REINVENTION: Breathing New Life into An Existing Senior Living Community

Over time, things wear out, expectations change, and attitudes adjust. Things will never be as they once were, and the ability to adapt to change is the key to survival.  Few community sponsors have the luxury to start over, but all have the ability to reinvent. Reinvention provides an exciting opportunity for good stewardship, while breathing new life into an existing community.

As consumer demographics, product preferences and service priorities continue to evolve, senior living communities can, and must, likewise reinvent themselves to remain relevant.

“In the past, it was not unusual for many of our clients to be the only option in town, but that’s rarely the case anymore,” says Eric McRoberts, AIA.  “Even in challenging economic times, providers still need to move ahead, it just might need to be more incremental.”

Whether for financial reasons, land constraints or stewardship of resources, reinvention is a viable consideration. If the existing infrastructure is a good fit for your program goals, substantial value can be gained from building re-use.

COVID-19 Realities

The only certainty as we live through the coronavirus pandemic is that things are going to change. As with other aspects of reinvention, maintaining the status quo is not an option.

As Robert Kramer, founder and strategic advisor for the National Investment Center for Seniors Housing and Care (NIC) put it during a recent webinar presentation, “Now as part of the marketing tour, you’re going to need to let people know what you have in place for the next outbreak.”

From a big picture perspective, anecdotal evidence reinforces the value of smaller, independent households and private rooms.  The ability to easily isolate smaller groups of residents from the population at large will be invaluable to control the spread of this virus and any future outbreaks. Although many communities previously had a couple of isolation rooms, designated isolation wings are another strategy being considered. Our design team is currently working with providers to explore opportunities for individual room adjustments to further protect health care residents during an outbreak.

Touchless faucets, automatic soap and towel dispensers and automatic doors in common areas are smaller scale measures worth considering. Forecasters are predicting that blower hand dryers will be phased out rapidly in a new normal where containment is key. Expect more advances on the horizon, like voice-activated elevators. Even materials selections will encompass a renewed focus on how easily surfaces can be cleaned, with preference given to antibacterial fabrics and finish materials such as copper and others expected to be developed. Researchers are already working on ultraviolet LEDs that have the capability to eliminate the coronavirus from surfaces—and potentially air and water as well.

Beyond protective measures, communities should also explore opportunities for social connections and personal development that allow for smaller gatherings with more personal space allowances in accordance with emerging guidelines.  For example, the dining venue of the future will need to incorporate comfortable and non-intrusive social barriers to avoid overcrowding and too-close-for-comfort space conditions.

Technology integration will continue to play a critical role in health and well-being beyond quarantine restrictions.  Smart home technologies have come a long way in recent years and increasingly are part of new housing amenities.  Now is the time to consider integration into older housing as well.

Renovation versus Reinvention

Renovation is about updating finishes to keep spaces feeling fresh and inviting.  Reinvention goes beyond appearance to change how spaces are used.

“Reinvention isn’t just cosmetic, it’s changing the essence of a building—introducing new wellness amenities, changing how dining operates, or providing smaller scale households with private rooms that function differently than what you had before,” according to McRoberts.

Reinvention responds to the reality that many communities don’t have room to expand or readily available capital for new construction. It acknowledges the inherent value of existing resources. It provides creative solutions to meld aging infrastructure and current best practices.  It’s extreme makeover meets home improvement.

3 Reasons to Reinvent

1. Addressing Aging Infrastructure

Perhaps the most obvious reason to reinvent is the age of your buildings.  Sometimes it’s as simple as a tired and worn appearance, but more often spaces need to be reconfigured to meet new program goals or operational needs.

“If you don’t have a café or bistro-style marketplace in your community, you are at a disadvantage for marketing today,” asserts McRoberts.  “Any communities that are still operating with a traditional, formal dining room need to figure out a way to reinvent the space.”

At Patriots Colony in Williamsburg, Virginia, formal dining was downsized, with a corresponding expansion of the pub and introductions of a new bistro venue with display cooking and a patio dining option.

Aging infrastructure can also mean that your building is no longer operating at peak performance. Not investing in regular updates could cost you more money in the long run.  According to the building consultants at ZumBrennan, deferred maintenance that becomes a breakdown event can cost a community exponentially more.

Most senior living communities have older and smaller housing stock which poses marketing challenges when trying to meet current consumer demands.

“There was a blip after the housing crisis where larger units were out of favor, but that was pretty short lived,” according to Mike Martin, AIA.

