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A Proposal for
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A Proposal for Implementing a Western Style CCRC in China
Objective of Proposal: The objective of this proposal is for implementing a Western Style
CCRC in China, considering the Chinese culture.
Describe the Problem: As we know that because of culture differences many Chinese might not
accept the idea of going to an CCRC when they need to.
Importance of the Problem: Older adult’s population is rapidly increasing each year and it
happens around the word, the idea of how elders in China wouldn’t want to go to a CCRC is
because of the culture differences. “For some 2,500 years, adult children in China have followed
the Confucian doctrine of filial piety and provided physical care for their aging parents at home.
Since the establishment of the People’s Republic of China in 1949, the government has required
by law that all adult children take care of their aging parents; only childless elders are cared for in
welfare institutions by the public sector or the government” (Zhan, Feng, Luo, 2008)
Current Knowledge: There has been massive amount of research in how elder care institution is
needed due to high demand from the elder’s population. For example, in (Zhang, 2019) Sending
parents to nursing homes is unfilial? An exploratory study on institutional elder care in China,
this study has shown that with the need of elder care institution in China and how Chinese culture
of filial piety plays a huge role in creating and operating an CCRC for Chinese elders.
Missing Knowledge: However, “the viewpoint of ‘sending parents to nursing homes is unfilial’
is still influential.” (Zhang, 2019) Elder care in China is needed but there is not an example of a
fully successful elder care facility in China. Thus, I believe that with the idea of implementing a
Western style CCRC in China with consideration the Chinese culture it would bring a highly
acceptance from the elders and the Chinese Society. And, even though that China is moving from
home care to institution care for elders it is their first step of moving forward.
Specific Objective of this proposal & hypothesis: In this proposal, we will determine the needs
of Chinese elder when considering Chinese culture; filial piety, family care, and education in
elder care workforce. I hypothesize that when all elements of Chinese culture are considered
when operating and implementing an CCRC in China, that Chinese elders and society will
increasingly accept the idea of an CCRC. This will serve as a huge step forward and will lead to
creating more CCRC in China in the future.
Specific Aims:
1. Determine the current health care facilities and survey the needs of what older adults in
China wants and need in a CCRC health facility. Sets of survey of needs will be sent out
to the elders.
2. Design and develop prototypes according to the need from the survey for older adults.
Depending on what elders want in China, we will accomplish what needs they want and
satisfy the need for elders.
3. Find out what could be improved after the prototypes have been used in the real world.
Have people randomly go to the CCRC and observe what staff and elders are having
problems with.
Expected Outcomes & Interpretation:
Each aim would be examining the needs of elders in China when we consider the Eastern culture.
As we begin to introduce the idea of the prototype sample of a health facility, like the ones in
America, Chinese elders would have a chance to get to know what a CCRC would look like and
even better when their own history and culture is heavily considered, it would be more successful
when it comes to going to a CCRC in China.
.
A Proposal for Strategic
Transformation Of
Dining Services AtABC
J
Executive Summary: After twenty-eight years of leading the market in senior living
options in the Baltimore area, ABC is looking mature and stagnant. Coupled with a still
sagging housing market and shifts in aging policies in Washington which threaten to cut
entitlements for an already benefit-reliant senior market, a generational demographic that
is characterized as demanding a more robust value proposition than their predecessors
regarding amenities and services will be even more discretionary as it considers senior
living options. Specifically, recent data indicates a transition in the prospective resident
marketplace, as elder consumers are placing more importance on the quality, diversity,
and healthfulness of dining and nutrition as a core component of overall human wellness
and optimal quality of life and its draw as a critical amenity in the purchase decision when
considering a CCRC. And as our ABC dining program was built on a traditional retirement
home, healthcare platform over twenty-eight years ago, with very little modernization of
facilities or programming, our dining program is at risk of obsolescence in the wake of the
demands on our transforming industry. Lest we lose our competitive edge in the senior
living market we once dominated, ABC must include a significant and comprehensive
enhancement of our dining services program as a prominent component in our current
strategic plan.
