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Best Senior Living Repositioning 2014: Hospitality-Meets-Rehab

February 27, 2015 by Jason Oliva in SeniorHousingNews.com

This article, written by Jason Oliva, originally appeared on SeniorHousingNews.com in February 2015. It is posted in its entirety with permission granted by Senior Housing News.

Providing senior care services in the same area for over a century merits a certain reputation. It also warrants the entire rebirth of an organization, from the services provided to the physical campus itself.

Such was the undertaking of Lutheran Life Communities, an Illinois-based not-for-profit senior housing provider whose repositioning of all the skilled care components at its Lutheran Home continuing care retirement community (CCRC) earned it top honors in the 2014 Senior Housing News Architecture & Design Awards.

One of the fruits of this campus revitalization led to the creation of a $50 million revamped post-acute care setting at Lutheran Home’s Arlington Heights, Illinois campus, a 78-private room short-term rehabilitation facility known as MyRehab Center that opened in July 2014.

But MyRehab, characteristically, is far from what has defined traditional nursing homes in the past — so much that guests with dated preconceptions of nursing care may have to ask at the reception desk if they are indeed in the right place.

“The architecture and, particularly, the interior detailing moves away from traditional and institutional and into the realm of hospitality,” says Jeff Anderzhon, FAIA, senior planner, design architect with Eppstein Uhen Architects and also one of the judges for the 2014 SHN Architecture & Design Awards.

And if first impressions mean anything, the main entryway of MyRehab is enough to send visitors’ sights flittering across the room.

“The entry lobby is the first experience the client has. Its volume, finish selections and layout speaks largely to the hospitality experience and even without initial staff interaction, the client must surely feel that they are in an environment which will offer an ‘experience’ rather than simply medical intervention,” says Anderzhon.

To create an such environment that was not only reflective of contemporary design and evolving consumer preferences, but also a place that would foster Lutheran Life’s mission in providing high-quality, rehabilitative care — in turn making it a preferred provider for a number of local hospitals and physicians — was the central blueprint for MyRehab Center well-before shovels hit the dirt.

The Concept

The Lutheran Home campus sits nestled almost seamlessly within a residential neighborhood in Arlington Heights, separated from the greater community only by the house-lined side street of Oakton St.

Despite its location roughly 25 miles northwest of downtown Chicago, the suburban Arlington Heights maintains a semi-urban appeal with proximity to a variety of retail, dining, entertainment activities and nearby Northwest Community Healthcare hospital, a prominent referral source for Lutheran Home that serves Arlington Heights and its neighboring communities.

While Lutheran Home already administered rehabilitation services, the need to refresh the CCRC’s existing short-term rehab program was triggered by certain shifts happening in the market.

“Rehabilitation is not new here on the campus of Lutheran Home,” says Rex Paisley, corporate communications director for Lutheran Life Communities. “This [MyRehab Center] was our response to meeting a growing need in the community.”

Previously, the Olson Pavilion on campus provided 252 rooms for both rehabilitation and long-term nursing residents. Its infrastructure, which was built in the 1970s, called for new updates, most notably transitioning from shared, Jack-and-Jill bathrooms to private rooms each with its own bathroom.

But over the last five to seven years, Lutheran Home saw more “younger” adults in their 50s and 60s in the area opting for elective surgeries, such as knee and hip replacements.

“They were coming to us and saying, ‘I’m having my hip or knee done, can I come to you for rehab?’” says Linda Smith, marketing services director at Lutheran Home. “That’s when we saw the whole market was changing. That was the catalyst to building this standalone rehab center catering to, on certain floors, a younger generation.”

A simultaneous shift had been occurring over the years in senior living and post-acute care, notably in the aesthetic design of facilities shifting from the institutionalized setting of nursing homes past to more hospitality-driven environments.

The key word is hospitality.

