Christopher Upton is only seven months on the job leading Adult Tendercare Center, but the two have been on parallel paths for much longer.
“I was founded the same year as the company,” says Upton, who this year turns 30 years old. “And now I’m in charge.”
In October, he was appointed director of the adult day care program north of town. Upton’s great grandparents, Clarence and Virginia Ketch, started Adult Tendercare Center in 1988, the year Upton was born. His grandparents, Bill and Clarene Shepherd, also took a stint owning and operating the family’s for-profit, state-licensed center, starting in the late 1990s.
ATC’s 14 employees care for adults who need assistance, supervision and structure, often due to Down syndrome and other developmental disabilities.
“They just need to go somewhere they can be safe,” Upton says of ATC’s 47 regular clients. “The majority of what we do is just caring.”
ATC has capacity for 80 people on its 1.4-acre property at 3729 N. State Highway H. The clients receive meals, socialization and recreation.
ATC is one of three licensed adult day care centers in Greene County, according to a Missouri Department of Health and Senior Services directory. The others listed are Daybreak Adult Day Care and Development Center of the Ozarks’ Senior Focus Adult Day Care.
“The adult day care industry is not very well known,” Upton says, comparing to traditional assisted or independent living structures. “We’re a little bit different.”
A key component to ATC’s model is giving their clients’ caregivers a break for the day.
“They still need to go home every day. They still need to go back to their loved ones,” Upton says. “Our goal is to make the caregivers’ lives easier, simplified by our services.”
According to the Missouri Adult Day Services Association, of which ATC is a member, its sanctioned programs:
• promote the individual’s independence;
• maintain functioning as long as possible, preventing or delaying further deterioration;
• restore and rehabilitate the person to their highest possible level of functioning;
• provide support, respite and education for families and other caregivers;
• foster socialization and peer interaction; and
• serve as an integral part of the community service network and the long-term care continuum.
Such efforts produced $300,000 in 2017 revenue for ATC. The company charges $85 for five hours or more, including the day’s transportation and meals. Upton says if a client stays for less time, the fee drops to $45 per day.
While ATC’s licensing is approved and maintained through Missouri’s DHSS, payments are by and large covered by Medicaid through the MO HealthNet program, Upton says. According to a fiscal 2018 state budget report, persons with disabilities accounted for nearly half of the program’s roughly $8 billion in annual expenditures.
According to regulators at DHSS, adult day cares also may provide medical care, education, counseling and physical therapy, but Upton says those are not focal points at ATC.
Among the goals on his short list are expanded services, multiple sites and an additional certification through the state Department of Mental Health.
“That’ll enable us to serve a wider range of clientele and expand our business,” Upton says, pointing to dementia and Alzheimer’s disease care; as well as a second location in five to 10 years.
“With the aging population, that’s definitely going to be a need in the community,” he says. “We’re in a good spot.”
Upton also is considering a shift to not-for-profit status.
“I only see advantages,” he says, citing tax incentives and benefits within the community. “If people know you’re a not-for-profit company, they will charge you less for their services.”
He’s referring to the activities ATC clients get out to enjoy in the community. Upton says he’s laying the groundwork to build those relationships for such outings as bowling, fishing or Springfield Cardinals games.
“Next week, we’re going to Dickerson Park Zoo,” he says.
State officials make annual visits to audit ATC. Record-keeping is critical to a clean bill.
“We have a lot of paperwork,” Upton says.
Auditors observe ATC’s services, like meals to ensure staff is meeting the health code, and they’ll review the company’s background check process and results.
Upton says background checks are conducted every 90 days through the Missouri’s Family Care Safety Registry and the Highway Patrol. While the frequency is required to maintain state licensing, he’s on board with it.
“Something could always pop up,” he says. “I expect a high degree of moral character for my employees.”
He says an infraction usually results in immediate dismissal.
“I’ve only had to deal with that once,” he says of a case for dismissal when he first arrived at ATC. “They understood.”
Upton reinforces the job requirements of a positive attitude but also the ability to handle sometimes tense situations.
“We give high fives and hugs all day,” he says. “You have to be strong for them. We deal with people who sometimes have terrible lives outside of our facility. We try to make sure when we are with them, they have nothing to worry about.”
He recalls a client from a rural family that lived without running water. Every day at ATC, staff would provide a shower and fresh clothes.
“That’s just something we were able to do for that family because they weren’t able to in their home. That’s an extreme case,” Upton says. “Instead of being down about it, they figured how to make it better.”
Those stories and others are making their way to social media, as Upton works to revamp ATC’s online presence. He’s been strategically active on Facebook and Instagram.
“You’ll see a lot of smiling faces having fun,” Upton says. “You get a guy with Down syndrome smiling at you a bit, you’re going to smile back. Just a fact.”
O’Reilly Development Co. is building a continuum-of-care community with 83 independent living units, 46 in assisting living and 16 in a memory care division.
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