Running an efficient, punctual transportation system within a long-term care facility is more difficult than it might first appear. Punctuality is a big challenge even for those working with the non-frail or elderly. Safety is always a concern, too. Below, representatives from the provider and supplier side offer their expertise to providers who are interested in keeping their vehicles running on time, secure and operating smoothly. 


Continuing care retirement communities have perhaps the widest array of transportation challenges to deal with.

Besides varying levels of resident acuity, there is also usually a broad spectrum of activities to consider. At The Mather in Evanston, IL, for example, Executive Director Sara McVey estimated there are “several hundred” programs, activities or outings or a month.

“Older residents take a little more time (to get ready),” McVey said. “Make sure you don’t promise too many people you can take them someplace. And remember that you have to accommodate walkers.”


McVey’s staff found that out the hard way after obtaining a Prius to drive residents to various appointments and activities.

“I recommend (providers) physically take a couple of residents and several different walkers with them to make sure they fit in the vehicle,” McVey said. “A Prius definitely does limit what you can accommodate, especially if they have assistive devices. You might also have to figure in space for groceries. You might not think about a lot of things until you’re put into the situation.”


Staff members are a critical element.

“Make sure they’re really well trained in assisting residents on and off the bus,” McVey advised. “You want a lot of training and education and testing. You don’t want to take any chances. You have to make sure you know who you’re dealing with, and what the staff has to deal with. You have to be really on top with staff observations.  Residents are most likely going to change as the months go on.”


To help things run smoothly, the Mather maintains an online database for residents who request a ride. That way any staff member can check vehicle availability, though only about eight people have the authority to book appointments. This allows maximum coordination with limited vehicle options, McVey said.


When it comes to bus equipment, self-tightening tie-downs for wheelchairs  are valuable, one expert noted.

“Even as you hit bumps and such, the chair settles down and will self-tighten,” said Bob Anderson, director of commercial sales for Nationwide Bus Sales/Midwest Transit Equipment. “It can save a person a lot of time. Otherwise, it gets loose and a person is liable to say, ‘I don’t feel safe.’”

Anderson said if a wheelchair user has mobility from about the waist up, “they could do it themselves.” The price is about $450 for the new style, compared with $250 for an older, less secure style.


Safety must be a top priority, Anderson emphasized. One slip, trip or fall not only could bring injuries but also throw travel plans into upheaval.

“You want to make sure that they can get in easily,” he said. “We recommend handrails that go parallel to the steps. What a lot of people do is put a handrail that runs vertically inside the door on both sides. That’s fine for the next step, but what about the next two? Otherwise, you’re slowing people down.”


Other less obvious features also are important, Anderson said. One accessory his firm recommends is remote-controlled, heated exterior mirrors. They cost about $700 and haven’t caught on with many purchasers yet, he acknowledged.

“A lot of facilities have multiple drivers, and if it’s not a remote-controlled mirror, there aren’t a lot of guys who will get out and adjust it,” Anderson said. “And if it’s icy, they’re not going to go out and scrape it. With these, you press a button and it defrosts in about a minute. They’re easily adjustable on both sides.”


Mistakes to avoid

-Not “test driving” all aspects of a vehicle with actual residents getting on board—with any assistive equipment they use

-Settling for less than what you want or need with regard to entryway stair systems and grab bars

-Not drilling staff members repeatedly on proper transferring procedures for residents