No regret shopping

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No regret shopping
No regret shopping
Budget-conscious long-term care providers always have carefully weighed each capital expense, and that penny-wise approach is even more prudent in today's lingering economic downturn.

More than ever, when replacing worn, outdated or poorly functioning equipment it's essential to not just stick to a reasonable budget, but also to a detailed purchasing strategy. It should balance the current and future needs of residents and staff, take into consideration design and space limitations, and deliver a solid return on investment.

If new bathing units and lifts are in a facility's foreseeable future, providers have a good opportunity to boost marketability and competitive advantage. They can do this through improved safety and satisfaction of residents and staff, and they can also log significant savings from the equipment's ability to streamline efficiencies.

But reaching those goals isn't always easy, experts warn. Many providers have learned the hard way that just one wrong or hasty purchasing decision can wind up costing them far more than they ever bargained for.

“We're talking about a capital expenditure here, not an impulse buy,” stresses Lee Penner, owner of Penner Manufacturing Inc.  “There's a lot to consider before making that final decision and you'll be making a big mistake if you're not really thinking it through.”

Deep research necessary

Multidisciplinary involvement, extensive research and equipment evaluation, and savvy negotiating each play a key role in turning a new equipment purchase into a wise investment. That approach worked well for Sanctuary at Bellbrook, a Trinity Senior Living community in Rochester Hills, MI. When the community set out to replace its dated bathing unit with a new spa-like system, executive director Becky Lund refused to take the plunge without exploring all the options.

“I did a lot of Internet research and also worked closely with staff,” she says, adding that nurses and nursing assistants, as well as maintenance staff, were key players throughout the evaluation process. Ease of use and safety were top priorities.

“Our old bathing unit had a lift chair that had to rise over the lip of the unit and many residents did not like that. Also, residents who had to utilize lifts were not able to use this old unit,” she explained.

Once Lund and her team narrowed the search to several bathing units, the vendors were asked to bring them onsite for up-close evaluations. Vendors agree it's a wise move, particularly given that many companies have vans or small trailers to transport bathing units to prospective customers. Still, providers should be aware that most demo units are just a shell, stripped of all plumbing.

While actual trial runs or even rental periods may seem tempting to a would-be buyer, it's an unlikely option — and one that should be avoided even if a bathing system vendor offers it, believes Jeffrey Wagner, director of operations, TR Group Inc.

“Because of the nature of bathing products in wet environments, all long-term care providers should avoid any manufacturer that offers test periods or rental equipment. Bathing equipment should only be dedicated to a single facility so that any infectious contaminants can be isolated and treated,” he says.

Still, there are other options for those who want to see a demo.

“It's pretty much a certainty that they'll need to travel to a facility in the area to view one that is installed,” says David Anderson, product manager for Apollo Bath. Often, seeing the unit in operation and asking another facility's opinion on the system's advantages and disadvantages can weigh heavily into a purchasing decision. It also can alert the prospective buyer to additional features that might not otherwise have been considered.

“A common mistake long-term care providers make when shopping for tubs is not checking the disinfecting system or process for that tub,” notes Joe Montemurro, corporate marketing specialist for Direct Supply. “Take into account the length of time it will take to disinfect. If it seems long or difficult, your staff is less likely to do it correctly.”

Another mistake is basing a purchasing decision on aesthetics alone. While a bathing unit's design certainly matters, particularly as facilities aim for more residential-inspired bathrooms, Penner explains that a bathing unit should not be judged solely by its outward appearance.

“Really look at all that [unit] has to offer and take the time to understand the difference in what's being offered by other companies,” he says. “People should look at units from at least two to three companies before making a decision.”

For Sanctuary at Bellbrook, seeing the demo units in person and having an opportunity to speak with equipment experts about the many features and benefits helped solidify the winner. Lund's facility chose a unit that allows current lift equipment to slide easily into the bathing system so residents only have to be lifted once. And because a spa-like bathing experience also was a priority for Bellbrook, the team chose a unit that provided warm air and aromatherapy. The decision already has proved rewarding.

“Our resident utilization of the spa has increased twofold,” raves Lund.

But there's more to a smart bathing equipment purchase than just the unit itself. Warranties, preventive maintenance and vendor support all factor into a system's overall value. While warranties can vary widely (from one to five years), some encourage prospective customers to look for a three- to five-year tub shell warranty, at minimum.

