FINANCIAL PERFORMANCE AMONG ADULT DAY CENTERS - RESULTS OF A NATIONALDEMONSTRATION PROGRAM

OBJECTIVES: This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adu lt day centers participating in a national demonstration program on da y services for people with dementia, including examination of possible predictors of financial performance. METHODS: Participating sites sub mitted quarterly financial and utilization reports to the National Pro gram Office. Descriptive statistics summarize the factors believed to influence financial performance. RESULTS: Sites averaged meeting 35% o f expenses from self-pay and 29% from government (mainly Medicaid) rev enue, totaling 64% of all (cash plus in-kind) expenses met by operatin g revenue. Examination of center characteristics suggests that factors related to meeting consumer needs, such as being open a full day (i.e ., 7:30 am to 6:00 pm) rather than shorter hours, and providing transp ortation, may be related to improved utilization and, thus, improved f inancial performance. Higher fees were not related to lower enrollment , census, or revenue. CONCLUSIONS: Adult day centers are able to achie ve financial viability through a combination of operating (i.e., fee-f or-service) and non-operating revenue. Operating revenue is enhanced b y placing emphasis on consumer responsiveness, such as being open a fu ll day. Because higher fees were not related to lower utilization, cen ters should set fees to reflect actual costs. The figure of 64% of exp enses met by operating revenue is conservative inasmuch as sites inclu ded in-kind revenue as expenses in their budgeting calculations, and p ercent of cash expenses met by operating revenue would be higher (appr oximately 75% for this group of centers).