Independent NP Practice Idea: Assisted Living Facilities
Barbara C. Phillips, NP
Nurse Practitioners who want to get started in business with low overhead would do well to look at this business model. In the United States, it is estimated that there are approximately 33,000 Assisted Living Facilities (ALF). With the growing Baby Boomer segment of the population, ALFs are only expected to grow. An assisted living facility provides private rooms and apartments for seniors who may need some level of assistance with activities of daily living, though many do not. Some facilities may be supervised by a licensed nurse, and most of the care is rendered by nursing assistants and is generally available 24 hours per day. The Need for Providers: Individuals living in ALF often will have some difficulty getting to and from appointments to providers. In many busy practices, it's difficult to meet the needs of the elder patient due to the rushed nature of the practice. In addition, with the shortage of primary care providers that many areas of the country are experiencing, there are not enough people who are willing to take the extra time and care that a senior may require. Additionally, ALF have guidelines they need to follow in order to assure the needs of their residents are met. That will include frequent notification of the provider for any change in condition. Again, this is something that many busy office based providers find difficult to deal with. What the Independent NP Can Offer: Unlike skilled nursing facilities (SNF's), ALF do not require a Medical Director in the form of a physician. Depending on the state in which they are licensed, the facility may be called boarding homes, domiciliary care, or community residences to name a few. Nurse Practitioners, especially those with skills in assessing and working with the elderly, are poised to offer their services to these facilities and their residents...at the facility itself. Win-Win-Win: This proposed business model offers what I like to call a Win-Win-Win situation. In other words, everyone involved in this model will benefit. In my mind, this is the perfect scenario. The ALF: They win because they will be able to ensure the care of their residents. They will meet their reporting requirements and ensure their residents are seen in a timely manner. In addition, the facility will be able to market their services citing the advantages and benefits of having an on site medical provider. The Resident: They win in that they have convenient access to a skilled clinician. They will have the benefit of working with a provider who will know them, take the time to listen to them, better assessment and likely spotting changes and trends much earlier. The Nurse Practitioner: Benefits greatly as well. This low overhead business model is ideal for NPs who are just getting started as well as the seasoned Independent NP. Instead of trying to see patients in several locations, you can see several in the same location. Additionally, reimbursement for visits to domiciliary facilities is higher than office visits. This particular business model meets several requirements when looking at potential businesses: there is a need, there are "customers" and there is funding to support the business. There only needs to be willingness on the part of the NP.
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