“We wanted to tap into a mindset that we’re going to serve patients in a hospitality-like environment, so we were definitely trying to tap into a resort, spa-like feel,” says Randy Bremhorst, project principal at Hoffman Planning, Design & Construction, Inc., which led the design process for MyRehab Center.

Based in Appleton, Wisconsin, Hoffman has worked with Lutheran Life Communities on a variety of projects since 2005.

Along with its work on MyRehab Center, Hoffman also lent its expertise in repositioning Wittenberge Village, a Lutheran Life CCRC in Crown Point, Indiana, by adding 77 independent living units, 20 villas and a town square. The firm also helped Lutheran Life reposition Pleasant View, a CCRC operated by the non-profit in Ottawa, Illinois.

“We started master-planning on the Lutheran Home campus in 2006,” Bremhorst says. “It eventually led to the solution to basically reposition all of the skilled care, with MyRehab Center being part of that larger skilled care repositioning.”

The Construction

Before construction could begin to revamp Lutheran Home’s skilled health care offerings, Lutheran Life had to sell the neighboring community on its concept.

“We’re part of a residential community here. To communicate to our neighbors that this $50 million addition, this MyRehab Center, was going to feel completely residential and fit into the community and surrounding area took a number of meetings,” says Paisley.

At quarterly meetings with its neighbors, Lutheran Life presented all of its plans for MyRehab Center, showing community members what the facility was going to look like before one could actually gaze upon a physical structure.

This included detailing features of the types of finishes that would be included within the Center and within patients’ rooms, plans for living spaces on each floor, dining areas and the two-story rehab gym with its high ceilings and abundance of natural light.

“That was something that I wouldn’t call a challenge, but it was something that we wanted to pay very close attention to as we presented this project,” Paisley says.

While some in the community raised concerns that construction would increase traffic and limit parking in the area, the quarterly meetings helped clear the air and ease these neighborhood anxieties.

“There was some community concern, but not much opposition,” Paisley says. “It was a first vote Village Board approval of the project.”

Minimizing the impact on the active Lutheran Home campus, as well as the neighboring area, called for a three-phase approach.

For the initial construction phase, a new parking lot would be added along the east portion of the campus to address parking concerns. As part of this first phase, and once construction of the lot was complete, the three-story MyRehab Center addition would then be built off the existing Olson Pavilion.

Prior to its renovations, Lutheran Home provided 392 units of skilled, intermediate care and assisted living. However, once all construction phases are complete, the campus’ population will be down to 380 after accounting for the addition of the new 78-room MyRehab and slimming Olson’s count by 90 beds—still a substantially large skilled operation for a CCRC.

“In remodeling that, the decision was to try to increase and allocate more of that skilled nursing bed population to accommodate post-acute rehabilitation,” says Bremhorst. “So at 78 rooms, MyRehab is on the larger side compared to what most operators are dealing with as a neighborhood for short-term post-acute rehab. That’s clearly a distinct feature.”

The architectural solution to create that post-acute care segment via new construction, while dedicating the remaining skilled beds being renovated in the adjacent Olson Pavilion as a traditional long-term care neighborhood, was another distinguishing feature of MyRehab.

“That allows MyRehab to stand alone. It’s almost operationally integrated with all of the skilled nursing, but still able to maintain its separate identity,” Bremhorst says.

Designing the new addition was not without its fair share of hurdles. At certain points, designers had to pull the building farther back away from the street, shrink the building’s height down, basically doing things that would lend to a recognizable residential character while clearly communicating a facility that embraced modern, state-of-the-art health care.

“The entrance, rehab gym, the use of large atrium spaces, windows and metal that we worked with helped communicate that this was a modern 20th century health care environment,” Bremhorst says.

The finished product as it stands today conveys that message loud and clear.

Completion

Construction on MyRehab Center wrapped up in April 2014, marking a turning point in the revitalization of Lutheran Home’s skilled care facilities.

