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Careful Planning Pays Big DividendsBy Peter Rauma, AIA, NCARB
When the Milwaukee Catholic Home proposed to build a replacement nursing home, which would more than double the number of skilled beds, there were many people who thought it could not be done. Designed during an era of decreased community census and difficult reimbursement policies, local competitors thought that they would fail. Fortunately the Milwaukee Catholic Home has been successful from the day it opened its doors. The secrets to its success can be traced to location, the unique care environment, security features and adherence to a conservative construction budget. Its all about location When asked how they defied the critics, executive director Paul Connolly said, "It is all about location. The new building is located adjacent to the existing continuing care retirement community (CCRC) facility and includes underground connecting links to the existing retirement apartment building and to Columbia St. Mary's Hospital." These physical connections created a marketing and true service advantage to the local, older adult community. It also provides an easy travel for staff, family and visitors. This complex is unique in southeast Wisconsin -- it provides 122 skilled nursing beds, 29 assisted living units, an intergenerational daycare center and lower level parking structure. The new facility allows for expanded programming and access to more residents. With the additional capacity, the facility serves not only its traditional skilled-care nursing residents, but also more persons with subacute/rehabilitation needs and those with Alzheimer's and dementia. Unique Care Environments
The dementia unit is specifically designed with a wander guard system and has its own kitchen/ craft/library space and secure outdoor porch. Seating areas located on the wandering path provide "destinations" for the resident. Memory boxes outside of each room help to remind the residents of their past and present. Assisted Living is located on the first floor. The 29 units have access to the secure central courtyard and gardening is encouraged for all residents. All resident units are large studio apartments with kitchenette, roll in shower and screened bed location. A large dining room is provided with views toward the courtyard. Personal laundry and crafts room/lounges provide many opportunities for resident interaction and activities. The intergenerational daycare center serves up to 36 adults and 115 children and is located on the first floor. Interaction between children and adults is encouraged on both the entry courtyard and the central courtyard. The adult daycare provides both private and public space for its seniors. Bathing and cooking facilities complement homelike living areas crafts areas, and a library. A private patio provides seniors with alternative outdoor spaces. Dining rooms are provided within the different care environments. Special care was given to interior design and furniture selection. On the back of each dining chair fabric loops are provided so that walking canes can be hung "out of the way" yet easily accessible. All meals are served "restaurant style," which is unique in a healthcare setting. This is achieved through careful placement of the kitchen in the basement. A dedicated elevator connects all the dining rooms, guaranteeing food quality and presentation. Other ancillary facilities include a large multipurpose room, convenient resident personal laundry service and extensive rehabilitation services provided on site. Defensible Design
The building is configured as a square, with a generous 120-feet by 120-feet interior courtyard; the building echoes the design aesthetic of the urban, predominantly multi-family residential neighborhood while allowing secure outdoor recreation for its residents. Designed with only one entry, the front door is staffed 24 hours a day. No one can enter the building or ride the elevators without being visually screened. On the upper floors "greeting stations" allow another level of supervision but are designed as an unobtrusive "concierge" service. The dementia unit is secure but not locked. Exiting is controlled on a 15-second time delay triggered by resident ankle or wrist bracelet. This allows for a safe special-care environment without limiting the movement of family, visitor and staff. A closed-circuit television system is constantly monitored. All secondary entries such as human resources, garage and dock tunnels are screened as well as all the corridors in the remote retirement apartment building. Ahead of Schedule and Under Budget Designed during an era of escalating constructions costs, adherence to budget and schedule were paramount to the Milwaukee Catholic Home's success. They embraced the spirit of partnership and developed collaboration among the contractors, architects/engineers and material suppliers. The construction methodology was a "negotiated construction contract" with a guaranteed maximum price (GMP). Open communications determined quality levels as they related to cost and an "open book" format allowed all parties to see the impact of decision making. Ultimately the project came in under budget and 1 percent of the unspent budget was returned to the owner. In the words of Paul Connolly, "The completed project exceeded our expectations. It allows us to meet the needs of many more seniors than we were previously able to serve. The design of private rooms has made the us the facility of choice in our market area." The project was so popular that it "filled-up" in nine months -- 18 months ahead of schedule. Peter Rauma is an architect with HGA, a national architecture, engineering and interior design firm. He can be contacted at (612) 758-4219, Prauma@hga.com or visit to www.hga.com.
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The
Milwaukee Catholic Home has been successful from the day it opened its doors.
The secrets to its success can be traced to location, the unique care
environment, security features and adherence to a conservative construction
budget.
The
skilled nursing facility houses 122 residents on the second and third floors of
the building. The floor plan utilizes a "cluster concept" with units
consisting of six to eight resident rooms. To avoid the typical
"institutional" feeling, decentralized nursing sub-stations facilitate
staffing of certified nursing assistants. The elimination of traditional long,
straight nursing corridors lends a more residential quality to the facility. All
resident rooms are private. This was accomplished by sharing generously sized
toilet rooms between each resident room. Approximately one-third of the resident
rooms have a dedicated toilet room. Toilets are centered on the wall to allow
assistance from either side, which facilitates stroke victims who typically have
paralysis in one side of their body. Grab bars swing into position allowing
suitable access from a wheelchair.
Considering
the new emphasis on security after the events of Sept. 11, 2001, building owners
are looking for ways to improve their safety. Built in an urban district the
Milwaukee Catholic Home took special precautions to protect residents and staff
from potential intruders.
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