The family business.

Recently I received a newsletter from Welch Healthcare and Retirement Group, of Norwell, Massachusetts, called "The Welch Connection," announcing the passing away of founder Thomas "Frank" Welch. At age 86, Mr. Welch must have reflected proudly upon the fact that the organization he and wife Rita started in their own home with a license received in 1949 now serves thousands of seniors in skilled nursing homes, rehab, independent and assisted living, adult day health centers, and home care services throughout Massachusetts. More to the point, it operates under the management of the third generation of Welches to do so.

What really got my attention in this story were a couple of quotes--one from Mr. Welch's son Thomas, noting that "he was a man who people mistook for the janitor instead of the owner because he kept the buildings in top-notch condition...." Mrs. Welch remembered, "In the beginning, Mr. Welch continued with his day job while improving the facility at night. We can picture him tiling the basement floor and plastering the boiler room." Their seven children also pitched in over the years, delivering meals, performing maintenance, and conducting resident activities.

This sort of family connection to the long-term care "business" is something that I have found to be not at all unusual. Ian Cordes, executive director of various Florida long-term care organizations, and a frequent judge for our annual OPTIMA Award, once told me stories of his growing up in a long-term care facility owned and operated by his parents. The Bortz Health Care chain, based in Michigan--its Traverse City facility won our 2002 OPTIMA Award--has a similar history. It describes itself as America's largest privately owned and family-operated nursing home organization. During the OPTIMA Award ceremony, I recall owner Donald Bortz mentioning how much he had enjoyed visiting with residents, sitting and swapping stories on the facility porch over many an evening before residents' increasing acuity over the years began to forestall that possibility. (That friendly spirit lingers, though, I'd say, judging from many residents' obvious excitement at seeing Mr. Bortz at the ceremony.)

I bring all this up because I think it illustrates the special nature of long-term care at its best. Truly excellent nursing facilities do more than simply process senior admissions and keep people functional. In these "homes," residents are treated as residents--deserving of all the warmth and attentiveness any guest would receive, and often attaining the status of personal friends of staff and management. Admittedly, as Mr. Bortz commiserated with me, it's more difficult these days to establish such relationships, what with the double whammy of resident acuity and demanding regulations; running a modern nursing home is a business challenge fit for the most advanced of MBAs.

But amidst all the modern sweat and strain, I hope that long-term care facilities never lose the family touch that is so unique to this healthcare field, and so attractive.

To send your comments on this editorial to the author and editors, e-mail [e-mail].

BY RICHARD L. PECK, EDITOR-IN-CHIEF