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160 In Pursuit of the Sunbeam: A Practical Guide to Transformation from Institution to Household
“While there is no question the number of nursing homes will decrease
in the coming decade, those that reposition themselves stand a much larger chance of not just surviving but flourishing.”
number of nursing homes will decrease in the coming decade, those that reposition themselves stand a much larger chance of not just surviving but flourishing.
Market analysis can illuminate the demographic trends in your area and provide census information within your marketplace. It also will help you see merger and acquisition potentials more clearly. This is important to investigate because merger and closure of one facility (or both if you build new households) not only increases your ability to add new accommodations; it will also ensure accelerating census stabilization, in turn strengthening financial feasibility. In addition, this can simplify the Certificate of Need process.
While a pre-feasibility study will give you a sense of what can be accomplished with your available resources, you still need to determine the environmental transformation goals and how they support the policy and operational changes you put into place. You need what architects and designers call a building program, or – if your project warrants it – a master plan. The organizational transformation goals need to be articulated, and then merged with and supported by the building’s physical design.
From here the scope of the project can be determined, which in turn leads to the next level of planning operational budgets, financial feasibility and environmental design.
Making the Decision – Retrofit or Build
Once you have used your existing financial model to forecast the costs of construction, staffing and organizational restructuring, you can determine the level of environmental changes your facility is ready to make. The pre-feasibility process should tell you which of the two Household Model approaches are possible.
You don’t truly arrive at this decision-making point until you complete the pre-feasibility inquiry. An alignment in your values, organizational structure, operational behaviors and environment begins to be evident, and you begin to realistically understand what you can accomplish.
The sense of scarcity is likely beginning to be replaced by an outlook of abundance. Rather than, “Can we afford to do it,” the question now is “Which can we afford?”
There are two environmental options for creating the Household Model: renovate and/or build. If you can’t or don’t prefer to abandon your existing facility, it can be retrofitted into multiple houses, often within the