Overview. The world is in the midst of a transformation within three dynamic and
integrated spheres: human aging, policies around aging, and the management of Aging
Services – the Aging Revolution. As Senior Living services concurrently transform, the
most successful and sustaining of those services will intentionally position itself at the
intersection of all three spheres, demonstrating awareness of evolving trends in all three
areas, as well as the agility to adapt in the midst of a national culture change regarding the
perspectives, needs and desires of aging Americans.
ABC, the flagship of Sponsor Living Management, has been successfully operating
at the intersection of the evolving revolution since its founding back in 1983; certainly, our
founder, Mr. Tee, has been a pioneer and advocate within the ranks of aging services
leaders for decades. But now, twenty-eight years later, ABC is beginning to stagnate. Lest
Page 1 of 13
it loses its competitive edge in the senior living market it once dominated, ABC is in the
midst of a strategic transformation of its own, evolving resident programming and
refreshing physical plant to ensure its place as a CCRC of choice among potential
consumers. Alarmingly, the dining services program is not prominent in this current plan.
1.) Identified Need
Issue & Urgency. Though the dining services program at ABC has historically been
regarded as an essential program to address the needs of current residents of the
community, thereby contributing to overall resident satisfaction and retention, it has not
been viewed as a significant influencer regarding the purchase decision for prospective
residents. However, recent data 1 indicate a transition in the marketplace, as elder
consumers are placing more importance on the quality, diversity, and healthfulness of
dining and nutrition as a core component of overall human wellness and optimal quality of
life, and its draw as a critical amenity in the purchase decision when considering a CCRC.
And as our program was built on a traditional retirement home/healthcare platform over
twenty-eight years ago, with very little modernization of facilities or programming in the
wake of our transforming industry, for ABC to stay competitive in the marketplace and
achieve its strategic objectives associated with its current planning, the dining services
program must transform concurrently and commensurately with its importance as a
purchase decision driver for prospective residents. And as the window of opportunity
regarding access to current project bond funds expires on December 31, 2013, it is urgent
that the ABC Board Of Directors hears and acts on this proposal promptly.
Justification. In a 2008 American Seniors Housing Association (ASHA) national
survey, 942 current independent living residents of retirement communities nation-wide
rated the top ten factors which contributed to their purchase decisions to move-in to an
independent living community: #3 was the dining services (32 percent); #7 was the type
1 Rose Report, 2008 (commissioned by Sponsor Retirement Communities); AASHA Report, 2008.
Page 2 of 13
and quality of food (27 percent); and #8 was the variety of menu choices (25 percent)2.
Interestingly, these were the only service/amenity attributes among the top ten factors. In a
Rose Report of 360 CCRC Concept Buyers from that same year, the second-biggest
objection (42% of respondents) to moving-in to a CCRC for age-appropriate prospects was
having to “eat all meals in a group setting.”3 As well, results from twelve, nation-wide focus
groups with 649 seniors sixty-five and older conducted in 2007 by Brand Integrity< identified differences in desired outcomes for younger seniors (aged sixty-five to seventy­ eight) that hypothesized the possibility that they have higher expectations regarding food choices and menu quality than seniors seventy-eight and older. In twenty-eight years, little has changed regarding the philosophy or approach to dining services at ABC, serving us well to this point. But research suggests that our large and open dining hall environments will not be appealing to the next generation of senior living consumers5. Moreover, with increased convenience, choice and optimal quality of life more associated in the senior consumer mind regarding access to nutritional food options and cooking methods6, our current programs and equipment do not support the evolving consumer product demand. And perhaps most importantly, as one of the biggest challenges to overcome in the senior living consumer mindset is to minimize the likelihood of having to move into an unfamiliar environment7 - especially an eventual transition to long term care - addressing issues related to the culture change movement in long term care dining being led by the Pioneer Network, among others, is essential. Proposed Solution. ABC must transform its dining services program to better meet the evolving needs of current and future residents. 