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Posted: August 31, 2005

Professional Caregiving

Inside Reality vs. Outside Perception in Senior Services

As senior service providers, we need to have a very intense understanding of our inside reality, vs. the outside perception of our business in the community.

The inside reality is how our day-to-day business operates. Are we providing quality care? Is the staff pleasant, easy to work with, and caring? Is the food good? Are we providing a home-like environment? Do workers show up on time for their shift? Does the administration project a positive example, and are they supportive of their staff? For nursing home environments, what did the last set of survey results reveal? Does the facility have a good relationship with their state surveyors?

Consider your inside reality for a minute. What is it really like?

Now, think about the outside perception of the facility or organization you work for. The outside perception for any senior service provider is related to two things: what the business is advertising, and word of mouth.

Of course, the advertisement is always positive ("luxury dining," "quality care," "we treat our residents like family," "dedicated to compassionate care," etc.). All of the ads in the Yellow Pages look almost identical, and say almost exactly the same thing (I have suggestions for that, as well, in a later column). Take a look sometime. What you will realize is that everyone wants to project just about the same outside perception -- "the best in senior living!" and "senior living at its best!" are examples.

Now, let’s talk about word of mouth. Word of mouth can make or break a business. There’s an old saying that if a customer is dissatisfied, they will tell 10 people about how terrible the business is, but if they are satisfied, they will tell (maybe) 2 people. Doesn’t seem fair, but that’s how it works. No organization can afford to have negative word-of-mouth spreading around town.

So, does your inside reality match your outside perception? If not, it’s time to innovate and rebuild the inside first.

I found a quote from a very wise man, George Hinkle, administrator of the Frankston Healthcare Center in Frankston, Texas, who shares his philosophy with this page from his facility manual:

"It is the opinion of the staff of Frankston Healthcare that Marketing and Public Relations are very important components of a successful operation. The primary consensus is that there must be something of substance to market before marketing can take place and be effective. Before a facility team goes out to market, the items referenced here must be in place. Until all are present, in place and noticeably functioning, you are not marketing the truth and you will be perceived as a fraud.

• You must provide excellent care.

• You must provide good food.

• There must be no odor.

• The residents must be safe and happy.

• The employees must have a great attitude.

• Positive reputation and family confidence.

Regulatory compliance.

• Great community acceptance.

• Good surveyor stability (you get along)

Leadership stability

Once these 10 steps are in place, then you have something to go to the public and market. If they are not operating in your facility, you should stay home and take care of your business so there will be something of substance to build upon.

Our facility motto is:

If better is available, good is not enough!"

Hinkle clearly understands something very fundamental -- inside reality must match the outside perception of the community. If it doesn’t, the organization is setting itself up for failure. We owe it to the seniors and families in each community that we serve to make sure that if we open our doors for business, we are doing it right every time. If an organization needs to change, that change needs to be quickly implemented and supported from the very top administrators in the organization. It can be done!

Let me hear about your experiences in this respect. You can email me at


Valerie VanBooven RN, BSN, PGCM, is a registered nurse, professional geriatric care manager, author, and professional speaker. She is a leading expert on long-term care planning and crisis management. Valerie is president of Senior Care Solutions, a private geriatric care management practice in the St. Louis area. Her books include Aging Answers: Secrets to Successful Long-Term Care Planning, Caregiving, and Crisis Management and her website is She can be reached at .

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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