Environments for Person-Centered Care by SWBR

SENIOR HOUSING

Environments for Person-Centered Care

Get in touch with us: Rob Simonetti, AIA Design Director, Certified Eden Alternative Associate 585 232 8300 rsimonetti@swbr.com Tom Gears, AIA LEED Green Associate Principal 585 232 8300 tgears@swbr.com Leticia Fornataro, AIA LEED AP BD+C Project Manager 585 232 8300 lfornataro@swbr.com

SWBR helps identify and prioritize the needs of your housing market. Designing cost effective and comfortable housing for senior adults is a complex business. SWBR becomes your partner in the design of housing targeted to your priorities and objectives.We analyze your wants and needs, as well as the desires of your prospective residents. Working as a team with you, we develop the value and marketability of your project. As your project proceeds, SWBR manages the issues that are critical to success. This includes participation in activities such as the acquisition of approvals and schedule compliance. In essence, we deliver the precise design project you want, in a manner that is consistent with your management and marketing strategies. Seniors want housing that enriches their lives. SWBR designs lifestyle choices. ··Senior Living Communities ··Independent Living ··Assisted Living ··Adult Day Care ··Memory Care ··Seniors Apartments ··Skilled Nursing

SWBR .COM

CORE MARKET OVERVIEW

ENVIRONMENTS FOR PERSON-CENTERED CARE Green House® and Small House Home Design SWBR has been involved in multiple Green House® and Small House projects. From each we have taken away lessons regarding not only architecture, but also organizational and group dynamics. We recognize that a strong commitment from administration may not yet mean buy in from all components of staff. Being strong believers in the benefits of person centered care, SWBR will assist in educating affected staff on the merits, realities, and impacts of changing to an environment which supports person centered care. We have often times played the devil’s advocate even with committed staff and administrators to push their approach to deinstitutionalization even further. Benchmarking A Parti from the French meaning “to make a decision”, often referred to as the big idea, is the chief organizing thought or decision behind an architect’s design presented in the form of a basic diagram and / or a simple statement. SWBR has taken the time to study many Green House® and Small House projects and has diagrammed our learnings into easily digested components. Two primary issues driving the plans are creation of welcoming attractive common areas and the location of bedrooms around the common areas.

Above: Illustrating the design concept to make all rooms visible from a centralized kitchen area.

SWBR .COM

The original Green House® homes of Mississippi Methodist employed an L shape parti. Many Green House® projects then followed suit with this parti. The idea of the plan is that all rooms can be seen from the centralized kitchen area. Since these first homes, the ideas generating building form have changed. SWBR will benchmark various building partis with you to identify benefits of each and to find that most suited to your needs.

Designing A charrette, sometimes called a design charrette, consists of an intense period of design activity. SWBR will use this technique to kickoff your design process. Together we will explore the values of your organization and establish specific goals and objectives for the project. This initial work will guide us all through the design process. SWBR has also documented and diagramed multiple areas within many small house homes. Using these diagrams our Design Team can effectively communicate with your team issues regarding specific areas of the home. These diagrams are used to bring you to other projects so that you may evaluate what you like and more accurately describe your expectations and theory of how your new facilities should perform. We will use these benchmarking exercises to guide you through design of the building parti, elder bedroom, elder bathroom, kitchen, bathing spa, and other critical areas of the home.

Above: Diagram reflecting benchmarked critical areas of a home.

SWBR .COM

GREEN HOUSES AND SMALL HOUSES Â®

GREEN HOUSE ® HOMES

ST. JOHN'S HOME Penfield, NY

COMPLETION

2011 RECOGNITION

Featured in the Spring 2012 issue of Environments for Aging Annual Showcase Issue

St. John’s leads the way in transforming nursing home services for elders and was the first in the nation to build Green House® homes embedded in a residential community. In this model, with its Eden Alternative foundational elements, elders are valued, respected, and reintroduced to a home environment, in which they may thrive during their final years. The Penfield Green House homes are built within a senior focused townhouse community miles away from St. John’s existing campus. This distance has contributed to the success of the homes where there is no reminder of the institutional past. The architecture of the homes blends with the rest of the neighborhood making them inconspicuous and attractive. This model is a radical approach to skilled nursing care, where each element — care philosophy, organizational structure, and architecture — is carefully crafted to remove ‘institution’ from long-term care. Warm, caring relationships are the basis of each day. Residents, referred to as elders, live as part of a family in the community while still benefiting from the full range of clinical services provided by St. John’s. Based on the success of the homes across elder, staff, and financial measures, St. John’s is now implementing small home renovations to their midrise traditional model home and experiencing similar positive results.