2 ASHA Report, 2008 (commissioned by Sponsor Retirement Communities). 3 Rose Report, 2008 (commissioned by Sponsor Retirement Communities). 4 Brand Integrity Desired Outcomes Focus Groups, 2007 (commissioned by Sponsor Retirement Communities). 5 Rose Report, 2008 (commissioned by Sponsor Retirement Communities). West, G. E. 0., Denise & Ouellette, Stephanie {2003). Resident and Staff Ratings of Foodservices in Long-Term Care: Implications for Autonomy and Quality of Life. Journal of Applied Gerontology, 22(1): 57-75. 7 Brand Integrity Desired Outcomes Focus Groups, 2007 (commissioned by Sponsor Retirement Communities). 6 Page 3 of 13 1. We must evaluate current programming and determine the gaps between what the market is demanding and what we're offering. 2. We must conceptually reconsider and innovate current programming to bridge those gaps in service. 3. We must assess current physical plant and equipment and conceptually redesign and innovate a new physical plant and operational design to effectively deliver on our redesigned programming. 4. We must retrain the core competencies of the dining team and other community partners to consistently deliver excellent, consumer-focused dining experiences. 2.) Solution Initiative Business Plan: The components herein offer a summary of the most critical factors of my Business Plan for this project. It is understood that more formal components of the Business Plan would be developed, as required. • Value Proposition: By offering flexible, convenient and contemporary food and beverage options in modernized, state-of-the-art, hospitality dining environments, ABC will differentiate itself in the marketplace as a senior­ living option of choice for consumers demanding great value and access to progressive amenities and services. • Market Opportunity/Industry Analysis: The market has been described, in brief, above. Regarding competitors in the industry: current trends show CCRCs reaching a similar maturity and stagnation of services, similar to ABC, in the marketplace; a trend is emerging, nationwide, with communities re-positioning themselves to meet today's changing, consumer expectations and to differentiate products and services in their communities. Page 4 of 13 • The Team: In a discovery phase, I have retained the services of industry experts to assess our current operations and establish independent, unbiased and objective baselines of current dining programming, staffing capabilities and physical plant conditions. Upon their reviews, we will work collaboratively with the ABC Executive Team, Sponsor Living Dining Services partners, and leaders from the ABC Dining Services Operations Team to create a cohesive, dining services redevelopment plan that will include a series of recommendations for consideration and approval by the ABC Board Of Directors. • Re-Programming: Beyond the phased redesign and renovation of the six dining spaces at ABC, we will concurrently transform the service options, concepts and production logistics of our programs. This will require a substantive reconfiguring of integrated tasks and a comprehensive skill set identification and retraining of competencies for many of our dining team members. (Baseline assessment of the current skill set and operational capacity of the team is being identified in the discovery phase, above). We will develop the structure concurrently with facilities redesign; we will communicate and retrain concurrently with facilities construction/renovation. • Capital Requirements/Sources Of Funds: As ABC has already executed on a $128,000,000 bond to fund approved projects in our current strategic plan, I will look to access contingency reserves of those funds to support our community objective-critical recommendations. It is anticipated that the total capital requirement for the proposed projects will be approximately $4,000,000 - about 3% of the total current investment in projected community strategic enhancements. (It should be noted that access to these funds is time-bound, expiring on December 31, 2013.) Pages of 13 • Timelines and Execution: See ABC Dining Project Timeline, pg. 11. Meeting In-House Concerns: As identified in Team in the Business Plan, during the assessment/discovery phase, I will engage an interdisciplinary team of stakeholders from within the organization to fully vet and address holistic costs and impacts of the evolving components of the dining services strategic plan on the community at-large. These concerns will be more fully addressed in Working With Stakeholders, below. 