Design Decisions: Racing to the future of care

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Design Decisions: Racing to the future of care
Design Decisions: Racing to the future of care
If you want to witness the transformation of nursing home design and evolving care models in one place, look no further than the Sam Swope Masonic Homes of Kentucky, in Louisville.

There, you can observe the older medical model, which until very recently, was located in a structure built in 1927 as an infirmary for widows and orphans.

Connected to the old building is the new, ultra-modern, 196,000-square-foot facility. It offers skilled nursing care, memory care, short-term respite and recovery care, palliative care, a rehabilitation center and a kidney dialysis center. The community offers private and semi-private rooms for 136 residents.

The new community was built in line with the “household model” of care, where residents live in one of six “households” with 20 to 24 residents. Each household has a fireplace area, a living room, a sitting room, a dining area, private and semi-private rooms and bathrooms.

“The household model provides us with resident-centered care,” says CJ Parrish, Masonic Homes of Kentucky's senior vice president of communications. “Earlier models were about convenience. This model is about the resident. This is their home.”

The lead architect for the project, Quinn de Menna, an associate with RLPS Architects, says he wanted to make sure each household looks as unique as possible. Interior designers were encouraged to incorporate aspects of Kentucky history and culture into household designs, such as paintings evoking the state's horse racing history.
de Menna's design priority was to shift each unit's focus from the nurse to the patient.

“If we look at design from years ago, where we had a more medical model, look at the design graphically,” de Menna says. “It's almost symbolic that the center of the design is where the nurse's station is. Through culture change, we move the nurse out of the center and put the patient there.”

He also wanted to make sure each household had its own identity with unique design features.

“Nothing smacks of institution more than finding the same chairs and the same light fixtures in every room,” de Menna says. “We encouraged all the interior designers to use their favorite color schemes, too.”

Lori Hess, the community's executive director and administrator, says that the facility's square footage is three times the size of the existing older building.

“The layout is not easier for the staff, but that's not our concern. It's more pleasant for the residents—it's more homelike,” Hess says.

Another part of helping a resident feel as if they are at home is the facility's “invisible” call system, which ensures that visitors and residents do not hear the paging system when another resident calls a nurse.

“All of our technology is wireless. Each staff member has a phone they carry around that is hooked to the call light system,” Hess says. “Residents can push their own button when they need a nurse or caregiver. If one caregiver is busy, the call rolls to the next available person,” she adds.

Lessons Learned

1.Installing a wireless paging system can require a variance from the state Inspector General

2. Administrators had to provide the state with lists of facilities that had open bathroom plans and silent call systems

3. State long-term care regulators are still getting up to speed on homelike floor plans

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