SWBR .COM

GREEN HOUSE® RESIDENT DIRECTED HOMES

SAINT ELIZABETH COMMUNITY East Greenwich, RI

SIZE

32,000 SF COST

Saint Elizabeth Community in East Greenwich, RI chose SWBR to design their new Green House® homes and neighborhood, challenging the design team from the start to push the boundaries of what skilled nursing care could look and feel like.

$9.5M COMPLETION

2017 CONTACT

Matthew Trimble COO 401 471 6060

The four homes are located along a residential cul-de-sac with a heavily wooded backdrop. The homes were sited intentionally along the curve of the street to allow elders sitting on any front porch to see the front doors, porches, and residents of the remaining homes. Complementing the strong sense of community each homes exterior is unique, drawing on the coastal vernacular of Rhode Island to create identity, individuality, and real curb appeal. Within the homes each of twelve elders has a spacious private bedroom with full en suite bathroom. Very strong connections are made to exterior through the use of large windows, French doors, front and rear porches, and beautiful courtyards. The open kitchen of each home is enough to make the most discerning cook’s mouth water with quartz countertops, a large island for gathering, and commercial grade appliances. Unique to these homes is the addition of a Master Bathroom where elders have access to a soaking tub, makeup counter, and hair dressing services. Susan Ryan, Executive Director of The Green House Project, has noted that the Saint Elizabeth Homes are among the most beautiful Green House homes to date.

SWBR .COM

THE COTTAGES AT GARDEN GROVE

LORETTO HEALTH AND REHABILITATION CENTER Syracuse, NY

Creating a true community. The Cottages at Garden Grove is a skilled nursing community of Loretto Health. The new campus of twelve homes creates a true neighborhood and a real community. Â Each house of 8,400 square feet is home to thirteen elders. The neighborhood of homes, adjacent to an existing town library and recreational facility, is arranged as a typical residential development. Each home has a driveway and front walk out to the community sidewalks. On street parking is provided for staff and visitors rather than a central parking lot. The exteriors of each home are unique and most back to a beautiful wooded lot. COMPLETION

2014 RECOGNITION

Featured in the Spring 2015 issue of Environments for Aging Annual Showcase Issue.

SWBR .COM

Inside, each elder has a private bedroom with full bathroom. The heart of the home is open and light filled with views to both the street and backyards with woods beyond.

SWBR .COM

MEMORY CARE RESIDENCES AT CREEKSTONE

ROCHESTER PRESBYTERIAN HOME Fairport, NY

COMPLETION

2016

Based upon their great success at the Memory Care Residences at Cottage Grove, Rochester Presbyterian Home is excited to open another four homes. The new homes serve Memory Care needs and are located in Perinton, NY, about 30 miles from the Cottage Grove homes. This new project allows Rochester Presbyterian Home to more broadly serve the needs of the community. The four new homes are each licensed for 16 beds although each home will operate with 14 private bedrooms. Each bedroom has been designed at a size to meet the requirements of a double room. The rooms will be used as single resident private rooms unless a couple requests to share a room.The Memory Care Residences at Creekstone proudly extends the long tradition of excellence that has characterized the Rochester Presbyterian Home.

SWBR .COM

GREEN HOUSEÂŽ HOMES

SENECA NATION OF INDIANS Cattaraugus Territory, NY

COMPLETION

2018 (Estimated)

SWBR is excited to be working on the first Green House Project homes for a Native American nation. The Seneca Nation of Indians is moving forward with planning of two homes to serve the elders of their Cattaraugus Territory in Western New York. The homes will allow the Seneca Nation to serve their elders on territory offering assisted living and long term care. Each home of ten private bedrooms will be designed with passive and active sustainable systems, to reflect the unique culture of the Seneca Nation, and to honor each elder.

SWBR .COM

GREEN HOUSE® PROJECT

HOVER SENIOR LIVING COMMUNITY Longmont, CO

Hover Senior Living Community currently offers Independent and Assisted Living on their Longmont, Colorado campus. Adding skilled nursing and memory care for residents has been deemed of the highest priority. Hover has been implementing culture change based on Dr. Bill Thomas’s Eden Alternative philosophy and is ready to implement the physical embodiment of that philosophy. To that end, Hover is working with The Green House Project® to bring four new skilled nursing homes to life. Hover’s Mission: Empower seniors to live the life they choose by offering innovative, affordable, and dignified choices in housing and services. SWBR is pleased to be working on the Hover team as a Green House model design consultant.

