Best Skilled Nursing/Post-Acute Design of 2021: Clinical Care Meets Small-House Design

By Amy Stulick

Built on the former site of Selfridge Air National Guard Base, Michigan’s newest state veterans home is the first to serve the southeast and Detroit region. And, it’s doing so with an innovative small-home concept that brings infection control and other benefits in a design-forward manner.

The 152,000-square-foot campus of the Michigan Veterans Home at Chesterfield Township consists of four “neighborhoods,” which each offer 32 private rooms and communal space, surrounding a central community building complete with clinic space, physical therapy space, pharmacy, multi-faith prayer room, barbershop and salon. A cafe bistro and gift shop can be found at the central building too.

Each of the campus’s 128 units has an en-suite bathroom, writing desk, wardrobe and sink. Common areas have a “residential-style” kitchen and outdoor courtyard only accessible to residents in that neighborhood.

The project is such a sterling example of the small-home concept that it earned top honors in the “skilled nursing/post-acute” category of the 2021 Architecture and Design Awards from Senior Housing News.

The concept

In its design, there are no spaces that are just linear, double-loaded corridors with rooms on each side; such elements are typical of traditional institutional settings, said Kerry Buck, senior principal at architecture firm SFCS.

Neighborhoods and individual units are more of a “familiar residential kind of experience,” Buck explained, where one enters a home and there’s a living and den area, the kitchen can be seen and there’s places to congregate with small groups. The further you get into the living space, the more private it becomes, just like a typical single-family home.

“Every house, every neighborhood has their own kitchen. It’s a full commercial kitchen. Food is warm and, you know, colorful and appetizing. That’s probably one of the benefits that our home is able to provide our members, is the quality of a meal,” said Jennifer Manning, administrator of Michigan Veterans Home.

Residents sometimes have a decreased appetite as a result of certain medications or disease, making a good, appetizing meal all the more important, Manning added.

Chesterfield’s interior and exterior design are what Buck considers nontraditional for the industry – “visually pleasing, fresh and new” without a “traditional institutional appearance.”

Gracyn Robinson, former Sr. Designer with LWDA Design, who is a candidate at Brown University to obtain her Master of Science in Healthcare Leadership and one of the judges involved in the SHN Architecture and Design Awards, said the “modern porte-cochere fenestration” serving as the entrance to the community center provided a noteworthy nod to the historical site; the former Selfridge base hosted the 127th Wing of the Michigan Air National Guard.

The entrance pierces into the air like a “plane between earth and sky,” Robinson said.

Jason Keen + Co Photography / SFCS

And the sense of airiness extends throughout the design.

“Natural light was very important. There really aren’t any spaces that don’t have natural light,” Buck said. “The finishes are very residential yet durable because it is a nursing home. It was a very successful blending of all those demands.”

Jason Keen + Co Photography / SFCS

The construction

SFCS Architects designed Michigan Veterans Home at Chesterfield Township to follow State Veterans Home Construction Grant Program specifications – 65% of project cost was covered though the program, according to Buck.

The firm has offices in Virginia, North Carolina, Pennsylvania and Kentucky and drew on its expertise in developing the small-home concept for this project.

“We’ve done several small house projects in various states and what we’re finding is, in terms of response to infection control demands from COVID, this small house model really works well,” said Buck. “Better than the old traditional institutional kind of hospital model.”

Jason Keen + Co Photography / SFCS

The Chesterfield location was originally designed to replace Michigan Veterans Homes’ Grand Rapids location, a traditional institutional-type model with sometimes as many as four people to a room, said Anne Zerbe, executive director of MVH.

Instead, two small home model campuses were designed, both by SFCS, for MVH residents. The Christman Company was the builder and general contractor for the Chesterfield project; TowerPinkster was listed as architect of record and SFCS as design architect, according to materials submitted to SHN.

“What we effectively did is downsized our census [at Grand Rapids]; so we split it into 128 beds there and 128 beds on the east side of the state, and we’ll plan to continue to add beds as we receive support and funding to do that,” Zerbe said.

Eventually, MVH hopes to have more than 700 beds across the state.

The modular nature of the Chesterfield design helped the team at SFCS expand or reconfigure to fit the site, Buck said. The Grand Rapids build was going on at the same time as the Chesterfield project, using the same small house model.

“It’s not quite as pure of a [small house] model because of the site limitations,” said Buck of the Grand Rapids project, noting the site was narrow and the firm had to work around existing buildings.

However, she said the basic small-home design held up well across the two projects.

The completion

The completed project has proven its merits in the incredibly challenging environment of the Covid-19 pandemic.

Chesterfield’s four neighborhoods offer the “inherent ability” to isolate residents if needed. Michigan Veterans Home can “carve out” four to eight beds for a small isolation area, Buck said.

“Infection rates are much lower in the small house projects than in the traditional skilled nursing model where you may have a long corridor with 50 beds off of that … [it’s] one of the biggest benefits we’ve seen from this in this design,” she noted.

Manning said the layout allows staff to “gown up” and get personal protective equipment (PPE) properly fitted from a clean environment at each neighborhood.

The layout works for norovirus and the flu as well, Manning said, with staff better able to minimize infection and cross contamination.

“Other buildings are multi-story buildings where we have to deal with elevators, how staff gets up to the unit. We eliminate a lot of those concerns with the design at these new homes because, as Jennifer pointed out, we have entrances and exits that we can kind of quarantine off from the rest of the facility when it’s needed,” said Zerbe.

So far, MVH hasn’t had to hire more staff in order to provide care, or drastically change logistics to fit the campus layout.

“[Neighborhood] storage rooms, clean facility, linen, everything is, for lack of better words, cookie cutter to every household, so they’re not having to walk across campus to get an item,” Manning said. “There’s really no reason for [staff] to actually have to navigate throughout the rest of the campus.”

For residents, the design suggests a sense of home rather than a hospital wing. Routine revolves around daily activities and being able to make their own choices, if they want to eat in their house or go to the main cafe, or meet friends at the community center, Buck said.

Jason Keen + Co Photography / SFCS

Data suggest choice is key to better quality of life within a skilled nursing facility and leads to longer lives, Buck said.

“The design really does matter in terms of improved outcomes for the residents, which is the whole point. That’s really the genesis of what started this idea,” Buck added.

httpss://seniorhousingnews.com/2022/02/02/best-skilled-nursing-post-acute-design-2021-clinical-care-meets-small-house-design/

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