F. L. Hoffman Corporation was engaged by Montgomery Meadows Residential Health Care Facility and the County of Montgomery, New York to prepare a feasibility study to help determine what could be done to improve the facility and increase the revenues.

Of primary concern was the loss of more than $1,000,000 per year from the Inter-Governmental Transfer (IGT), which was to be completely phased out by the end of 2005.

Following is the scope of services, which describes the basic points to be considered in the feasibility study (Notes in bold type express changes in the scope of services):

Coordination of an initial feasibility study for MMRHCF to address the development of a Master Plan for the facility to include the considerations of building, site and future programming alternatives. This study will be performed in conjunction with an independent local/extended market analysis; and program planning project and consideration of financial package design.

Scope of Services will include the issuance of a formal written summary report to be presented by the contractor to the Finance Committee and Full Board of Supervisors. Thc report will address the following components:

I. Physical Plant Evaluation:

1. Comprehensive written evaluation of existing physical plant to include an overview of building conditions, equipment life expectancy, useful life of materials, systems and space; evaluation of identified life safety issues; evaluation of energy conservation issues; evaluation of mechanical, electrical and plumbing systems; evaluation of useful life of furnishings; evaluation of building's remaining life and methods to maximize value and re-use of existing building.

II. Site Consideration:

a) solar orientation
b) vegetation
c) views
d) adjacencies and size
e) expandability areas

III. Integrate results of an independently commissioned market analysis/program planning study which identifies demographic trends for the Montgomery County and surrounding area; identification of current senior services in this market and a projection of thc future needs for the frail elderly who reside in the facility's catchment area. Utilize these results to assist facility in developing a programming plan to identify potential niche markets for future provision of service to the elderly. These may include occupant as well as non-occupant programs/alternatives; (medical model day care, adult home services, assisted living. child day care or primary medical care clinic on site) development of specialty services for the current population (dementia unit; increased rehab services, pulmonary rehab, etc.)

IV. Analysis of the facility current population to identify internal population characteristics and accompanying resident needs of each sub-group. Clarification of resident need by unit related to areas of toileting, dining and general nursing care. Use information to assist facility in identifying sub-programs and specialty services which may not be provided under current physical plant conditions and operations.

V. Analysis of current facility operations and projections for future considerations including food delivery systems, materials management (including laundry services); method of central supply function; staffing plans with consideration to goals and staff efficiency; overall strategies for departments use of space to positively affect facility operations including provision of improved delivery of resident care and staff satisfaction with the physical environment.

VI. Integration of the input from staff, residents and families obtained during the formation of "focus" groups to review issues with the current physical plant and suggestions for renovation and/or building replacement in relation to:

1. physical layout
2. program development
3. staffing considerations
4. improved resident care provision
5. materials management

The ultimate goal will be to identity the ways to match program determinations to design conceptualizations to meet present and future needs of seniors. This will require a flexible design plan which integrates multiple levels of care.

VII. Identification of budgetary cost projections related to the determined scope of project: new construction vs. re-modeling vs. re-modeling with new addition(s).

Estimation of time schedules associated with building project.

Integration of the results of an independent financial analysis and plan which focuses on verification of debt and borrowing capacities relative to cost estimates. This will include the effect on financial reimbursement related to the capital component of the rate and potential for "re-basing'" per DOH criteria.