title: Financial performance among adult day centers: results of a national demonstration program.
abstract: OBJECTIVE
  This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adult day centers participating in a national demonstration program on day services for people with dementia, including examination of possible predictors of financial performance.
  
  
  METHODS
  Participating sites submitted quarterly financial and utilization reports to the National Program Office. Descriptive statistics summarize the factors believed to influence financial performance.
  
  
  RESULTS
  Sites averaged meeting 35% of expenses from self-pay and 29% from government (mainly Medicaid) revenue, totaling 64% of all (cash plus in-kind) expenses met by operating 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 transportation, may be related to improved utilization and, thus, improved financial performance. Higher fees were not related to lower enrollment, census, or revenue.
  
  
  CONCLUSIONS
  Adult day centers are able to achieve financial viability through a combination of operating (i.e., fee-for-service) and non-operating revenue. Operating revenue is enhanced by placing emphasis on consumer responsiveness, such as being open a full day. Because higher fees were not related to lower utilization, centers should set fees to reflect actual costs. The figure of 64% of expenses met by operating revenue is conservative inasmuch as sites included in-kind revenue as expenses in their budgeting calculations, and percent of cash expenses met by operating revenue would be higher (approximately 75% for this group of centers).
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1087, USA.
authors.forename: B V
authors.initials: BV
authors.lastname: Reifler
authors.forename: R S
authors.initials: RS
authors.lastname: Henry
authors.forename: J
authors.initials: J
authors.lastname: Rushing
authors.forename: M K
authors.initials: MK
authors.lastname: Yates
authors.forename: N J
authors.initials: NJ
authors.lastname: Cox
authors.forename: D D
authors.initials: DD
authors.lastname: Bradham
authors.forename: M
authors.initials: M
authors.lastname: McFarlane
mesh_terms: D000368:Aged; D003151:Community Health Centers / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D003631:Day Care, Medical / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D003704:Dementia / Q000628:therapy; D005249:Fees and Charges; D005376:Financial Management / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008484:Medicaid; D012144:Respite Care / Q000458:organization & administration; D013997:Time Factors; D014186:Transportation; D014481:United States