Douma Driven To Serve

June 5, 2006
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GRAND RAPIDS — As a young man, David Douma didn't know that he'd make a career of serving the elderly, but he might have had a suspicion.

He knew that he had a desire to help people, perhaps inspired by his father's work as a minister. He knew that he wanted to invest in his community to make it a better place. What Douma didn't know was how he'd turn a high school education and an entrepreneurial mind into a leadership position with one of the area's most respected senior housing and care organizations.

"I did not have, when I was young, a vision that I wanted to take care of seniors," he said.

In fact, as a senior in high school, Douma started his own real estate investment business. He bought and sold houses. He acted as landlord for rental properties. He took a few college classes and honed his business skills.

A few years later, he had completed a stint in the military and had started a family. The skills he developed as a young landlord won him a position with a fledgling senior care facility. That was in 1970. And from his first job as facilities manager, Douma has made his way to the top of the organization.

A lot has changed along the way. Douma finished his college degree in the early 1980s, just in time to be named executive director of the organization. PorterHillsPresbyterianVillage has become Porter Hills Retirement Communities & Services, in order to reflect the growth and changes in the organization. Douma's role has changed along with it. Now he is president and CEO of a nonprofit organization that offers a complete continuum of care, including low-income senior apartments, community-based care, rehabilitation services, skilled nursing and assisted living facilities.

"That is us today, serving just short of 1,000 people with a little over 600 employees," he said.

As his responsibilities at PorterHills have matured, his role in the lives of the residents has changed as well. That is a mixed blessing.

"The front-line people get the fun and the enjoyment of service. Leadership can be challenging, at times, but you're still setting the stage for others to really make a huge difference in the lives of seniors," he said.

Douma said that in the early days of his career, he dedicated around 80 percent of his time to directly serving the needs and desires of the residents. His responsibilities have grown, but so have the pressures on his time. Now, after 20 years of leading the organization, Douma splits 80 percent of his time equally between fundraising, strategic planning and operational matters with the board of trustees and various committees. That leaves him just 20 percent of his time to attend to the needs of the residents. Douma is grateful for a strong staff and leadership team who make up for his inability to give PorterHills' residents the attention he used to.

While that staff attends to the needs of a growing resident population, Douma is looking out into the future. With the baby boom generation reaching retirement age, the long-term care industry is examining how it will serve a drastically larger population with a very different personality.

"The demographics would tell you that we're in a growth business," he said. "You have to be careful about how you look at those demographics. They're right, in that the over-65 population is going to balloon, and soon. But their expectations are different than the residents we're serving today."

In other words, just because there are going to be a lot of people of "nursing home age" in 20 years doesn't mean there will need to be a surge in nursing home construction to house them.

"Most people in the 55 to 65 age range are going to the health club every day. They're taking care of themselves. They watch what they eat. They're very independent people. And so they will make choices differently than some of our residents past," Douma said.

"We're not alone in our assumption that brick and mortar will not be the primary choice of the next generation. They will want to stay in their own homes. And they will want services. At some point, they may want to move into one of our community settings."

But even those community settings may look very different from the long-term care facilities of today. PorterHills is currently in the process of developing several "Green House" facilities, which focus on a small, social model that is more home-like than institutional.

But as Douma plans for the next generation of long-term care, he has to keep today's finances in mind. PorterHills is fortunate to have a resident base that is "financially independent," as Douma put it. In a typical long-term care facility, nearly three quarters of the population receives care paid for by Medicaid. At PorterHills, only 25 percent of residents rely on the governmental insurance program. Because of the relative financial comfort of PorterHills residents, Douma counts on many of them for charitable support, in addition to their payment for services.

"Our residents are a major part of our giving platform, and they've been extremely good to us," he said. Like many West Michigan nonprofit organizations, PorterHills is apprehensive about the future of charitable giving in the community. While Douma doesn't expect Grand Rapids' magnanimity to disappear overnight, he recognizes that the current generation of benefactors is unusual in its generosity, the scale of its wealth and the sheer number of wealthy, charitable individuals.

Again, Douma looks toward an uncertain future, but remains rooted in today's operations. In doing so, he faces one of the more difficult — and most common — challenges of his job: addressing the needs of today's residents in a way that will benefit them, PorterHills and residents in the years to come.

"You have to listen to their issues and you still have to be bold enough to make decisions that are appropriate for their well-being first — even though they might not always fully understand that — and the well-being of the organization, because you are going to have to serve a different customer somewhere down the road, and their expectations are going to be different."    

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