“Be sure the warranty on the door seal is much longer than the standard three- to five-year warranty,” says Montemurro. He urges customers to look for a lifetime door seal. “If your door seal is not working properly, you cannot use your side entry tub until it's fixed. Many manufacturers offer this lifetime warranty, and it is worth putting on the ‘must-have' list when purchasing a tub.”

Penner Manufacturing, for example, offers a five-year warranty, which covers everything on the actual bathing unit itself, except the mixing valve (if a unit includes an integrated television, the warranty is provided by that TV manufacturer).

Some vendors offer extended warranties and, in some cases, extended parts warranties can be negotiated into the purchase price if a long-term care operator buys in volume or is willing to purchase skin care or equipment care products from the same vendor. Bellbrook bought an extended warranty for its new bathing unit, and an extended parts warranty program was offered for the blower motor and air plumbing system, including air valves and more.

“The standard warranty with the spa purchase was three years. We extended that warranty for an additional seven by agreeing to purchase a case of the recommended liquids — shampoo, conditioner, moisturizing soap, etc. — once every two months,” Lund says. “We need the liquids anyway and we thought it was well worth it to extend the warranty.”

Onsite in-servicing also should be expected and provided. Having a vendor representative onsite not only lets him or her verify that the equipment was properly installed and is in good working order, but also ensures that staff are adequately trained, reasons Anderson.

“Supplemental resources, such as an in-service DVD are also beneficial,” but they shouldn't replace live training, he emphasizes.

Lighten the load
Like bathing units, options abound for lift equipment. Unfortunately, some providers get carried away with a purchase decision without fully exploring what's available.

“A common mistake long-term care providers make when shopping for lifts is buying what they are used to from past experience and ignoring the fact that many worthwhile improvements have been made to other brands and models,” says Montemurro.

As a “Safe Lift” organization, Sanctuary at Bellbrook avoided that pitfall by trying out different equipment and gauging staff's overall acceptance of each lift before signing on the dotted line. Maintenance staff played a part in the evaluation process to ensure that the facility could comply with the manufacturers' preventive maintenance recommendations.

“It was important for them to review expectations around preventive maintenance to be sure it was something that could be done and would not be too costly,” Lund notes.

Such trial periods are often negotiable, and purchasing volume may help work to a facility's advantage. The duration of such a trial period can be discussed, according to Montemurro.

Halving transfers
Dual purpose lift equipment is another option, and can prove  useful for residents who must be transferred in and out of bathing equipment, Wagner says.

“The ability to do a single transfer from a bed to a bath versus a bed to a wheelchair to a bath lift or chair lift [cuts] the number of transfers in half,” he notes. “Across a facility population and over time, this can have significant implications for resident satisfaction and safety of care staff.”

The TR Combilift, for example, can convert from a stretcher position to a chair position to accommodate residents who must be transferred from their beds, but prefer to bathe in a seated position, Wagner explains.

Weight capacity is also an important factor, although it remains an unfortunate afterthought for many operators.
“Many facilities buy equipment that is of low-weight rating. It is often marginal for all people and sometimes inappropriate for others,” says Alan Bingham, senior product manager at AliMed Inc. “The weight rating of the lowest denominator dictates the weight rating of the system.”

Weigh in on warranties
One-year warranties are typical for lifts. Sources generally agreed that's typically enough time for any manufacturing issues to arise (although extended warranties and service agreements may be available). Still, providers should always read the fine print to determine what is actually covered.

“Also, consider the replacement parts, shipping and loaners when a piece of critical equipment is out of service for an extended period of time,” Montemurro cautions.

And don't forget the back-up batteries, warns Lund. “Once you institute protocols for safe lifting, you must have equipment ready and in good working order.”

Where prospective customers may want to flex their negotiation muscles is on in-service training and post-purchase support. 

“The type of in-services a customer should expect from lifts depends on the size of the opportunity. A single lift may qualify for one level of in-service, while several units might qualify for more,” Montemurro says. “Vendors usually include DVD-based training and may have web-based live and/or recorded sessions.”

And what if capital budgets simply don't allow a new lift purchase? Montemurro says that although renting is available from some vendors and might make sense for short-stay residents with specialized needs, the “rented equipment can usually be owned outright for less than one year of rental fees.”