3.) Selling The Program The Sales Pitch: Below is my succinct Elevator Speech which addresses the issues, goals, and ROI of the proposed project, with a focus on the sustained impacts in support of community strategic objectives as a result of the full execution and implementation of proposed recommendations, as well as the price of inaction. The Senior Living Market is on the verge of transition, with consumers demanding higher quality, perceived value and breadth of services than their predecessors only years earlier. Those communities that enhance their dining options will feast in this market; those communities that offer out-moded dining options will soon experience a famine of consumers. ABC must choose its future dining option now: Feast? Or famine? Working With Stakeholders: Upon arriving at ABC in January, 2009, I became aware of the strategic plan that was developed by an interdisciplinary task force of ABC leaders that had been two years in the making. Much of the data that I referenced earlier in this proposal was not available to this team. When I sat with the Director Of Strategic Planning (hired by the Board Of Directors concurrently with my hire) to review the strategic plan, and dining's place therein, I was alarmed to learn that there was very little regarding substantive evolution of programs and culture change for dining services. New as I was to the community, I intentionally began to identify key stakeholders in the strategic planning Page 6 of 13 process and softly started amassing power8 through the strategic development of relationships, intentionally softening-up these stakeholders to the urgent need to transform the dining services program. Significant Timelines: • June, 2010: Collaborated with Associate Executive Director to continue creating awareness about the lack of dining presence in the strategic plan, most notably with influential members of the Resident Life Subcommittee of the Board of Directors. Concurrently engaged dining services partners at the newly created Sponsor Living Management to create awareness of and build support for the urgency to act on my concern. • August, 2010: Developed and presented a formal presentation to the Resident Life Subcommittee of the Board of Directors, emphasizing the strategic alignment of the transformation of the ABC dining program with the overall strategic objectives of the community. ABC's Executive Director is formally introduced to ideas. Included dining services partners from Sponsor Living Management as a co-presenter, to demonstrate collaboration, solidarity and support with and from our corporate partners. • September, 2010: Board approves request to begin the search for team of industry experts to offer an objective assessment of the current dining services program. • January, 2011: Executive Director and Board of Directors approve contract to engage identified team of industry experts to determine operational and facilities baselines and facilitate interdisciplinary team through discovery and recommendation phase of strategic planning for dining. • March, 2011: Project initiation. (See ABC Dining Project Timeline Gantt Chart, pg.11.) 8 Kingdon, J. {2003). Agendas, Alternatives and Public Policies (2nd ed.) pgs. 127-131. New York, NY: Addison-Wesley. Page 7 of 13 Potential Enablers: Potential enablers with specific influence who support my initiative include members of the Board of Directors who have parents who live at ABC (2); resident members of the Board of Directors (2); Sponsor Living Management Vice President of Operations (formerly the Associate Executive Director of ABC with whom I partnered to navigate the softening-up process of my initiative); ABC's Director of Strategic Planning, who reports directly and solely to the Board of Directors; and the Young Elders of ABC (current residents between the ages of 65-74) who best represent the demographics and desires of prospective residents of ABC. Barriers/Headwinds: Ironically, the dining services program is at risk of becoming a victim of its own success. ABC dining has experienced four, successive years of improved resident satisfaction as determined by annual satisfaction surveys conducted by Holleran. Specifically, resident satisfaction in our Skilled Nursing area increased by statistically significant margins in all five, surveyed categories in 2010. As well, the most satisfied residents at ABC, by age range, are our Young Elders, who represent the very market that we are expressing concern over regarding their perceptions of our maturing and stagnant program. Other headwinds might include timeliness of permitting for various projects, as well as funds approvals by both the Board of Directors and, more significantly, MAHEEFA, the organization who has direct oversight of how our bond funds are dispersed and employed. Lastly, day-to-day operations are constant headwinds, as, regardless of our plans to enhance and transform the dining program, we are still operationally obligated to serve between 2500-3000 meals every day, 365 days a year. The Strategic Plan: The Strategy Statement: Page 8 of 13 By December 31, 2013, ABC Dining Services will reposition its programming to specifically serve the identifi ... Purchase answer to see full attachment

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