Long-Term Care Industry Program Capstone - Essay Example

? Long-term Care Industry Comparison In the United s the long-term care industry at one time consisted of convalescent homes, nursing homes, or “old-folks homes.” Today the long-term care industry has upgraded to assisted living facilities (ALF) and adult care homes (ACH) as a mainstream alternative to nursing homes and the like (Kane, et al, 1991). The more prolific of the two alternatives are adult care homes. An ACH is a small assisted living facility providing long-term care in a house in a neighborhood. In an ACH, personal assistants – commonly called caregivers – give long-term care to individuals such the elderly, the physically disabled, or the developmentally disabled in a home-like environment (Wake County Human Services, 2011). An adult care home is an actual home business that just happens to be closely regulated by the state in which it is located. A person cannot simply take a care-dependent individual into his or her house and then declare the house an adult care home. Only a license from the state will legally make a house an adult care home and a business license will make it a legitimate business. Before a license is considered the house as well as the owner/operator and any employees will be inspected by the state in which the house is located. The house may have to be remodeled to meet state requirements such as a private room for each client as well as the resident manager and the substitute caregiver. Every room in the house will have to have a smoke alarm that meets the Fire Marshall’s standards, and at least one fire extinguisher will have to be on every floor of the building (State of North Carolina, 2010). After the house is inspected the owner/operator and the employees will come under scrutiny. The owner/operator and resident manager must be of legal age; they must be of good physical and mental health; they must be of sound mind; they must submit a physician report testifying to the fact they are of good physical health, mental health, and sound mind; and they must submit to a criminal records check – which may include finger printing – and pass the check. All of these items must be submitted and approved before a license will be granted. In some states, for the first year, the owner/operator is required to be the principle caregiver in his/hers first home by living in and operating the home (State of Oregon, 2010). In some states, the type of license that is given depends on the training and experience of the owner/operator and the employees. A class I license is granted when the owner/operator and resident manager have completed and passed the basic training course and examination. An owner/operator will be granted a class II license when he/she and the resident manager have completed and passed the basic training course and provided proof of two years full-time experience in providing direct care to an elderly or physically disabled person. To get a class III license the owner/operator and employees must complete and pass the basic training course and provide proof of three years full-time experience providing direct care to the elderly or physically disabled persons who required full assistance with four or more activities of daily living (ADLs) (State of Oregon, 2010). There are no barriers to becoming an adult care home operator outside of the licensing process. If an individual can acquire the funds and the license then he or she can operate an adult care home. Adult care home operators range from the wage earner who, for most of his or her adult life, has worked hard for someone else and now finally has a stake of his/her own, to the savvy business owner and college graduate. Such diversity of people makes for different managing styles and different choices of business entities. The owners who have one home usually operate his/her home personally as a sole proprietorship. Owners of more than one home usually incorporate and under that umbrella operate his/her homes. Usually it is the owners of more than one adult care home who hires “Resident Managers” to handle the day to day planning, organizing, leading, and controlling (POLC) needs of the home, leaving the owner free to focus on the macro POLC functions of the corporation. Regardless of the form of business entity, the owner of an adult care home providing quality care for the elderly that makes the client feel loved in a home-like environment can earn per person per month as much as $4,000. A care home housing five elderly persons, at $4,000 per person, can net at least $4,000 monthly. The business of adult foster/care homes is quite lucrative. The homes providing elder care are more lucrative than homes providing care for the developmentally disabled simply because elder care ACHs can charge more. Science has yet to learn how to stop the aging process, therefore, growing old will continue to be a fact of life. For that reason, adult care homes have a place in the future of the United States as an option for a home business. For that reason ACHs are nationwide. The state of Oregon is one of the few states where adult care homes flourish. The Oregon adult care home proliferation began in the 1980s when Oregon allowed adult care homes to receive Medcaid for payment (Kane, et al, 1991). It was thought that adult care homes would supplement or replace nursing homes when in fact, as research has shown (Kane, et al, 1991), adult care homes are one step before the nursing home. In Oregon, the macro-environmental affect on the adult care homes begins and ends with the State of Oregon Adult Foster Homes Administrative Rules (OAFHAR). The OAFHAR even determines that the clients are referred to as “residents” not “patients,” that the staff members are caregivers not caretakers, and that each client accepted into the home must be given a copy of the Residents’ Bill Rights and have each item explained to the client’s understanding. The idea of adult care homes is to allow the elderly person to be as independent as possible. If the elderly person can do his/her toileting and hygiene, then the operator and caregiver must allow the elderly person to do so even if it is difficult or painful for the person. It is extremely easy to dominate an elderly person. It is also extremely easy to care an elderly person into dependency. Some unethical owners who charge according to what care is given, will do just that, care the elderly person/resident into dependency. By intentionally caring a resident into dependency an owner will have violated the resident’s rights. If this violation comes to the attention of the State the