Design strategies for working “inside the box” to renovate or combine existing units can provide creative and affordable solutions that offer lasting market appeal. Combining older units is one good option, but providers may also want to consider strategies to rework smaller units so they “live bigger” than the actual square footage. Some communities have embraced the “not-so-big” movement as a marketing differentiator that allows them to maintain a lower price point option.  This is typically accomplished by opening up living spaces to create a larger sense of scale and openness while paving the way for updated finishes, fixtures and lighting.

This “inside-the-box” 529 square foot apartment reinvention reorients the unit so the primary living spaces have more daylight exposure and feel much larger. The bedroom is set up so that it can function as a home office or hobby room with the use of a pull-down “Murphy” bed.

“Some of our clients are addressing the need for moderate housing by reworking older apartments to create appealing, modestly-sized rental units,” reports Dan Godfrey, AIA, LEED AP.

Converting older apartments to assisted living, reducing census in healthcare or eliminating some hard-to-market apartments can also pave the way for converting a group of residences into neighborhood common spaces.

2. Attracting New Residents

Marketing begins at your front door. The building façade is sometimes overlooked in favor of interior updates, but if the first impression does not reflect your community’s desired brand identity, prospective residents may never come inside.

Prior to facade updates, marketing staff at Masonic Village in Lafayette Hill, Pennsylvania would sometimes see prospective residents arrive for their scheduled appointment, only to continue out the other side of the entry drive.

Attracting new residents requires more than an appealing building and caring staff members, particularly for markets where older adults have access to a “bright and shiny” new community down the street. Baby boomers want options, and they don’t want to move into “a place for old people.”  One result has been niche communities, like the Jimmy Buffet-inspired Latitude Margaritaville, offering distinctive experiences to entice people to move from their homes.

Reinvention allows providers to respond to this evolution by introducing lifelong learning opportunities or diverse cultural programming to create the types of experiences consumers are seeking. Seniors working in retirement, by choice or necessity, suggest opportunities for introducing a co-working space within your community.

“Reinvention is about building upon the unique qualities that make the experience of living at your community special,” states Martin.

For Meadowood Retirement Community in Worcester, Pennsylvania, this involved animating underutilized courtyard spaces to provide a wealth of new opportunities for exercise, socialization and resident engagement. At Woodcrest Villa in Lancaster, Pennsylvania the community entrance was reoriented so that wellness and vitality have become the focus at the front door.

The updated courtyard at Meadowood promotes environmental therapy and social interactions through an outdoor exercise area that is ideal for activities such as yoga and other fitness classes. Beyond that, the space is filled with walking paths, lush landscaping, a fresh herb garden, water features, a fire pit, and even a fully-equipped outdoor kitchen.

3. Maintaining Mission and Values

Many of today’s life plan communities were founded as not-for-profit nursing homes, dedicated to serving older adults regardless of their financial means. This vision has become increasingly challenging with declining Medicare reimbursements and nearly half of households headed by someone 55 and older lacking some form of retirement savings, according to the latest estimates by the U.S. Government Accountability Office (GAO).

Many older communities have small rooms with two-piece bathrooms. Combining three undersized rooms into two new rooms creates more private living space and allows for introduction of accessible showers.

Despite these realities, most not-for-profit community sponsors have maintained their commitment not only to provide health care services, but also to improve upon these care settings. In a 2019 poll of older boomers 40% of respondents would want to live somewhere other than their current home or apartment if they had a physical disability that required them to need help with daily activities.

This illustrates a value proposition that can be offered to aging boomers. Rather than something to be dreaded, senior care settings can create inviting person-centered residences that enhance life experiences for those who need some form of assistance or care. Increased in-home services along with other necessary cost cutting measures have corresponded to reduced health care census which paves the way for reinvention to create a smaller, homelike setting.  Emerging data related to the COVID-19 pandemic has reinforced the value of private rooms and small house settings.

“Many of our clients have indicated that smaller households with private rooms have helped them protect residents in the midst of the pandemic,” reports McRoberts.

5 Keys for Reinvention Success

1. Evaluate Your Resources

Reinvention begins with an essential evaluation of programs, people and provision of care. Future program goals should be considered within the framework of current infrastructure.  Existing building stock requires a professional assessment for adaptability considerations including accessibility guidelines, care facility codes, structural capacity and useful life of building systems.

“If the “bones” are good—if the structure allows for good ceiling heights and changes to the fenestration, reinvention just makes sense,” Godfrey points out.  “Another thing to consider is where the mechanical, electrical and plumbing (MEP) systems are in their lifespan.  If there is usable life left in the MEP infrastructure, those are costs the owner will not have to worry about for a defined period of time.”

