RenaCare Dialysis Clinic — Operations Plan
Facility design and specifications, equipment inventory, the staffing model and organisational chart, the patient journey, capacity management, IT and electronic medical records, and supply chain and procurement.
Section 6 · Business Plan
Operations Plan
Facility design and specifications, equipment inventory, the staffing model and organisational chart, the patient journey, capacity management, IT and electronic medical records, and supply chain and procurement.
6.1 Facility Design & Specifications
The flagship clinic will occupy 850 m² of gross lettable area on a
single level with universal accessibility. The facility design has been
informed by benchmarking against best-in-class units in South Africa,
the UK and Australia, and by the clinical requirements for water-treated
reverse-osmosis feed, separate isolation for sero-positive patients, and
optimised patient flow to minimise cross-infection risk.
| Zone | Area (m²) | Functional Purpose |
|---|---|---|
| Main dialysis floor | 340 | 16 stations, arranged in four bays with nurses station |
| Isolation bays (HepB / HIV) | 60 | 4 additional stations in negative-pressure isolation |
| Pre-dialysis assessment | 45 | 2 assessment rooms, weighing station, vital signs |
| Water treatment plant | 55 | Dual-pass RO with central distribution; ultrafilters |
| Clean store & medication preparation | 35 | EPO storage (2–8 °C), medication unit-dose |
| Nephrology consult rooms | 30 | 2 rooms for visiting specialist consultations |
| PD training suite | 25 | Dedicated teaching area for peritoneal dialysis |
| Patient reception & waiting | 70 | Seating for 30; coffee service; accessible WC |
| Staff facilities | 60 | Change, shower, rest area, office |
| Administration offices | 50 | MD, Finance, Billing, BD |
| Services, storage & circulation | 80 | Waste handling, linen, corridors, plant |
| Total area | 850 |
6.2 Equipment Inventory
Capital equipment has been specified on the basis of clinical
performance, total cost of ownership over the 8-year useful life,
supplier support infrastructure in South Africa, and compatibility with
local power and water conditions (including load-shedding
resilience).
| Equipment Category | Units | Capex (ZAR) | Notes |
|---|---|---|---|
| Haemodialysis machines (Fresenius 5008 or Baxter Artis) | 20 | 8,000,000 | 8-year useful life; vendor lease option |
| Reverse-osmosis water treatment plant (dual pass) | 1 | 1,600,000 | Sized for 100 sessions/day; redundant pumps |
| Water distribution loop & ultrafilters | 1 set | 400,000 | ISO 23500 compliant; hot-water disinfection |
| Patient treatment chairs (reclining, electric) | 20 | 600,000 | R30k per chair; motorised recline |
| Crash cart with defibrillator & emergency drugs | 2 | 250,000 | Clinical floor + isolation zone |
| Weighing platform (chair scale) | 3 | 120,000 | Calibrated and zeroed daily |
| Point-of-care testing (electrolyte, iSTAT) | 1 | 180,000 | Reduces lab turnaround for urgent cases |
| UPS & solar backup (16 kWh battery) | 1 set | 900,000 | Critical for load-shedding continuity |
| IT infrastructure & EMR servers | 1 | 500,000 | Cloud-backed EMR; electronic treatment records |
| Furniture, fittings, clinical fit-out | Lot | 1,500,000 | Waiting room, consultation, admin |
| Leasehold improvements (construction) | Lot | 5,000,000 | 850 m² clinic fit-out at R5,880 / m² |
| Working capital reserve | Lot | 950,000 | 60 days operating cash + inventory float |
| Total capital investment | 20,000,000 |
6.3 Staffing Model & Organisational Chart
Staffing is the single largest operating cost category and the
primary determinant of clinical quality. Renacare’s staffing ratios are
calibrated against South African Nursing Council and HPCSA minimum
standards and against the staffing benchmarks observed in
high-performing international dialysis networks.
Staff establishment — steady state
| Role | FTEs | Reporting Line | Annual Cost (ZAR) |
|---|---|---|---|
| Managing Director / CEO | 1.0 | Board of Directors | 1,800,000 |
| Medical Director (Nephrologist — 0.5 FTE) | 0.5 | MD | 1,200,000 |
| Head of Nursing & Clinical Operations | 1.0 | MD | 960,000 |
| Finance & Admin Manager | 1.0 | MD | 780,000 |
| Business Development & Compliance Lead | 1.0 | MD | 720,000 |
| Dialysis Registered Nurses | 10.0 | Head of Nursing | 4,800,000 |
| Clinical Technologists | 4.0 | Head of Nursing | 1,360,000 |
| Dietician (0.5 FTE) | 0.5 | Head of Nursing | 280,000 |
| Social Worker (0.4 FTE) | 0.4 | Head of Nursing | 180,000 |
| Reception & Patient Admin | 2.0 | Finance & Admin | 520,000 |
| Billing & Medical Aid Coordinator | 1.0 | Finance & Admin | 380,000 |
| Quality & Infection Control Nurse | 1.0 | Head of Nursing | 520,000 |
| IT & EMR Administrator (0.5 FTE) | 0.5 | Finance & Admin | 240,000 |
| Cleaning & Hygiene (outsourced contract) | 2.0 | Finance & Admin | 180,000 |
| Total permanent establishment | 25.9 | 13,920,000 |
Note: staffing costs in the financial model use conservative loadings
(including benefits, CPF, training and leave relief) and ramp to this
steady-state level from Year 2. Initial Year 1 staff costs are budgeted
at R7.35 million reflecting a phased build-up during the utilisation
ramp.
6.4 Value Chain & Patient Journey
6.5 Operating Hours & Capacity Management
The clinic will operate six days per week (Monday to Saturday), with
three haemodialysis shifts per day. Sundays will be reserved for deep
cleaning, equipment disinfection, planned maintenance and emergency
services. Peritoneal dialysis training and clinic follow-up will be
scheduled Tuesday to Friday afternoons.
6.6 Information Technology & Electronic Medical Record
Renacare will deploy a cloud-hosted electronic medical record (EMR)
specialised for dialysis. The EMR integrates scheduling, clinical
treatment records, billing, medical-aid electronic data interchange
(EDI), and quality indicator reporting. The selected platform supports
HL7 integration with pathology laboratories (including PathCare and
Ampath), and offers a patient portal for appointment management and
results access. Data protection will comply with the Protection of
Personal Information Act (POPIA); backup and recovery will be replicated
to an off-site data centre.
6.7 Supply Chain & Procurement
Dialysis consumables are the largest variable cost in the operating
budget. Renacare’s procurement strategy balances cost discipline against
supply continuity and clinical quality. The principal supply categories
and mitigation strategies are as follows:
| Category | Key Suppliers | Continuity Strategy |
|---|---|---|
| Dialysers (single-use) | Fresenius, Baxter, B. Braun | Dual-sourced; 6-week rolling inventory |
| Bloodlines (single-use) | Fresenius, Nipro | Vendor-consigned stock |
| Dialysate concentrate | Fresenius, Baxter | 30-day on-site reserve; local manufacturing |
| EPO & biologics | Cipla, Sandoz, Roche | Cold-chain 2–8 °C storage; just-in-time |
| Water & power | Municipal + borehole backup; grid + solar + UPS | Storage tank ≥ 12 hrs; UPS covers 8 hrs |
| Clinical engineering & maintenance | OEM service contracts | Annual preventive maintenance; 24-hr call-out |
Confidential — this business plan is provided to prospective investors and lenders for evaluation purposes only and may not be reproduced or distributed without the written consent of RenaCare Dialysis Clinic (Pty) Ltd.