Once again, the editors of DESIGN have asked the designers of the citation-winning projects to tell their stories. It is our way of giving readers more than the attractive photographs and succinct descriptions found in the “Architectural Submissions”—to present readers with the “value-added” of real-world perspectives on the creation of long-term care facilities having outstanding design merit. Also included is a sidebar on the projects the DESIGN 2008 jurors thought deserved Honorable Mention, and the distinctive features that gained them special attention. What follows are design project stories told by the architects in their own words, in interviews with DESIGN Editor-in-Chief Richard L. Peck.
The Villages of North Branch, North Branch, Minnesota
Gregory A. Woollums, KKE Architects; Jauson L. Almer, Encompass Interiors; Steven Mork, Ecumen
Woollums: The existing county-owned nursing home was aging and losing money. Both county and city leaders needed to be educated in the nursing home business in order to make the right decisions for the community.
Mork: In the early stages of negotiations, Ecumen hoped the county would build the community and lease it back with an option to buy. However, a majority of the commissioners decided that they wanted out of the nursing home business. At one point, the new county commissioners wanted us to go directly to the public, so we held community information meetings around the county. The commissioners started to see community support and began to understand the plan. However, they still wanted out, so Ecumen suggested they put out a Request for Proposals. The Ecumen proposal replaced the lease concept with a buy-out approach. However, there was significant opposition to the need to sell county land at the old site to generate capital for the new community. In response, we worked closely with county commissioners and key county staff to help them understand the nursing home reimbursement system. We emphasized our commitment to reinvest any proceeds and benefit provided back into the community. We communicated the jobs that this approach would save and create. As frustrating as it was, we stayed the course and continued to negotiate through our differences.
Woollums: In the end, the existing facility and the land it sat on were used as equity to jump-start the project. Creative financing was developed, including working with HUD, tax increment financing (TIF) money was provided by the city, and a local family donated land.
Mork: In the end, the stars aligned for the project to move forward.
Woollums: The decision to have two 17-bed households was made to keep the households as small as possible but still realize some staffing efficiencies and provide the number of beds needed.
Mork: We arrived at the number 17 beds for staffing and economic considerations. Since the two households are tied together, we would place one nurse manager over 34 staffers, considered to be a manageable nurse manager workload. Also, having 17 residents allowed us to have three or four caregivers per household during the days and at least one per household at night.
Almer: For cleanability we used porcelain tile and wood-look vinyl flooring in food service areas and high-traffic areas such as the garden room, which serves as the memory care entrance. In addition, there is a lot of carpeting throughout, particularly in the corridors and lounges, which we varied throughout the building to give each area its unique look. We worked closely with the client to establish the design direction. The “country casual” look was achieved by using a combination of stained oak, painted wood, and some wrought iron and warm earth tones reflecting the exterior color scheme. A Minnesota photography society provided us with several local photos and we commissioned two hand-painted murals, one color and one black-and-white, to help with wayfinding as one enters the skilled care households. The chapel features stained glass panels taken from the original facility, which are sentimental for the residents and bring pieces of the old building to the new.
Mork: We learned several important lessons from this project, including: people do respond to a new vision of senior services; projects like these take years to make happen; transition to a new, household-based care philosophy is a huge change for staff and systems; the new household approach and the larger buildings do not save money; and residents and families love the new environments.
Woollums: With staff spread out in the new facility, this has changed how communication is done. Energy costs are much higher in the new facility because of new regulations governing HVAC systems and the spreading out of the one-story facility, compared with the multi-stories of the old one. With the household design we are seeing a higher level of resident participation in group activities and some residents seem to need less assistance with activities of daily living. Families have expressed much appreciation for the new environment and say they feel more comfortable there.
Rainbow Hospice Ark, Park Ridge, Illinois
Janet Merutka, Hanna Z. Interiors, Ltd.