties about future project value. Under the circumstances, governmental support to attract private funding is necessary to implement green building projects. The objective of this study is to suggest a financing model for facilitating green building projects with a governmental guarantee based on Certified Emission Reduction (CER). In this model, the government provides a guarantee for the increased costs of a green building project in return for CER. And this study presents the validation of the model as well as feasibility for implementing green building project. In addition, the suggested model assumed governmental guarantees for the increased cost, but private guarantees seem to be feasible as well because of the promising value of the guarantee from CER. To do this, certification of Clean Development Mechanisms (CDMs) for green buildings must be obtained.

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.

Construction enterprises' green financing efficiency and its influencing factors including internal and external: Based on four-stage DEA model.

Under the background of carbon neutrality, green development is the theme of today's times. The construction industry is an important part of the green development plan, and it is of great significance to study its green financing efficiency. Based on this, this paper uses the four-stage DEA model to explore the green financing efficiency of listed construction companies from 2019 to 2020. The conclusion shows that: firstly, the green financing efficiency of listed construction companies is low, and the demand for green financing has not been met. It is necessary to strengthen the support of green finance to meet the needs of its expansion. Secondly, the efficiency of green financing is significantly and complexly affected by external influencing factors. It is necessary to dialectically treat external influencing factors such as local industry development support, financial development level, and the number of patent authorizations. Thirdly, among the internal influencing factors, the proportion of independent directors has a significant positive impact on the green financing efficiency of listed construction companies, and the proportion of R&D investment has a significant negative impact. Listed construction companies need to increase the proportion of independent directors and control the proportion of R&D investment.

Analysis on the hidden cost of prefabricated buildings based on FISM-BN.

Facing the pressure of environment, sustainable development is the demand of the current construction industry development. Prefabricated construction technologies has been actively promoted in China. Cost has always been one of the important factors in the development of prefabricated buildings. The hidden cost of prefabricated buildings has a great impact on the total cost of the project, and it exists in the whole process of building construction. In this paper innovatively studies the cost of prefabricated buildings from the perspective of hidden cost. In order to analysis the hidden cost of prefabricated buildings, the influencing factor index system in terms of design, management, technology, policy and environment has been established, which includes 13 factors in total. And the hidden cost analysis model has been proposed based on FISM-BN, this model combines fuzzy interpretive structure model(FISM) with Bayesian network(BN). This model can comprehensively analyze the hidden cost through the combination of qualitative and quantitative methods. And the analysis process is dynamic, not fixed at a certain point in time to analyze the cost. We can get the internal logical relationship among the influencing factors of the hidden cost, and present it in the form of intuitive chart by FISM-BN. Furthermore the model could not only predict the probability of the hidden cost of prefabricated buildings and realize in-time control through causal reasoning, but also predict the posterior probability of other influencing factors through diagnostic reasoning when the hidden cost occurs and find out the key factors that lead to the hidden cost. Then the final influencing factors are determined after one by one check. Finally, the model is demonstrated on the hidden cost analysis of prefabricated buildings the probability of recessive cost is 26%. In the analysis and control of the hidden cost of prefabricated buildings, scientific and effective decision-making and reference opinions are provided for managers.

[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.

Design of a multifaceted referral equine hospital.

There is no simple recipe for designing a multifaceted practice. However, keys to any design are the devotion of the people involved and proper positioning of such people in the organization. Anyone designing such a practice also must pay keen attention to details and a keep a finger constantly on the pulse of the business to ensure that it maintains a sound financial footing and a consistent vision. Little money is made from savings or pushing financials. Profits come mainly through building additional sales, maintaining a clear vision, and making shrewd investments. Like for every small business, success in the multifaceted practice is clearly tied to such factors as financial acumen, forward thinking, technology, lifestyle, vision, and a willingness to take a calculated risk.

Non-acute care facility ownership: if not you, who?

Physician groups now face a dynamic medical real estate market that can provide an attractive alternative to self-owned and self-financed outpatient facilities and medical office buildings. The ownership and financing options available to physicians and physician groups considering the development of new medical projects have expanded greatly over the past few years and are likely to continue to evolve in the foreseeable future. This changing environment, driven by new sources of institutional capital and the emergence of qualified developers, has led to a more competitive market for physicians and groups seeking real estate capital partners, and physicians are starting to take advantage of it. Physicians and groups have embraced third-party ownership and management of real estate, because it can preserve capital resources and minimizes risk. These groups are using third parties to develop and own new medical real estate projects. This article describes medical real estate project development alternatives, the attributes and concerns of developers, typical transaction terms, and a recommended process for physicians and groups to select the best real estate development partner.

Construction--still booming.

The 2007 Hospital Building Survey shows no letup in construction. But some experts see signs of a slowdown.

Culturally appropriate organization of water and sewerage projects built through public private partnerships.

This paper contributes to the pursuit of socially sustainable water and sanitation infrastructure for all people by discovering statistically robust relationships between Hofstede's dimensions of cross-cultural comparison and the choice of contract award types, project type, and primary revenue sources. This analysis, which represents 973 projects distributed across 24 low- and middle-income nations, uses a World Bank dataset describing high capital cost water and sewerage projects funded through private investment. The results show that cultural dimensions explain variation in the choice of contract award types, project type, and primary revenue sources. These results provide empirical evidence that strategies for water and sewerage project organization are not culturally neutral. The data show, for example, that highly individualistic contexts are more likely to select competitive contract award types and to depend on user fees to provide the primary project revenue stream post-construction. By selecting more locally appropriate ways to organize projects, project stakeholders will be better able to pursue the construction of socially sustainable water and sewerage infrastructure.

Opportunities for nurses in a private finance initiative.

The private finance initiative is part of the government's building procurement policy, incorporating both public and private sectors. This article outlines the part nurses can play, as a clinical adviser, within a PFI project team and within particular aspects of the PFI process.

2006 hospital building report. The boom goes on.

Our survey of construction trends finds that the most significant expansion and replacement of U.S. hospitals since the post-World War II building spree continues to fuel a red-hot market. And the building boom is likely to last through the rest of the decade.

The boom goes on. Technology and consumer demands keep driving construction and renovation.

Facing a vastly outdated infrastructure, U.S. hospitals are undergoing their most significant expansion and facility replacement effort since World War II. Although the reasons and the focus of building projects vary, flexibility remains the watchword.