CASE Friendly Assisted Living Facility-1 Friendly Medical Center, an urban, nonprofit, 450-bed rehabilitation hospital, began to see a significant decline in admissions. Friendly Medical Center's mission focuses on inpatient and outpatient rehabilitation of the severely injured and catastrophically ill. While the patient census aried from month to month, it appeared to the Friendly Medical Center Board of Trustees that the inpatient population was slowly but steadily declining. The hospital's market researchers reported that fewer people were being severely injured due to the popularity of seat belts and bicycle/motorcycle helmets. In order to get a handle on the future of the organization, the Board, and the CEO, Fred Splient M.D. called for a major strategic planning effort to take place. In January 20X6, Friendly Medical Center held a planning retreat to identify future opportunities. The outcome of the retreat was that the Medical Center needed to focus its fforts around two major strategic initiatives. The first, a short-run initiative, was to be more cost-effective in the delivery of inpatient care. The second, a long-run strategy, was to develop new programs and services that would capitalize on the existing, highly competent rehabilitation therapy staff and Friendly Medical Center excellent reputation in the region At the time of the retreat, Fred Splient's parents were living with him and his family. Fred was active member of the "sandwich generation." His parents were aging and developing many problems common to the geriatric populace. Their increased medical needs were beginning to wear on Fred and his family. It crossed Fred's mind that life might be more pleasant if the hospital Board approved an expansion of the Medical Center's campus to include living facility ssisted In March 20x6, Fred had his Business Development team prepare a rough estimate of the potential return on the investment of an assisted living facility. He asked the team to identify different options for facility construction and the associated costs. The team also did a complete competitive analysis and examined the options for services to be offered based on Friendly Medical Center's potential population base and catchment area. The Business Development team visited several facilities across the country. The team also interviewed companies that could oversee the design, building, and operation of the facility for Friendly Medical Center. The development team produced a preliminary business plan based on the recommended structure for the facility, estimated capital expenditure needs, estimated income from operation of the facility, as well as projected revenues to other Medical Center programs resulting from the facility's population. The plan was presented at the May 20X6 meeting of the Board of Trustees. Fred Splient and his team introduced the Board to the concept of opening an assisted living facility on Friendly Medical Center's campus. The facility would be set up as a for-profit subsidiary of the Medical Center so that it could generate a profit and not be subjected to the strict guidelines of the hospital's accrediting agencies. As a subsidiary organization, however, the Board would still have control The chosen facility design was a freestanding apartment-like facility with a sheltered connection to the Hospital for access to the kitchen and hospital services. The facility would have 100 units with 15 to 30 of the units classified as "heavy-assisted" and built to code to house the physically and medically disabled. The rest of the units would be "light-assisted larger apartments. The population would be approximately 110 to 150 residents, with most being single occupants rather than couples
