The Social ROI: Turning Belonging and Connectedness into Scalable ADS Business Model in the State of New Jersey

Authors:

Angelo Sirepisios, MSc IME, Hellenic Open University and Autumn Lake Healthcare;

email: angelo.sirepisios@gmail.com

Georgia Passali, MSc SSE; Hellenic Open University;

email: georgia.passali@gmail.com

Theodore Katerinakis, MSc, PhD; Drexel University and Hellenic Open University;

email: tkaterinakis@gmail.com, katerinakis.theodoros@ac.eap.gr; tel. 6977681283

Abstract

The rapid aging of the United States population has intensified pressures on long‑term care systems, particularly for older adults experiencing social isolation and for family caregivers managing sustained and complex care needs. While Skilled Nursing Facilities (SNFs) provide essential high‑acuity care, they remain costly, inpatient, and limited in opportunities for social engagement. Adult Day Services (ADS) have consequently emerged as a community‑based, socially responsive alternative that promotes older adults’ wellbeing, alleviates caregiver burden, and may reduce systemic healthcare expenditures. This study examines ADS as a socio‑economic and socially innovative model within New Jersey’s elder‑care ecosystem and market. A qualitative methodology was employed, including two focus groups—one with healthcare professionals in institutional settings and one with informal family caregivers—and two in‑depth interviews with an aging services expert and a primary care physician. A structured protocol ensured ethical compliance and methodological consistency. Thematic analysis identified strong consensus on the importance of social connectedness, dignity, and meaningful engagement for older adults’ wellbeing. Participants viewed ADS as beneficial for socialization, caregiver respite, and cost‑effective support for individuals not requiring continuous medical supervision. Divergences emerged around access, personalization, workforce instability, and policy fragmentation.

The current analysis integrates business and policy frameworks, including ADS model typologies, a Business Model Canvas emphasizing dual social and economic value creation, and SWOT and PESTEL assessments of the New Jersey environment. Findings position ADS as an underutilized yet strategically significant component of the long‑term care continuum—one capable of integrating social, organizational, and technological innovation to enhance dignity, belonging, and preventive wellbeing. ADS is presented as a social innovation bridging home‑based and institutional care, contributing to a more humane and sustainable long‑term care system, combining the market and the family operation for both sides that operate as stakeholders.

Keywords: Adult Day Services (ADS), Social ROI, New Venture Creation, Focus Groups, Social Determinants of Health (SDOH)

JEL codes: I11, I18, I31, M12, M14, O35, Z13