How Can Smaller and Older Assisted Living Facilities Compete?

It’s a common theme – bigger is better. Maybe so. But if you own a smaller assisted living facility, there are ways to compete with the big boys.

old house

That’s one of the topics we covered at the recent Spring Conference of the Wisconsin Assisted Living Association. I was fortunate to sit on a panel with three others who are in the trenches everyday marketing their facilities and finding new ways to provide top service to their residents. My assignment was to discuss how the physical environment of a facility comes into play when competing with newer, larger facilities.

There are many issues that owners and operators of smaller and older facilities face when it comes to their physical environment. Here’s a quick list.

(Please note that some of these items are Wisconsin specific and may not apply to facilities in other states.)

1. Doorway and hallway width. Many older, smaller facilities were originally single family homes. Some were built many years ago when doorways and hallways may have been smaller. Even newer single family homes may be built with doorways that are too narrow to meet code. Requirements vary depending on size and class of facility, so consult DHS 83 for your specific situation. In some cases, doorways need to be increased in size to continue operating under the same license. Obviously, this can be expensive or not even possible.
2. Stairs. While you and your residents may have been able to navigate stairs, newer facilities are often single story or equipped with elevators. If you have stairs leading to resident units, you may find it difficult or impossible to continue using those units because of both regulation and consumer expectations.
3. Sprinklers. For most CBRFs, sprinklers are now required, whether it’s an existing CBRF or new construction. There are some exceptions for smaller facilities and those serving residents able to exit a facility without assistance but, generally, most facilities either need a sprinkler system now, when they sell, or by 2014. If your facility doesn’t have sprinklers, you may not be able to continue serving the same residents you have in the past.
4. Shared Occupancy. Semi-private units, double occupancy or whatever you call it was a lot more common years ago than it is today. There is still a place for shared occupancy units, especially in larger 2 bedroom units. Many providers correctly point out the benefits for both residents when they have a roommate. However, the trend seems to be toward only private resident units.

So, how can a smaller, older facility address these issues and compete with their new competitor?

That’s the million dollar question. And, in many cases, it might seem like it will take a million dollars to fix the issues that need to be overcome. But there are many assisted living providers who are competing and winning by using smart ideas.

First, many fixes to the physical issues of smaller, older facilities can be made without breaking the bank. Quotes for adding a sprinkler system range from $5 to $15 per square foot. Other remodeling may be more affordable than expected, and it may produce the additional benefit of giving a facility a much needed facelift. For units that can no longer be used because of stairways or narrow doors, turn them into additional common space, bathrooms or activity rooms.

Second, if you can’t beat them, join them. Build. Some assisted living facilities are just at the end of their useful life – at least for their current use. Some are re-purposed and used for a different client group that is able to life in the facility. While others are converted to a completely diferent use, such as a day care, office or back to a single family home. With the old facility sold, a provider can move along with their residents into a shiny new facility.

Third, find a new niche. Older, smaller facilities may find it more difficult to compete against all that a new competitor has to offer. Another option is to not compete at all by finding a new niche, or narrowing the niche served to take an advantage over the new facility. Examples of this include caring for residents with a specialty need, or a need that isn’t offered in your community. Ask referral sources which residents are more challenging to place and find if that’s a need that can be met with the older facility.

Owning and operating an older or smaller facility can present challenges. But those challenges can often turn into opportunities when you know where to look.

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