For an administrator and owner/operator, a long-term care facility in need of renovation is a daunting prospect. The mini-hospital or the 1970s motel look that seemed so appropriate for its day fades badly when compared with the newer facilities on the market. Forget about the sparkling, sometimes ritzy mega-projects that our annual DESIGN issue displays—just some modest improvements would be welcome in most facilities. But are even these beyond current budget realities? No they're not, not if you approach the challenge sensibly and with a careful eye—at least so says Janet Merutka, a long-time interior merchandiser and vice-president of the Chicago firm Hanna Z. Interiors, Ltd. in Riverwoods, Illinois. Their firm won a Citation of Merit in DESIGN for Senior Environments 08 (Rainbow Hospice Ark, p. 86), a striking facility makeover that featured several relatively low-cost elements—and there are more where those came from, says Merutka in this interview with Long-Term Living Editor-in-Chief Richard L. Peck.
Peck: In thinking about renovation in an economical way, what are some good first steps?
Merutka: Basically, you want to create what I call a master plan for the facility's environment—an idea of how you want the facility to look when the interior renovation project is totally completed. The first step is to develop a consumer profile of your facility—a demographic of not just current residents, but who the residents are likely to be two, five, ten years from now. One thing I'm finding is that older administrators who are nearing retirement are asking themselves, “Would I want to stay in a facility that looks like this?” The answers they're coming up with are leading to some new concepts and plans.
When considering a new interior look, it should not be cutesy or trendy. I see the goal as more a resort-type look—comfortable, familiar, relaxing, although the definitions of these might vary depending on the clientele you serve. Some people prefer a Four Seasons Hotel-type look, others would be quite happy with a nice Holiday Inn approach. Administrators know their current and future consumers and their demographics. One thing I do is to visit nursing facilities on weekends to observe the adult children and check out the cars in the parking lot. They are often the next generation of residents. Also, when I get a chance, I ask them how they like to spend Friday and Saturday nights, where they shop, where they go on vacation, and so on. It's not a focus group, but I do get a pretty good idea of their design preferences and level of sophistication in a short period time. This information is given to our design team who interpret the input in designing cost-effective, dignified residences.
The next key to initial planning is to project renovation expenditures over a period of time and not to be daunted by the prospect of the total cost of the master plan. Rather, think of it in phases. For example, a $1 million project could be done in increments of $250,000 every year for four years. This helps keep it in within the realm of reason.
Peck: What might a typical approach to phasing be?
Merutka: Usually facilities start with the front of the house—lobbies, admissions, dining rooms. Up on the resident floors, often one of the first things is to redesign the nurse's station (figure 1), making it more like a concierge desk. Many “neighborhood” or “town center” concepts involve reducing the size and presence of the nurse's station and replacing it with small desks and concealed charting areas. In the next phase you might remodel corridors, physical therapy rooms, the library/computer areas, activities areas, and common areas. In the final phase, many clients begin the redesign of resident rooms, perhaps only three or four at a time, and extending that phase over a period of time.
Nurse's station is designed to look like a concierge desk
Renovating key areas that create “memories points” for potential residents and their families can be effective in emotionally motivating people to make the decision to select your nursing facility over the competition. These renovated areas set the tone for the campus or facility and subtly indicate to potential residents the level of environmental sophistication and comfort the facility is offering. There was one facility, for example, that converted its 1970s-looking mauve hair salon into an updated spa (figure 2), with zoned areas for massage, pedicures and manicures, and a seating/coffee area, along with new lighting and even a waterfall wall sculpture, all within very limited space. This became one of the facility's chief marketing tools.
Hair salon was transformed into a spa
Peck: What are some low-cost options for starting within these phases?