SWBR .COM

GREEN HOUSEÂŽ HOMES

LAKE HEALTH DISTRICT Lakeview, OR

COMPLETION

2017 (Estimated)

SWBR worked with Lake Health District in Lakeview, Oregon as Design Architect for their proposed new Green HouseÂŽ Homes project. Lake Health District will construct three new homes of twelve elders. Two homes will serve skilled nursing needs while the third will be assisted living. Lake Health is a critical access provider in what is deemed a frontier county because of its remote location. These new homes will bring much needed services to the residents of Lakeview, OR.

SWBR .COM

COMMUNITY LIVING CENTER - CANANDAIGUA CAMPUS

DEPARTMENT OF VETERAN AFFAIRS Canandaigua, NY

COMPLETION

2022/2023 (Estimated) RECOGNITION

Featured in the Spring 2013 issue of Environments for Aging Annual Showcase Issue.

The Design Concept for the CLC cottages includes a community-oriented, residential living experience. The program, character and design of the homes are formulated to promote maximum levels of personal independence and social interaction for the veteran resident. In addition to Small House living concepts, specific project goals for the VA Canandaigua Community Living Center include the following criteria: • • • •

Organize the Community Living Center Cottages in a manner that promotes neighborhood identity and interaction Provide direct access at grade to usable exterior space for residents of each cottage Complement the existing historic campus Achieve LEED® Silver Certification for all buildings

Cottages are designed to provide support to veterans focusing on the following care areas - Dementia, Gero-Psych, Long Term Care, Hospice, Short Term Care and Rehabilitation.

SWBR .COM

MEMORY CARE RESIDENCES AT COTTAGE GROVE

ROCHESTER PRESBYTERIAN HOME Chili, NY

COMPLETION

2009

Rochester Presbyterian Home is an established assisted living home in downtown Rochester, NY. In an effort to expand their mission and value, Rochester Presbyterian Home developed 48 beds of enhanced assisted living in a suburb of Rochester focusing on memory care. Inspired by the philosophy of the Eden Alternative and the Green House® model, these homes are a dramatic departure from the typical model of elder care. There are no long corridors, nurse’s stations or medication carts. The medical model is replaced with a home where 12 elders live. Each elder has a private bedroom and bathroom. A central hearth area with an adjacent dining room and state-of-the-art kitchen, provide ample living space for the “families.” In addition, each home has a front porch and a secure patio and courtyard enabling the elders to freely enjoy the outdoors. The Memory Care Residences at Cottage Grove proudly extends the long tradition of excellence that has characterized the Rochester Presbyterian Home.

SWBR .COM

SMALL HOUSE SKILLED NURSING

BAPTIST HEALTH Schenectady, NY

Baptist Health Nursing and Rehabilitation Center consists of a 48 acre parcel master planned as a five phase project. The completed first phase includes a three story Assisted Living building of 64 apartments. The second phase includes the construction of 16 Small House homes and a commons building, which will contain administration and support services for the nursing population. Â Baptist Health is located in Scotia, NY. Upon completion of the Small House component, the existing nursing home will be converted into medical offices and affordable senior housing.

SWBR .COM

GREEN HOUSEÂŽ PROJECT

JEWISH HOME LIFECARE Mamaroneck, NY

SWBR was referred to Jewish Home Lifecare by The Green House Project to provide design review services in an effort to help reduce projected building size and construction cost. After analysis of the design documents, SWBR was able to propose a conceptual design which reduced floor plate size by roughly 1,000 square feet per floor. The proposed concept was noted by the client to offer elder and staffing advantages by reducing travel distances and optimizing service routes. Building massing was analyzed and the pictured concept reduced building volume while promoting a contextual design responsive to the neighboring community.

SWBR .COM

MID-RISE GREEN HOUSE® CONCEPTS

EGER NURSING HOME AND REHABILITATION CENTER Staten Island, NY

The Green House® concept may be employed in low, mid, and high rise solutions in urban areas or on existing health care campuses. Each home is treated individually with its own entry, service, and public areas for elders. Outdoor space is accommodated through the use of a balcony. Every effort is made to ensure that each house maintains its own unique identity and staff. SWBR has worked Eger Nursing Home and Rehabilitation Center on Staten Island, NY to explore the possibility of a mid-rise Green House® model on their space constrained primary campus. While sitting atop a hill with a beautiful view, Eger would like to maintain the character of the wooded steep slope site. In this concept views are created to the nearby bodies of water surrounding Staten Island.

