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154 In Pursuit of the Sunbeam: A Practical Guide to Transformation from Institution to Household
unfolding that will take the marketplace by storm. In the decade ahead,
“It is a mistake to think past and present inertia will remain. New ways are unfolding that will take the marketplace by storm.”
“The physical environment is not only a major component in the lifestyle of people who live within it; it is a very visible aspect of how the market perceives your organization.”
new physical and organizational designs will be all around you.
(Authors’ Side note: A surprising number of providers continue to build traditional facilities. The only thing more dangerous economically than an old, depreciated, traditional nursing home competing with a neighboring Household Model is a new, un-depreciated, mortgaged, traditional facility competing with a neighboring Household Model.)
Not only is the physical environment a major component in the lifestyle of the people who live within it; it is a very visible aspect of how the market perceives your organization. It is the first signal to those who compare your services with other nursing homes. The Household Model clearly stands apart. The question is who is going to offer it, you or your competitor? One day, even if you make the right decision, it will be both. Then it will be a matter of who does it better.
Admittedly, we push this point rather strongly. However, we have seen many instances where staff and residents rally around a vision of the Household Model, only to have it unnecessarily stunted because scarcity thinking led the ownership to limit capital investment. Instead of creating a new future, they put a bandage on the rising hopes of the organization by eliminating the nurses’ station, putting in plants or creating a buffet. These interventions moderately improve the status quo, but they are not a good end game.
Will Abundance or Scarcity Shape the Possibilities?
As the vision of a resident-directed, decentralized organizational culture begins to take shape in the minds and hearts of planners, mental images of the home environment are stirred. Hunger for physical changes usually becomes evident as planning for transformation advances.
This is when you arrive at a fork in the road. One road takes the dream toward reality. The other is a dead-end where the dream bumps against real or perceived resource limitations. It is very important that the Administrator (we use this term to include the senior decision maker whether it be the owner, CEO, President, etc.) carefully considers the available and potential resources needed to make the physical changes that must accompany full fruition of the Household Model.
Scarcity Thinking
The traditional nursing home model has created a mindset of