Engaging a multi-disciplined team of marketing, financial and design professionals can mean the difference between success and failure when evaluating resources and considering future options.

“Financial resources must be considered not only in the context of financing options, but also in determining, do the numbers make sense?” states Martin.  “It’s important to recognize that regular updates are necessary to stay competitive. Some of them are going to have a positive impact on generating revenue for you, but others are simply the cost of doing business.”

Potential cost savings must be weighed against the compromises associated with reinventing existing spaces. In a major renovation project, cost savings from retention and reuse of the building shell, foundation and structure can represent 15% to 20% of the value of the building.  However, these savings can be offset by additional time needed for phasing, accommodations for existing residents and added costs associated with updates within the constraints and operational inefficiencies of an existing building shell.

“While we don’t advocate for building new every time,” Martin says, “we also acknowledge there are circumstances where reinvention is not the best approach. The building evaluation and cost analysis are critical for informed decision-making.”

2. Understand Your Market

There is no single formula for future success. Financial survival depends on the ability to reach the consumers in your market—meeting the local housing/care needs, reinforcing regional priorities and providing unique experiences. A market study will help to identify necessary census realignment, particularly when reinventing housing options or adjusting your health center unit mix to coincide with current and anticipated consumer demands

Looking at changing consumer expectations and provider challenges from a multi-disciplined perspective allows for meaningful consideration of new technologies, services and settings to successfully convert ideas into viable realities. If existing spaces are underused, that is an indication that something about the design and/or programming is not resonating with your end user.

“Many older communities had a small pool, an eight-by-eight foot spa and a single fitness room for their wellness component. That just isn’t cutting it today,” says McRoberts. “To get people to move in, you need to offer what the Baby Boomers are looking for—and that’s a state-of-the-art equipment room, classrooms, a lap pool—and maybe even a slide so the grandchildren want to visit more often.”

Understanding your market is an ongoing evolution. The multiple phases often associated with a reinvention provide the opportunity to make minor adjustments, or occasionally major revamps if needed, based on lessons learned in earlier phases.

Incremental apartment renovations at The Osborn in Rye, New York focused on updating kitchens and bathrooms to meet changing consumer expectations and improve accessibility.  Subsequent phases built on the lessons learned through the initial updates to streamline the process for residents.

3. Reinvention Takes a Village

Reinvention requires coordination among multiple planning disciplines, as well as community leadership, residents, staff and family members. Drawing on the perspectives and knowledge of experienced planning and design professionals helps providers look at the possibilities from different angles and determine the viability of potential changes.

“In a multi-story building, the infrastructure between floors has to be considered, ” Eric Endres, AIA, LEED AP, points out. “Aligning the programming so that units can be stacked in a way that maintains the existing structural and mechanical infrastructure provides greater cost efficiencies.”

Design and development professionals can also help define the underlying challenges and fundamental changes in operations and facilities that need to be made. Planning scenarios must account for operational costs associated with intended design changes.  For example, staffing ratios need to be considered when defining household sizes.

“For one client, the development consultant helped them understand that they needed to combine many of their smaller units to make the long-term numbers work. They did not realize the extent to which they had been subsidizing these units over the course of many years and the financial burden it placed on their community—that it was threatening their long-term viability in the marketplace,” McRoberts shares.

Residents and staff members are sometimes overlooked in the reinvention planning process.  These in-house experts can provide valuable insights as to how things are working and ideas for future updates.

“Focus groups are an efficient way to engage multiple groups of staff members, residents, even residents’ family members,” according to Martin.  “Many of our clients have found that just giving people the opportunity to share their ideas and have their suggestions considered goes a long way for future buy-in, even if the end result is something different.”

Trends presentations, reinvention concept sketches, resident slideshows, viewing windows into construction areas and progress tours for trustees, staff members, residents, and guests help communicate the long-term benefits that can be realized in return for temporary inconveniences.  It can also be helpful to phase reinvention so that portions—like introducing a new coffee shop—can be introduced while other phases continue.

At Garden Spot Village in New Holland, Pennsylvania, the café was reinvented in the first phase before tackling the main lobby in the community center.
Viewing windows into construction areas enabled residents to see lobby updates as they progressed at Garden Spot Village in New Holland, Pennsylvania.

