Nursing Home/Long Term Care/Home Care/opening an adult day care

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Question
Dear Ginelle,
I have a very large beautiful home with a pool set on 2 1/2 acres. Since my children are grown it's much too large for me but given the market can't sell and overhead outrageous. It is a shame that such a nice place is not used to benifit someone or at least earn enough to pay for itself.  I've had many ideas from a catering hall (zoned residential),transitional housing for abused women and children to an alf. I am over my head working the business I have but do have a home office I work from much of the time so don't have the time needed to devote to these projects. When I read about adult day care this seemed the fastest and easiest way to do something.
There is only 1 in the area and it is by far not as nice as my home.  I worked many years as a CNA and activity director at nursing homes so am familiar with senior care, enjoy older adults and doing things for them.The fact they leave at days end would enable me to continue to live here.
Could you please tell me a bit more about this type of business?  What start up costs would be incurred, number of employees needed, types of activities expected and anything else you feel relavent or any advice?  I am sure it is not as easy as it sounds and if I decide to follow through want to assure everything is done correctly and it is an enjoyable place for them to come.
Thanks,
Jayne

Answer
Dear Jayne,
What a wonderful idea to take your lovely home and use it to help others!  I have been involved with the planning of adult day care facilities and agree that this is a much needed service.  
Here are the answers to your questions.  
Could you tell me more about this type of business? – Adult day care is provided for adults with disabilities or seniors who are not able to complete their own activities of daily living independently.  They may need help with cooking, eating, taking medicine, toileting, walking, etc.  There is usually a mix of adults in a daycare.  Adults may be there because of physical needs or for cognitive issues.  The service can be flexible to accommodate those who may want to come a couple of days out of the week or be available for full-time.  The seniors have their meals and medicine there.  They have social activities and other activities adapted to their abilities to occupy their day.  
Start up Costs, the staff ratios, etc. can be found in the licensing requirements.  Adult Day Care facilities are licensed facilities and these requirements may differ from state to state.  So the answers to many of your questions would be found in the licensing requirements for Florida.  I looked up the licensing authority on the Internet.  Here is the link.  http://elderaffairs.state.fl.us/doea/adcc.php   At the bottom of the page, on the link attached is the opportunity to get a packet with all the licensing requirements.  There are usually requirements that the house has to meet regarding fire codes, handicapped access, parking, etc.  These are usually the costly start up items.  I have worked with two other adult day care start ups.  You will have to do a diligent in preparing your projections on expenses vs income.  This is what I have found in the past – most adult day care facilities while starting up can take in private pay adults.  These adults paying for the service themselves or family paying for the service.  What I have found is that this is not the “bread and butter” of adult day care.  Private pay clients are usually the exception.  I am not sure why though because Adult day care costs are usually cheaper by the day than getting a private pay sitter.  So those families looking for economy in day care will sometimes choose Adult Day care for the cost savings.  Once licensed you can take in clients whose services will be paid for by another funding source (a Medicaid program, or Veterans Benefits) depending on the requirements for your state.  This I find is usually the majority of the population in an adult day care.  So if you are serving clients before you are licensed (which may be allowed by your state) you are usually far from operating at full capacity.  This is important to factor into your profit and loss estimates.  Some other items to consider when factoring in costs will Florida allow the nurse on staff to be “part-time” or is the nurse required full-time?  Can the nurse be an LPN?  Or does the nurse have to be an RN?  Staffing will be determined by ratio of staff to client.  The more clients you have the more staff required.  This will be outlined in the licensing packet.  Also there is usually a nutritionist who has to sign off on the meal plans.  And sometimes the nutritionist has to prepare the meal plans.  This may have a big impact on your bottom line.  Activities can be music, music therapy, crafts, movies, walks, gardening, audio books, etc.  You may be able to engage volunteers to help out on a regular basis with activities.
Honestly I have found that Adult Day Care facilities have a difficult time making it financially due to the licensing requirements.  So if the owner of the Adult Day Care is hoping to make a profit, this does not usually happen.  However there are different business models that help Adult Day Care facilities survive including being nested in another business (for example:  being housed inside an assisted living facilities, etc.)  This would not be the case of course with your Adult Day Care.  However, you can be creative in ways of meeting the requirements and economize on the overhead.  I have found the more profitable venture is a residential living facility for seniors.
With this said, you can determine if you are looking for a profit and if the business model as outlined in the licensing requirements would allow you to realize this profit.  If not, you may consider the residential living facility, where seniors live there.  This is also a licensed facility and you can acquire the packet from the State of Florida also.  Due to round the clock care, this is a much more profitable venture.  In the models I have seen in the past, your facility would go from not profitable, or breaking even as an Adult Day Care to being profitable.  
My final suggestion would be to visit Adult Day Care facilities.  If you are able to travel out of your area somewhat, you can ask open questions about starting a center and obtain a wealth of information.  You can also make calls to centers outside your area and when the directors are able they will usually share as much information as possible.  
I hope that this information was helpful to you and that you are able to move forward with utilizing your home to open an Adult Day Care center.  If you have further questions, you are welcome to contact me directly at Ginelle_leblanc@ymail.com.  My best to you as you pursue this opportunity.
Sincerely,
Ginelle LeBlanc

Nursing Home/Long Term Care/Home Care

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Ginelle LeBlanc, CSA

Expertise

I can answer questions regarding home care solutions for seniors, in home care scheduling and care giver solutions, funding sources for home care, how to find a quality Care Giver, what questions to ask when interviewing a caregiver for home care, how to solve home care problems. All things related to caring for a senior at home, and the caregivers taking care of a senior. Additionally for those who own a home care business, I can help answer questions regarding the start up and operations of a home care business for seniors.

Experience

I am a Certified Senior Advisor (CSA) accreditied to help seniors and thier families to find the best solutions for their needs. I owned and operated a Home Care service for Seniors for 6 years and was able to help nearly 1,000 families find the best caregiver match for their parents, or senior loved one. I have supervised a staff of caregivers providing care in private homes, assisted living facilities, hospitals and nursing homes. I continued in the Senior Care/Home Care Industry as Regional Director of Training for Comfort Keepers providing training and operational support to 10 offices in the Gulf South Region. I now have 12 years in this field. I now own and operate my own Senior Care Consulting business, GL Consulting, LLC (www.GLconsultingLLC.com)

Education/Credentials
Graduated from Southeastern Louisiana University, Hammond, Louisiana. I am a CSA (Certified Senior Advisor).

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