Some of the most well meaning professionals contact our offices or one of our affiliates wanting to increase their personal income and serve society by entering into the assisted living business - sometimes on a small-scale (6-12 beds) and often much larger. These special programs provide clinical competence, quality shelter and personal care assistance for some of the most vulnerable among us including the catastrophically injured and the medically fragile elderly who do not belong in a nursing home.
Those who contact us seek direction on program models and types or they look for valuable information from our paid webinar or conference call sessions (which are conducted early mornings and late evenings for the convenience of busy professionals). Some of you look to engage others in your business plans, i.e. relatives or existing business partners and would like direction on how to do it.
Having assisted in the establishment of or the refining of more than 200 programs, we delight to help people enter the business correctly. After all, America was built on entrepreneurism.
However, there are even more people who enter the business having made some critical, avoidable mistakes and end up having to pay us to clean it up. We are happy to do it, but it makes our job harder. So let us discuss some key ingredients associated with a pattern of success by enumerating those five, (5) most commonly made mistakes:
I. Wrong Real Estate
Those who engage the technical advisor/consultant early in the process have quality direction in advance of purchasing real estate. Since real estate should be selected based upon how best it can serve the needs of the intended population and not just due to its reasonable price, professional insight in this area is meaningful.
II. Wrong Interim and Initial Personnel
New entrepreneurs are quick to align themselves with people who have worked in care. Often these are individuals who have provided direct care to a population with grave illnesses. Perhaps they have performed well in the clinical end of care. For some, thanks to meeting the requirements of one, (1) year of experience and completion of high school, they qualify to act as the administrator of record for the newly licensed program based upon currently published licensing guidelines.
Problem: This same person, while a high quality direct care deliverer, is not a trained, effective or savvy marketer. Their contacts with referral sources may leave them feeling as though they are completely out of their league. As a result this new entrepreneur in the business of care has set-up a good person to fail as a result of asking them to perform tasks they are not qualified to undertake and the initial impression to the long-term community at large may be a bad one to start.
This same person - on whom the new entrepreneur in care has latched - is not a technical writer. They may also not be trained in the professional development of plans of care, contract negotiation with community mental health agencies, responding to insurance issues affecting payments from no-fault insurers for a catastrophically injured person or the management of a clinically competent care environment. All of this underscores the need to be discerning in the selection of this initial staff member, especially management.
Ask yourself: Are they a certified brain injury specialist? Do they have clock hours learning what is involved in plan of care development? Do they have an advanced degree? Is their experience limited to simple, small-scale home management and direct care delivery or have they successfully swam with the sharks of long-term care?
Sentimentality cannot be allowed to override good judgment in this process. You need the right people.
III. Ignoring Regulatory Requirements
Every state of the union has clear, concise guidelines for determining what program models require licensure. Some attempt to render services without adhering to these guidelines resulting in licensing authorities seeking injunctions in circuit courts and even worse. Often a cursory review of licensing guidelines is not enough to consider oneself literate in this process.
Refusal to accept the value of regulatory compliance can be a fatal mistake on multiple levels.
IV. Refusal to Accept the Necessity of Effective Marketing
Many feel they have entered the business once they have a house. This is far from the truth. That house has to be converted into a workable, marketable, community responsive and clinically competent program with expert management. Holding title to the structure is by far not enough.
A similar situation would be present if this line of thinking existed as often occurs when you have the wrong personnel. Nice house - but no long-term profitability.
V. Absence of Operational Protocol
A business needs clear, enforceable guidelines to govern the work of its employees. An assisted living business needs routine and general policies and procedures to ensure there is a daily protocol that is not abandoned in the execution of services to residents. Staff must be trained in wound prevention and management, medication administration guidelines and so much more. Without it, no business can exist and thrive.
Want to avoid these pitfalls? Employ the right technical advisor/program manager who will hold your hand every step of the way. After all, a little leadership can be the recipe for avoiding tons of headaches down the road.
I am hopeful all of this will be extremely helpful to you and I thank you for allowing me to share.
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