MLTCN January 2019, Design Decisions

Skilled nursing and rehab are essential components of a continuing care retirement community, providing residents with the services they need while they age in place.

But the designations over who should have SNF-level care sometimes can be subjective and restrictive. That’s why the newly renovated Kendal on Hudson in Sleepy Hollow, NY, has reduced its accommodations for skilled nursing in favor of more assisted living and “special needs assisted living” levels.

With Project ReNew, the 8-year-old CCRC undertook a strategic re-thinking of the long-term care offerings for the community. By taking advantage of new healthcare licenses from the state that allow higher levels of care within the assisted living environment, the design team renovated the health center.

The 68,000-square-foot renovation added a new 13-bed memory support unit, expanded the current assisted living from 24 to 34 apartments, and reduced the skilled nursing facility from 42 beds to 28 beds. As part of this project, the design team also improved and expanded the independent living commons and fitness areas, including construction of a new library and entry porte-cochere, renovated reception area and bistro lounge, enlarged multi-purpose gathering room, physical therapy areas and relocation of marketing and administrative offices.

“The repositioning effort reflects Kendal’s values and philosophy of care — focused on the least restrictive, most home-like settings possible, providing maximum autonomy and independence consistent with safety and wellness of the residents,” says Stephen G. Bailey, senior vice president of new business and development at Kendal.

Boston-based architectural firm DiMella Shaffer offered empathy and expertise in reshaping the community to fit the Kendal vision. Firm principal Diane Dooley oversaw the project.

“When we look at how care is provided in the CCRC, there is a trend toward providing a less-restrictive level of care for residents,” she says. 

The regulatory enactment of the “special needs” level of assisted care now allows CCRCs to furnish a higher level of care than conventional assisted living while staving off the need for designated skilled nursing care, Dooley says.

“What we’re seeing is communities partnering with home health agencies to bring care to the residents where they are,” she says. “Kendal realized they didn’t need the previous number of skilled beds, which created more space for a new level of care within the assisted living environment.”

Ultimately, Kendal’s approach is to elevate everyday care and maximize support services. 

“The goal,” says DiMella Shaffer senior associate Jovi Cruces, “was to elevate where people eat, gather and read.”