Is Bigger Better?

by Teresa D. Johnson

 

There comes a time in the life of most successful businesses that decisions must be made regarding the size and scope of operations.  Adult day centers are no exception.  Typical questions include:  Do we increase the capacity at our current center by building on, relocate to a larger facility or seek to establish a satellite in an outlying community?  Can we afford to add nursing services to assume ‘health center’ status?  This article is the first of several articles to be published addressing the expansion issue.

 

Determining if bigger is better for your program hinges on your asking one question:  "How can our center best serve its customers--participants and their families?"  Here are some things to consider.

 

 

Expand the Product, the Market or Both?

Identify the products your center provides to its customers, e.g. respite, personal care.  Is your intent to offer more services or to expand your market?  Do you intend to attract additional participants for existing services, expand the service area currently served by the center, create a service niche or expand the types of clients served by the center?

 

The Center’s Mission and Goals

A starting point for determining if a center should expand or not should be based on the mission and goals of the agency.  The mission statement should define not only what happens in a program, but why things occur.  From such a statement, goals are constructed which shape the direction of the program.  The establishment of measurable goals creates a critical evaluation system for short and long term actions.  Revisit your center’s mission.  Evaluate your goals and how expansion fits into them.

 

‘Community’ at its best

One of the unique features of adult day centers that attracts many customers is its community-based nature.  The routine of leaving home in the morning and returning in the evening seems most like a normal life.  ‘Growing’ a center must not cause staff and administrators to lose touch with what makes a program unique.  If other adult day centers operate in the area, what makes your center different from theirs?  A program personality valued by customers and staff can get buried if the center’s uniqueness is not supported and nurtured in the expansion. 

       Caregivers and participants value convenience in using the community-based service.  However, no matter how good a center’s services may be, if the center is not located so that customers can access it quickly and easily, particularly working caregivers, they are likely to choose another care option.  Convenience may be perceived as the distance and/or commute time required from home or work to the center, traffic intensity in accessing the center or ease of entry to and from the center.

 

The Staff

One of the most feared dangers of expansion for participants and caregivers is the loss of contact with staff.  Bonds they’ve established with each other are often special.  Consider the impact on the customers of relocating staff to other sites if new centers are opened.  One way to ease the transition may be to gradually schedule the staff away from the center, rather than making abrupt changes.  Allow time for everyone to say their goodbyes.

 

If expansion means altering the nature of the clients served in the center, the staff-to-participant ratio must be reconsidered.  Serving participants who require higher levels of care may necessitate hiring additional staff.  Staffing with a combination of part-time employees and full-time employees may provide the most equitable balance.  Diversified staffing patterns often yield more flexibility and advantages for all the employees.  Whether the center expands to multiple sites, increases its capacity or product in the established site, all adult day center staff must be properly trained to ensure the provision of quality services.

 

The Facility

The building chosen to house an adult day center directly affects its capacity, the type of clients which can be served, services the center can offer and the opportunity for future expansion.  Without the setup and space for a treatment area, for example, health services are limited, e.g. showers, hair care.

 

While a building may offer a considerable amount of square footage, its floor plan, accessibility and ‘user friendliness’ are key factors in determining its appropriateness in serving as an adult day center.  Buildings with many rooms and long hallways often pose problems for demented participants, as well as ‘group control’ problems for staff.  Bright, open areas are much more appealing.

 

Renovating space to make it meet building, fire, sanitation and other regulations sometimes proves more costly than leasing, expanding a current facility or even building a new center.   Some programs choose to operate multiple sites in smaller settings rather than try to manage one megacenter.  Those persons might say that sometimes the best gifts come in small packages.  Adult day care homes are an option for an even more intimate setting.  Such facilities usually accommodate less than ten participants in single-family dwellings.

 

Menu of Services

Choosing to offer ancillary services in adult day centers is a common method of program expansion in order to meet customer demands.  A program operating at multiple sites may be better off piloting the proposed service(s) at one center before launching promotional campaigns at all their facilities.

 

Is bigger better?  Not if the quality of service for the participants and their caregivers is compromised!  Bigger is only better when expansion guarantees customers get quality service.  In a growing industry with a promising future, the question to ask may not be "Is bigger better?" but rather "Which bigger is best?"¥

 

Reprinted from The Information Source for Adult Day Centers®, October 1997