“So many times, existing residents have valid concerns about the costs and inconvenience during construction and default to things being fine as they are, ” according to McRoberts.” But in the end everyone is typically thrilled with the result.  Ultimately that short-term anxiety wears off pretty quickly.”

4. Expect the Unexpected

A reinvention strategy must acknowledge and account for the unknowns.  Input from facility personnel can help to define if the building has been evaluated for hazardous material or if there are known issues with the building’s mechanical, electrical and plumbing infrastructure or envelope.  These are some of the big impacts on cost and schedule. However, most, if not all older buildings will have been subtly modified over the years with changes that have not been documented. Selective demolition as part of the up-front building evaluation or during the early design phases will help to avoid major surprises later in the process.

“When you start working with a building that’s 30, 40 years old, or older, you never know what you’re going to find inside the walls, the condition of a structure, or utilities added over the years,” states Endres. “Reinvention projects need to carry a contingency, even into construction, recognizing the likelihood of something unexpected.”

Reinvention requires design flexibility and ongoing collaboration to absorb the unknowns. Involvement of not only financial and development professionals, but also a construction manager is crucial for cost estimates, constructability input and development of phasing strategies.  A careful, up-front planning strategy anticipates roadblocks and builds rapport between design and construction professionals to address anything that comes up along the way.

“A design charrette is a great way to get ALL team members together, it’s very efficient and productive for reviewing options,” states Endres.  “The development and construction groups understand the market and the local bidding climate and can let us know right away if something is likely to be an issue.”

 

5. Embrace the Need for Change

Old habits die hard as personnel and boards struggle with impending change mandated by bureaucracy, economics and market expectations.  The ability to embrace change as an opportunity rather than as a concession will prove to be your best resource. Especially when times are challenging, it can be easy to defer needed updates and their inherent challenges for another time.

“Not doing anything, puts your community further behind the curve and it gets more expensive because you haven’t been maintaining what you have,” states Endres.

Many providers find that current residents are more supportive of planned updates and the associated disruptions if they have experienced a regular rotation of updates to keep a community fresh and relevant.  Some campuses have a continual process, reinventing smaller pieces to continually bring new energy and life into the community.

“Staying current with technology, lighting, and building systems is critical today,” asserts Endres.  “Technology is constantly changing and allowing us to become more integrated and connected.  Likewise, better lighting and indoor air quality can directly improve well-being and quality of life for your residents.”

3 Reinvention Success Stories

The Lofts at Village on the Isle; Venice, Florida

Assisted Living & Memory Care Households

Located along the gulf coast, this island community was comprised of several distinct and separate buildings that had, to various degrees, outlived their marketability. Master planning resulted in a multi-phased update process, with some buildings to be replaced and others reinvented over the course of several years.  This began with the conversion of the 80,000 square foot Mark Manor assisted living residence into The Lofts.

The former Mark Manor building had a sturdy concrete structure that was in good condition and well suited to the Florida climate. Community leaders made the fiscally-responsible decision to work with the “good bones” and renovate each floor to create person-centered households. The overall census dropped from 90 beds to 64 suites, 16 on the second floor for residents with dementia and 48 on three other floors for assisted living.  The change is immediately apparent with the revitalized exterior façade, updated to be compatible with new construction on campus.

A variety of window types and sizes, stucco color placement to define masses, and smaller details such as railings and brackets combine to accomplish a visually appealing and renewed building on campus. Clear, insulated impact glass replaced pink tinted windows and hurricane shutters.

Despite the added challenges associated with vertical mechanical and plumbing infrastructure when renovating a middle floor, the owner decided to start on the second floor so residents with dementia would not have to move multiple times. Updates were carefully implemented to maintain utilities on other floors while replacing plumbing stacks and upgrading mechanical systems in the renovated spaces.  Due to the eight-foot floor to ceiling height, every bulkhead is functional to maintain as much height as possible while introducing outside air through a new mechanical system.

We enlarged resident rooms and relocated and expanded common spaces on each floor. The elevator lobby has been re-envisioned as a foyer with a front door leading into the common living spaces much like the entry experience in a private residence. Staff areas were relocated behind the scenes at the core to maximize natural light in living areas and emphasize that this is a loft residence.

Some of the former residences on each floor were combined to provide common living spaces including introduction of a serving kitchen and dining room within each household allowing residents to have flexibility in when and what they want to eat.

The main dining room in The Lofts building is also being updated and the current Renaissance Room—where cultural performances, educational seminars and worship services are conducted—will be turned into a 200-seat auditorium.