owner and the caregivers will be prosecuted (Department of Human Services, 2010). . The tight regulation the state puts on owners and the strong competitive environment make up two of the toughest obstacles owners must hurdle. In spite of this, there are owners who operate more than one home. Two such owner/operators are the owners of Garden Place Senior Adult Care Homes (GP) and Fromont Adult Care Homes, Inc. (Fromont). Garden Place Senior Adult Care Homes was started with a mission in mind of giving back as much independence as possible to its elderly clients through a high quality of service and a good quality of living in a “home-like” setting. It is policy that GP clients are not thought of or referred to as clients, residents, or patients. They are thought of as and called “Grandmas” because that makes it more like family. Because one person caring for five attention-needing persons – as the state regulates – lessens the quality of care, it is policy to have a 2:5 employee-client ratio in the mornings and evenings. In addition, it is policy; whenever possible the “Grandmas” are assigned a household task in order to help them feel useful and needed and therefore more “at home.” It is policy that meals are balanced and prepared from fresh foods. The owner requires the resident manager to prepare a week of menus and a grocery list so the ingredients are stocked. Garden Place Senior Adult Care Homes (GP) has an outstanding reputation in the community for friendliness, integrity, honesty, high quality of care, and a pleasant place to live and work. As a result, Garden Place has a waiting list not only of potential customers but potential staff members as well. The government requires the owner of an adult care home to make a weekly visit to each home. The owner of GP will visit daily in order to interact with the clients so they will know they matter. The owner requires the employees to daily engage the clients in some type of activity. The owner is an “out front” leader – not a behind the scenes supervisor – leading by example. All the housekeeping tasks and all the direct care duties, the owner has done and sometimes will do. For that reason, the owner has no qualms about demanding the same from the GP employees. Monthly staff meetings create a forum for the airing of concerns and the resolution of conflicts. For that reason the owner has no qualms about firing anyone who is not a team player. In adult care homes there is little to no room for advancement so promotions are not given. However, there are yearly performance evaluations and raises or bonuses given. Garden Place Senior Adult Care Homes S W O T Reputation in community and city x x Does not provide health and dental insurance x x Resident manager may have change to lease home x Number and quality of ACHs in local area and city x Years in business x x Possible injures from heavy lifting x x Long-term care industry is permanent x x Larger assisted living facilities x The policies of the owner of Fromont Adult Care Homes, Inc. differ slightly. The employee-client ratio is 1:5, but the resident manager has more autonomy. The owner visits each home weekly, but also does all of the maintenance for each home. In the Fromont homes it is policy that each meal is balanced and prepared from fresh wholesome foods. It is policy that at each meal the food is set on the table and everyone – including the on-duty employee – sits and eats, like at home. The owner of Fromont Adult Care Homes, Inc. also does not give promotions but instead yearly evaluations and raises or bonuses. The owner requires all homes are clean inside and groomed outside. It is the resident manager’s duty to plan daily activities and engage in them with the clients. The owner of the Fromont homes uses the services of a placement service to acquire new clients to fill a vacancy instead of a waiting list. Fromont Adult Care Homes, Inc S W O T Reputation in community and city x x Does not provide health and dental insurance x Resident manager may have chance to lease home x Number and quality of ACHs in local area and city x Years in business x x Possible injures from heavy lifting x x Long-term care industry is permanent x x larger assisted living facilities x Happiness and contentment in an adult care home is no easy task. Each resident is someone who spent decades building a home, raising children, and filling a house with memories. Because they age and can no longer care for themselves, they are taken from their home of memories and put into a room in a house with other people they don’t know and may not like. In addition, they must endure being touched in private places by a stranger. Add to these feelings the feelings of guilt the family members feel for placing their loved one into the care of someone else and the feat of happiness and contentment in an adult care home can be fully appreciated. The perceived happiness shared by the residents is an indication the owner has taken care to be sure each person accepted into the home has a personality that blends with the other residents. As result GP and Fromont homes have vacancies because a client has died. Adult care homes are businesses even though they are home businesses. Operating an adult care home is the business of tender loving care but it doesn’t have to look and feel like a business. The owners who have conquer the task of making their adult care home business look, feel, and smell like a home are the owners whose home(s) are always full and the homes have a waiting list. References Kane, R.A., Kane, R.L., Hixon Illston, L., Nyman, J.A., & Finch, M. (1991, Sept.). Adult foster care for the elderly in Oregon: A mainstream alternative to nursing home? American Journal of Public Health, 81(9), p1113-1120. Retrieved June 13, 2007, from SocINDEX database with Full Text. Wake County Human Services. (2011). Senior and Adult Services: Adult Care. Retrieved May 25, 2011 from http://www.wakegov.com/humanservices/adult/adultcare/adultcare.htm. State of North Carolina. (2010). Division of Health Service Regulation - Adult Care Licensure Section: License an Adult Care Home. Retrieved May 25, 2011 from http://www.ncdhhs.gov/dhsr/acls/floadult.html. State of Oregon. (2010). Licenses, Permits and Registrations."Adult Foster Home." Retrieved May 25, 2011 from http://licenseinfo.oregon.gov/?fuseaction=license_icon&link_item_id=14213. Department Of Human Services. (2010). Seniors And People With Disabilities Division 50: Oregon Administrative Rules - Chapter 411: Adult Foster Homes. Retrieved May 25, 2011 from http://arcweb.sos.state.or.us/rules/OARS_400/OAR_411/411_050.html. Read More