Focus On…Transportation

Resident-focused care does not stop at a facility's door. If transportation services are provided, care extends beyond the property into the local community and beyond. Whether a facility simply offers local, convenient trips or has advanced activity programming that includes educational and adventure travel for its residents, the first and foremost concern is resident safety-and that means vehicle safety. Whether it's a minivan or a small (16 passengers or less) or large bus, purchasing a facility vehicle is an expensive proposition. The question is: When is it time to revitalize your transportation? Is your vehicle still reliable and meeting your needs, or is it beginning to cost more to maintain than the value it provides?

To answer these questions, Nursing Homes/Long Term Care Management recently asked Halsey King, president of Halsey King & Associates, maintenance educator, and speaker on transportation issues, for his advice.

When should a facility begin to think about replacing its current transportation vehicle?
King: Vehicles used in this capacity have a four-year life cycle, which is somewhat determined by U.S. government testing standards. Of course, a long-term care facility wouldn't automatically spend that kind of money every four years. This is an accelerated life cycle testing protocol that the government suggests is applicable on a nationwide scale. If a facility has an excellent maintenance program, good driver training, and a pleasant operating environment, that vehicle may last much longer than the four-year standard.

What are the first warning signs that a vehicle, whether it is a bus, van, minivan, or paratransit, is nearing the end of its usefulness?
King: The first thing that management will notice is the higher maintenance costs. It becomes more expensive to keep the vehicle on the road and out of the shop. Like your personal automobile, components will eventually wear out and need replacement. The savvy administrator will have to decide when it is more prudent to replace than rehab resident transportation.

Another trigger revolves around frequent and costly body and component maintenance. Generally, a vehicle with 150,000 miles of service will begin to have mechanical body issues. For instance, if the facility is in a northern climate, environmental conditions can affect the vehicle's body. Driving over salt-treated streets can rust out the muffler and exhaust system and other components under the bus.

In some cases, the last straw in the decision hinges on repeated problems and breakdowns on the road. Heaters don't keep the bus warm in the winter, and in summer the air-conditioning doesn't keep the interior cool. Your riders-your residents-get tired of complaining about these malfunctions and you, the administrator, become concerned about the continuing comfort and safety of the vehicle.

How long is it wise to keep "fixing" problems with the vehicle?
King: That is a judgment call. The bus may be perfectly operational, although a worn out driver's seat might make it uncomfortable for the driver. But a wheelchair lift leaking hydraulic oil-the very oil that makes it work properly-is an entirely different situation. If that leak goes unnoticed, it can seep under the interior linoleum or rubber flooring and attack the plywood floor underneath, making the bus floor very soft. In a small bus it will, in time, reach the back of the driver's seat, and when passengers board the bus it will feel like they are walking on bags of marshmallows. Again, other indicators that it's time to assess your transportation situation include frequent breakdowns and repeated road calls.

The warranty won't necessarily be the determining factor because when you match it against vehicle life, it's a footrace. Small buses (16 passenger or less), minivans, and vans are generally good up to 250,000 miles, but some vehicles go farther.

Should every facility provide some type of transportation service?
King: Operating transportation for a facility is costly. Do you want (or need) this level of service? This is the driving question. Convalescent facilities normally don't plan day outings. Their vehicles are used to provide basic transportation for those who are mobility impaired in lieu of contracting with an ambulance service. Other, generally larger facilities with a more active population may have a well-established transportation department that will take residents to the airport, casino outings, and the like.

What maintenance tips would you recommend to help keep a vehicle in top working order?
King: If you buy a passenger transport vehicle but don't want to maintain it, contract with a local garage owner who understands bus technology and maintenance. Provide him with all the maintenance information pertinent to your bus or van, since the vehicle is a composite of different manufacturers. The maintenance facility will need this information to contact them for parts. For example, if there is a problem with the wheelchair lift, the chassis manufacturer won't be able to help.

Meet with the garage owner and develop a scheduled preventive maintenance program. Make sure that the garage owner has the tools and skills necessary to service your vehicle. Chances are your bus or van has some technology on it that is not familiar to the mechanic. The first thing that will "hit him between the running lights" is the wheelchair lift. The mechanic probably is familiar with the in-dash air conditioner, but can he work on the rear air conditioner? In addition, many buses are ADA compliant and therefore are equipped with bright yellow handrails, LED lighting systems, and larger windows, which means that the mechanic (or garage owner) will have to become knowledgeable about ADA requirements and why they are important to maintenance staff.

Other than serving the residents, have you come across ways that a facility can make more use of its vehicles and get more for its investment?
King: Many organizations have a need for transportation. The Red Cross, for example, operates a fleet of buses but sometimes needs to temporarily acquire more. Other special organizations, like women's clubs and other service organizations, may be sponsoring an event or outing and could contract with a facility to provide transportation. Or there may be a facility down the road that doesn't have a transportation option and could work with you to fill that need.

If you have a bus or van that does a morning run and returns at 9 a.m. to sit idle for the rest of they day, a good dispatcher or marketing person can keep that bus going (and profitable) during the facility's off hours.

Halsey King is President of Halsey King & Associates in Carlsbad, California. With more than 26 years of experience, he has provided consulting services and training to more than 700 fleets worldwide. He provides seminars on maintenance for a number of organizations. For more information, phone (760) 434-2400. To send your comments to the author and editors, e-mail .
Wheelchair-Accessible Minivan

Atlantic Turtle Top's wheelchair-accessible minivan doesn't look like an institutional vehicle. Small groups can ride in comfort and style to doctor's appointments, hospital visits, social, functions, and more. This van comes standard with removable front driver and passenger seats and two wheelchair securement positions. This allows the passenger in a wheelchair to ride alongside the driver in the copilot area. Capacity options include six passengers plus driver or three passengers, two wheelchairs, plus driver. Easy access to this ADA-compliant vehicle is achieved with a lowered floor and low angle, nonskid entrance ramp.

Bill Flynn, Atlantic Turtle Top, 508-839-3301,
Resident Transportation

The ElDorado National Aerotech is a safe, comfortable, and dependable transportation choice. It is available in a variety of lengths and configurations to meet all transportation applications.

Aerotech has been crash tested in an automotive testing facility. The steel-reinforced composite body is highly resistant to impact, rust, and corrosion. The gelcoat exterior keeps its glossy finish for the life of the vehicle and absorbs temperature at a lower rate than metal, making the bus easier to heat and cool. The fiberglass body panels allow minimal sound transmission, resulting in a quieter interior for improved passenger comfort.

ElDorado National, 785-827-1033,

Commercial passenger and ADA-compliant, wheelchair-lift'equipped vans and buses are Mobility Transportation Services' only business. Because they are specialists, they can customize a van to a client's specifications and deliver in less than 30 days-in fact, many times in less than 10 days-at the lowest price. Financing with $0 down at special interest rates is available.

Thomas Leoutsakos, Mobility Transportation Services, 800-854-4687,

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