Chestnut Ridge at Rodale; Emmaus, Pennsylvania

Adaptive Reuse of Former Office Building

Following the sale of the Rodale publishing company, the 38-acre headquarters in Emmaus was vacated.  This unique property led to Phoebe Ministries’ vision for Chestnut Ridge at Rodale, a wellness focused residential community for ages 62 and up.

The community will evolve in phases, beginning with adaptive reuse of the former Rodale offices. The 111,940 square foot, three-story office building will be converted into 122 one and two bedroom apartments with a center courtyard. An adjacent one-story office building will be replaced with a second apartment building. The buildings will share amenities and every apartment will be equipped with smart technology infrastructure and accessible design features.

Adaptive reuse of the former office headquarters maintains lateral bearing walls and the structural column gridline.  Those two realities dictated the size of the interior courtyard and the remaining floor area for apartments.  The design literally cuts a hole in the center of the building, replacing an enclosed atrium with an open courtyard. A green wall highlights the new opening and is visible from the street. Existing elevators and exit stairs are being reused for additional cost savings.

The building façade reflects a contemporary industrial aesthetic, working within the constraints of melding the existing brick and Exterior Insulation and Finish System (EIFS) on the current building with the façade of the new building using the same language, but introducing stone to create a more natural look.

An onsite childcare center will continue operation and support intergenerational programming. An adjacent service garage that was most recently used as a farmer’s co-op has been converted into the welcome center and sales office.  When Chestnut Ridge opens, this building is envisioned to function as a farmer’s market.  Likewise, a former warehouse now houses a full size apartment mock-up, with future plans for it to serve as a resource for the greater community, potentially housing the Emmaus Arts and Innovation Center.

Acts Retirement-Life, Communities – Cokesbury Village; Hockessin, Delaware

Community Center Updates

After affiliating with Cokesbury Village, Acts Retirement-Life Communities needed to update the community to better reflect its brand and meet market expectations. This began with reinventing the main building housing the community center and apartments. A new porte cochere and expanded drop-off area provides a welcoming gesture.

Next, we focused on updating the façade. The existing building featured a straightforward concrete face associated with the brutalist architectural style of the 1960s and 70s. The straight line of “raw” balconies were underutilized and blocked sunlight into the apartments.  Removing sections of the solid concrete balconies and replacing them with thin aluminum railings expanded views and daylighting and softened the building face.

Wrapping the building in a warmer, contemporary palette of glass, stone, stucco and metal panels added variety while reducing the perceived scale. The updated building face maintains a heavier masonry base that transitions to expressive cornice to provide a sense of hierarchy.

The unique aspect of the interior reinvention was that space was not necessarily at a premium.  The existing building had many open, spacious common areas, but significant square footage was dedicated to underutilized sitting areas. Many of the community common spaces were reorganized to locate active areas, such as the café/coffee shop at the front door.

In addition to a new hospitality desk at the entrance, the re-energized lobby design includes fireplaces, water features, and a green wall.

The new vision for dining reflects today’s lifestyles and consumer expectations. The design result is an expanded casual component, a new clubroom, and flexible private dining venue. Sliding doors allow this space to become part of the larger venue for special events and pop-up dining. An outdoor terrace dining venue with a series of causal seating areas is planned for a future phase.

On the lower level a multi-functional serving kitchen/event space serves as the hospitality “backbone” for varied meetings and special events.  This flexible venue hosts pre or post event gatherings as well as cocktail hours, wine tastings, guest chefs, cooking demonstrations and a myriad of other activities.
Read More Reinvention Success Stories

 

Is it Time for Reinvention at Your Community?

It is often simpler to tear down an aging building and build new, but reinvention done well can provide spaces that look, act and feel like new. Reinvention explores the potential for cost savings and creative solutions for sponsors who, either by choice or circumstance, need to maintain their existing infrastructure. Reinvention also respects your community’s heritage by maintaining unique features or architectural detailing that often has sentimental value.

“The big picture is if the reinvention is done properly, effectively reusing the existing building can build goodwill from saving an older building,” says McRoberts. “A lot of the reinventions we’ve done, when we can make them feel new, that goes a long way not only for the leadership team, but also with staff and residents that we did the right thing.”

Perhaps the most important step is to get started.  Take a hard look at your community or ask an impartial third party to help you identify the message your physical presence is sending to prospective residents.  Make sure it not only reinforces your brand and mission, but also reflects current consumer expectations. If you are unable to remember the last update, it probably is time for reinvention!

Contact us if you would like to discuss reinventing spaces at your community