SWBR .COM

SKILLED NURSING HOUSEHOLD MODEL

SKILLED NURSING FACILITY

CATTARAUGUS COUNTY THE PINES AT MACHIAS Cattaraugus County

COMPLETION

2003

SWBR completed programming through construction administration services of a 117-bed Skilled Nursing Home for Cattaraugus County. This new home replaced the existing building on the same site. A contextual residential environment has been created in both appearance and function. Residential scale at the living areas provides departure from the institutional arena. Shorter travel distances encourage greater resident mobility and decreased reliance on nursing aides. The new home provides a greater sense of resident personal space and control with a decreased emphasis on sacred â&#x20AC;&#x153;staff territoryâ&#x20AC;?. The physical layout promotes staff cross training and staff empowerment. The Pines at Machias home uses the concept of the household unit. A smaller, selfcontained unit provides the residents with a more personal, homelike environment. Two 12-bed households offer dementia care. Dining, kitchen, living, individual rooms and bathing all occur within a 12-bed household. Administrative functions and public entry occur in the historically detailed Octagon House at the center of the home. Modeled after 19th Century rural architecture, the Octagon House acts as the hub of the campus around which all of the residential households are clustered.

SWBR .COM

SKILLED NURSING FACILITY

THE FRIENDLY HOME Brighton, NY

COMPLETION

2009

The Friendly Home is one of the oldest, most established Nursing Homes in Rochester. Facing competitive pressures, the Friendly Home was hampered by small double rooms in their existing home, and a lack of storage space. A new entrance addition creates a welcoming first impression to the building. The Friendly Home added 42,500 new square feet of building additions including newly designed rooms with spacious companion suites, a relocated Transitional Care Center and new Memory Care Center. The Friendly Home has undergone a dramatic transformation in size and appearance, as well as in offerings of new amenities and enhanced services. â&#x20AC;&#x153;The new building represents the next chapter in our history, enabled The Friendly Home to best satisfy the needs and expectations of our Members which have changed and grown significantly over time,â&#x20AC;? notes James Dewhirst, President and CEO.

SWBR .COM

WELCOME HOME

BEECHWOOD CONTINUING CARE Getzville, NY

COMPLETION

2009

Beechwood Continuing Care hired SWBR in the Fall of 2003 to prepare a master plan for the Campus. In particular, Beechwood Continuing Care wished to convert the Beechwood Residence and the Nursing Home into a “neighborhood concept” nursing home model, from the traditional medical model layout. Over the next several years, SWBR developed a series of design options addressing these goals. The renovations were broken into a pilot program and two distinct phases. Under the pilot program a single household was created by Limited Review CON’s in each of the buildings. These households served as test cases for not only the architecture, but also the operations, staffing, and culture change required. Upon realizing success with the pilots, Beechwood then rolled out plans for more extensive renovations broken into Welcome Home Renovations, Phases 1 and 2. This “household concept” has risen out of experiences and research at a number of facilities; notably Providence Mount Saint Vincent in Seattle and the Evergreen Retirement Community in Oshkosh, Wisconsin. The basic premise is to create 1820 resident “households”, in lieu of traditional 40 resident nursing units.

SWBR .COM

INDEPENDENT AND ASSISTED LIVING

BRICKSTONE ACTIVE ADULT COMMUNITY

ST. JOHN'S SENIOR COMMUNITIES Brighton, NY

COMPLETION

2014 RECOGNITION

Environments for Aging 2016 Annual Showcase Design Award Winner

SWBR designed St. John’s Brickstone Community. It is aimed at active seniors and includes 40 apartments, 9 townhouses and 53 bungalow units. The community was designed with New Urbanism principles in mind; a relatively small, pedestrian-friendly cluster development that includes amenities such as shops and cafes within walking distance to the homes. Rear-loaded parking garages are opposed by front porches that encourage a separation of vehicular and pedestrian traffic. The central winter-garden serves as a gathering space for Brickstone residents as well as the greater Town of Brighton community. The community portrays a village character, with larger masses broken into smaller buildings with unique materials and accents.

SWBR .COM

COTTAGES

THE HIGHLANDS AT PITTSFORD Pittsford, NY

COMPLETION

2005

SWBR .COM

The 36 cottages on the campus of Highlands at Pittsford are designed with â&#x20AC;&#x153;Neotraditionalâ&#x20AC;? design concepts in mind; welcoming front porches, an extensive sidewalk system, and unobtrusive rear garages. Cottage designs blend nicely with those of the greater Town of Pittsford. The exterior design, roof lines finish materials and colors are varied to produce a true village environment. Two basic floor plan designs have been customized to meet the needs of each resident. The Hahnemann Club is a cottage community gathering place and includes multipurpose, wellness and kitchen functions.SWBR collaborated with CSD Architects and LeCesse Construction as design and construction team members.

