No one in care enters a business to hurt someone. We want to help relieve the stress of family caregiving, help intensify the clinical competence of care providing entities and enhance to what extent we can help someone to be self-reliant. We are not sure anyone does this better than well-managed adult day care programs.
These programs combine supervision, personal care, transportation and more, often in such a way that families can take a breather and premature hospital re-admissions can be avoided as well as placement into institutional settings, i.e. nursing homes. Unfortunately for some programs limitations out of your control cause major problems. What are these?
Well for more than twenty (20) years waivers to the Medicaid program have reimbursed adult day centers for their services. This is a wonderful arrangement. It means those who are traditionally lower income have access to comprehensive care arrangements which helps families promote a continuum of care and reduces the likelihood of abuse and neglect in the family caregiving environment.
The problem comes in when it takes months to get someone enrolled into a State run managed care program, normally Medicaid funded. In some cases we are hearing it can be a six, (6) month wait which is devastating for the person waiting to be enrolled. This devastation extends to the family caregiver whose employment may be in jeopardy due to having to stay home to supervise someone with dementia or other diagnosis that makes being at home alone unsafe.
Smart, innovative providers have learned to be sure their programs appeal to all segments of the population. One way to do this is to ensure that those who can afford to pay privately feel they are getting their money’s worth. This means the program needs:
- A comprehensive daily activity program that occupies participants in a person-centered way
- A well-decorated, functional facility
- Privacy for medical intervention and naps
Others – who may be more clinically astute – develop programs that are physician driven and serve the rehabilitative, nursing and related care needs of those enrolled. Many operate as Medicare certified Comprehensive Outpatient Rehabilitative Facilities (CORFs) and lead thorough, person-centered patient care initiatives that keep people grounded in their communities and out of hospital emergency rooms. These programs can be a real complement to neighborhoods and the local healthcare delivery system as a whole.
At the end of the day the goal has to be preventing the adult day care provider from developing an exclusive dependency on Medicaid waiver dollars and what might be an admissions backlog among 
managed care agencies. Let’s face it, many of these only employ key personnel part-time.
Of course operating a CORF is a skilled endeavor that requires professional protocols and best practices that cannot be managed unreliably or irresponsibly. However, the impact upon the community can be a very positive one. Be sure you check with licensing in your state if applicable to ensure this additional business component does not violate any licensing provisions. Most will simply want to be sure you do not invade the space for the adult day care’s primary activity area.
Yes success comes with many ingredients. Among those ingredients are thoughtfulness and creativity. Combining them leads to a program that can guarantee its long-term financial health.
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