This quiet and distinctive project was carefully designed to replace a pre-existing skilled nursing facility a few miles away, and accommodates 132 residents needing long-term, short-term/rehab, and memory care. The existing facility was an early 1960’s institutional design with mostly multi-occupant rooms arranged around large visible nurses’ stations. We wanted to provide a new home for these residents that embody the elements of culture change and resident-centered design: choice, dignity, respect, self determination, and purposeful living. The owner was committed to this notion but was skeptical of the culture change movement, and challenged us to provide a new building that maintained the staffing ratios present in the existing one. We were also required to include several different room types to provide similar cost options available in the existing facility.
Our main goal to provide a de-institutionalized and residential design started with 6 fully autonomous households, each serving 22 residents. Each household is laid out like a typical house would be: with a porch, front door and entry that leads into a living room, which has visual access to the dining room, with an adjacent kitchen, and views out to a back porch with free access to a private yard. The sleeping rooms are located off a corridor adjacent, but “softly” separated from the more public spaces. Meals are provided by focusing on resident choice, and served in each household’s dining area and country kitchen, but prepared in the facility’s main kitchen. All care services are centrally located and accounted for in each household, but maintain a silent presence mostly hidden from view.
The residential character of the forms, spaces and surfaces helps to establish a clear contrast to the institutional setting of the facility that this Center replaces. In this way, the project team of owners, caregivers and designers worked in close collaboration to fashion a resident-centered facility that accommodates an older business model yet creates a fresh culture of care, interaction and outlook.