RIVERS RUN SENIOR HOUSING AT RIT

LIVING COMMUNITIES, INC. Rochester, NY

COMPLETION

2009

This project includes 70 cottage units and 82 independent living apartments (with another 38 independent living apartments and a 40 unit assisted living building planned for Phase II) adjacent to the campus of the Rochester Institute of Technology. This senior community is a destination for RIT alumni and its’ significant deaf population. The Atheneum, RIT’s center for adult learning, will cooperate with the new community to provide life-long learning opportunities. Rivers Run is located along the Genesee River and near RIT’s boathouse for the crew team. Correspondingly, the architecture has a nautical flair.

SWBR .COM

CHERRY RIDGE

ST. ANN'S COMMUNITY Webster, NY

COMPLETION

2005

St. Ann’s Community developed their Cherry Ridge campus 15 minutes from it’s existing location. The project consists of 55 patio homes, a 71-unit independent living facility, a 51-unit assisted living facility with multi-purpose space and a chapel, as well as a 24-hour unit care facility. The entire campus portrays an arts and crafts theme, with the chapel serving as the centerpiece. Elements of stone and brick were used for entrances to the new buildings and wood cedar shake, a style of siding, was used as opposed to horizontal sizing, which is used more often today. Residents have the choice of one and two bedroom apartments as well as two bedroom cottage homes. The 1,300 SF cottage homes include a kitchenette, living room, two bedrooms, bathroom and a garage. Common areas shared by residents include a library, café, beauty salon, fitness center and the chapel, which is the centerpiece of the campus, with meditation rooms. Cherry Ridge takes its’ name from the careful site master-planning aimed to preserve the specimen cherry trees adjacent to Ridge Road, the entry point of the community.

SWBR .COM

CHAPEL OAKS

ST. ANN'S COMMUNITY Rochester, NY

COMPLETION

2014

St. Ann’s developed the beautiful Chapel Oaks as a rental retirement community for people who want to enjoy an active, independent retirement. The property is located on 14 acres of the St. Ann’s Community campus and offers one or twobedroom private apartments for its residence. The addition of the Chapel Oaks Wellness Center allows the residents to achieve personal wellness without leaving home. The center offers a 20’ x 30’ heated pool with easy access steps, an underwater treadmill, ADA approved power lift and open lanes for lap swimming. In addition to the pool, there is a fullyappointed fitness center with changing rooms, space for new senior-friendly training equipment and room for exercise classes, all taught by well-trained instructors. In addition to the Wellness Center, the residents are also enjoying a new bistro café, porte-cochere, remodeled business center, convenience store, center stage/ demonstration area, fireplace and dining room.

SWBR .COM

FERRIS HILLS AT WEST LAKE

THOMPSON HEALTH Canandaigua, NY

COMPLETION

2001

Ferris Hills at West Lake has been designed to meet the discerning needs of the Canandaigua independent living seniors market. The 96-unit independent living, 36-unit enriched living community has been carefully sited upon its sloping hillside to afford the maximum views of Canandaigua Lake from resident apartments and gathering spaces. The 57 acre site retains its natural wooded edges and is improved with the addition of walking paths and water features. Activity areas within the 20,000 SF common area include a greenhouse, arts and crafts, beauty shop, gift shop, dining room and a cafĂŠ. 48 below grade parking spaces have been provided for the residents. The focus of the design is the second-story Club Room, over the entrance porte-cochere, with its stone fireplace and panoramic view. SWBR collaborated with Greystone (development consultant) and LECESSE Construction as members of the design and construction team.

SWBR .COM

CLIENT REFERENCES We have listed our project experience, but the best credential is the testimony of our clients. Please ask them about our service and capabilities. St. Johnâ&#x20AC;&#x2122;s Home Rochester, NY Mr. Charles Runyon, CEO (585) 760-1200 Department of Veterans Affairs VA Medical Center Canandaigua, NY Mr. Troy Waller, Project Manager (240) 494-2972 Saint Elizabeth Community East Greenwich, RI Mr. Steven Horowitz President and CFO (401) 471-6060

SWBR .COM

Pride Mark Homes, Inc. Rochester, NY Mr. James Barbato Vice President (585) 424-4444 Contractor for St. Johnâ&#x20AC;&#x2122;s Green House and the Rochester Presbyterian Home The Green House Project Baltimore, MD Ms. Susan Frazier Ryan, Chief Operating Officer (703) 647-2314