5 steps to preventive maintenance: is your preventive maintenance a vicious circle, getting you into budgetary trouble, or a virtuous cycle, keeping costs under control?

Nursing Homes, Jan, 2003 by Jo-Anne Kempe

Every few months somebody has a new requirement that adds to our Environmental Services workload. More and more, we need to document processes and work histories to prove we're in compliance with regulations. But are our budgets increasing to reflect greater demands? Just the opposite: I'm being forced to cut costs and still somehow improve quality of care. My Environmental Services staff is working to capacity and I can't afford more people. We all just keep trying to do more with less.

Rob Millar, Administrator, Summit Place,

Central Park Lodge, Region 3, Canada

Sound familiar? The leaders of senior living communities whom I meet in my work are deeply committed to the comfort and safety or residents. They're trying hard to continuously improve the living environment while staying competitive and meeting financial targets. So when we discuss implementing a structured preventive maintenance program, they're both excited and daunted by the prospect.

They're excited because they see an opportunity to turn what's become a vicious circle into virtuous cycle-saving time, money and hassle. They're daunted because, with all the competing priorities on their plate and no template or structure to start from, the task seems overwhelming and the payback too far into the future.

And yet, when a major piece of capital equipment breaks down at exactly the wrong time--a heating system in the middle of winter or the air conditioning in July--they have a problem. Beyond the negative impact this malfunction has on their reputation for providing quality care, there's a big unexpected cost to explain to the board and cover somehow.

Malfunctions in fire-safety systems or resident-care devices such as lifts are an even greater worry, because they put the safety of residents and staff at risk and can lead to lawsuits or skyrocketing worker's compensation premiums. If communities can't prove they've done the preventive maintenance the manufacturer prescribes, they can be found liable for damages. And, as more and more of us are learning these days, that can be very expensive.

The Vicious Circle

We all know that preventive maintenance is important. For a leader responsible for millions of dollars worth of buildings and equipment, as well as the health and safety of residents, the business case for preventive maintenance that reduces cost and risk should be clear. But it's not easy to break out of the self-reinforcing vicious circle.

Here's an example of how the vicious circle works: It might start when the recommended practice of regularly vacuuming clothes-dryer vents gets neglected because the task is not on anyone's priority list. The dryer catches on fire. It's a small, localized fire and nobody gets hurt, but there's smoke damage to repair, a $5,000 dryer to replace, and laundry needs to be sent out in the interim. Because maintenance staff are kept busy cleaning up the mess, a backlog of requests for minor repairs is created. With no prioritization system in place to help staff manage the workload, they juggle requests as best they can--responding to whoever asks most often or is most persuasive. Once again, preventive maintenance is put on the back burner.

If time does become available for preventive maintenance, much of that time is wasted figuring out where to start and what to do. Equipment manuals and binders of safety regulations are gathered from far-flung corners of the community. Staff try to remember when the fire alarm system was last tested and what exactly was involved. They try to reconcile generic maintenance lists someone put together years ago with the equipment they're using now.

In another example, an expensive motor seizes up and needs to be replaced. It turns out the worker who had been doing preventive maintenance on the motor didn't know that part of the job was to lubricate the vanes. Money that was earmarked for energy-saving upgrades of the heating system now has to be diverted to replace a three-year-old motor that should have lasted longer. Budgets get cut. The vicious circle spirals faster.

In the back of the leader's mind lurks the worry that lack of proper preventive maintenance may be jeopardizing the safety of residents. A generator goes out and critical life-support systems can't function. Or perhaps smoke detectors fail to give warning of a fire. (In one actual case, a paraplegic woman was scalded to death in the shower when the water temperature controls malfunctioned.) But hypothetical risks are easier to ignore than an irate resident on the telephone, and so important tasks get neglected.

The Virtuous Cycle

With a small upfront investment of time and attention, senior living communities can put in place a comprehensive preventive maintenance plan that turns the vicious circle into a virtuous cycle.

The virtuous cycle starts when you clarify preventive maintenance priorities and pull all the right information together in one easy-to-access place. With a robust manual (e.g., wall calendars) or automated (software-enabled) reminder system in place to make sure the right tasks are getting done at the right time, there are fewer emergencies, accidents, or unexpected breakdowns. The operating budget becomes more stable and predictable, and less subject to unplanned and difficult-to-justify spikes. The reputation gained for high-quality care and a safe environment helps attract and retain the best staff and keep the community at capacity. Over time, the preventive maintenance program prolongs the useful life of expensive buildings and equipment, delaying the need for capital investment and saving on financing costs.