With acute precision, the MyRehab embodies the most defining traits of new age design in post-acute and skilled nursing care, exemplifying a hospitality-driven environment through the use of materials such as natural stone and wood to invoke a style more typical of a resort or spa than a health care facility.

“The entrance lobby, all at once, combines wood, glass, stone, metal, and tile in curves and angles,” says Elisabeth Borden, principal with The Highland Group, a Boulder, Colorado-based research, planning and marketing firm for 55+ housing and care communities, and who served on the awards judges’ panel. “The overall effect is filled with light and visual interest, while reading much more as a contemporary hotel than as a health care center.

Moving beyond the main lobby, each of the building’s three floors features a spacious living room furnished with several couches and other seating areas where patients may come gather with family or friends to socialize, whether that means gathering around the hearth of the fireplace to watch television, read a book or have a meal in the adjacent bistro-style dining area.

The living area leads into a wide, carpeted hallway where a reception desk and nurses station bisects two corridors of patient rooms. Though MyRehab Center is a place for recovering post-surgery, no wheelchairs or other medical equipment grace the halls in plain sight.

Rather, such specialized equipment can be found in small alcoves cut into the main hallways used specifically to store gear and free up hall space, a distinct feature that was a conscious decision in the design plans.

When equipment is fetched from these storage areas, carpeted floors aid in reducing the sound of their travel down the hallway, adding to the serene atmosphere MyRehab Center strives to provide for the patients it serves.

“Really that is what a successful rehabilitation provider desires: clients want to become healthy again and go home, but as they are in the center, they want to be pampered,” says Anderzhon. “The design enhances that pampering while maintaining the facility’s ability to respond successfully to the clients’ physical and occupational therapy needs as well as privacy.”

The completion of MyRehab Center has translated into a number of successes for Lutheran Home, not the least of which includes its reputation as a mainstay in the Arlington Heights community and a preferred provider of various physician groups and nearby hospitals in the area.

And that has largely to do with Lutheran Home’s effectiveness in reducing readmissions and producing quality outcomes. The community has produced readmission rates as low as 3.53% for weakness with falls, 5.48% for cardiac patients, and 1.93% orthopedic rate, according to data Lutheran Home collected from November 2013 through April 2014.

“One of the keys to success in a rehab program is to partner with physicians and assure them that you’re going to follow their specific protocols and show them the outcomes that result from the services you provide,” says Smith. “And so now we have strategic alliances with certain physicians and hospitals that we’re becoming leaders in the industry for.”

Lutheran Home achieved those successes even before MyRehab Center opened its doors in July 2014 following approval from the Illinois Department of Public Health. But even though the approval came two months after construction had been completed, thus delaying the grand opening of MyRehab Center, anticipation of the arriving facility in the community still remained.

“There was word in the community and in the surrounding communities that MyRehab Center was coming and it was needed, and so there was a real desire to get on the waiting list,” says Lutheran Home’s Executive Director Shareen Anderson.

“We had people who had surgeries scheduled in June that moved them to August, so that they could get in here [MyRehab],” added Smith.

Marketing for the community began about six months before MyRehab’s opening. This included outreach in the neighboring area by holding “power lunches,” where Lutheran Home invited people to visit its campus to see renderings of MyRehab. The community also went to churches, senior centers, physicians’ offices and local hospitals to spread the word of the forthcoming rehabilitation center.

Before MyRehab, Lutheran Home previously exercised a “Prehab” program in their marketing, inviting prospective patients to visit the facility and get a feel for the environment where they would be recovering following a hospital stay.

The program, however, has been discontinued due to overwhelming demand at MyRehab Center, whose waiting list forces Lutheran Home to turn away 10 to 30 inquiries a week.

“Prehab was a great program, but the unfortunate part is that we can’t guarantee everybody a space any more because of the popularity of the services,” says Paisley.

“The day we opened was the day we were full,” added Smith.

Renovations at Lutheran Home continue to unfold. The campus is currently in the third phase of its process, which is repositioning half of the Olson Pavilion, the oldest building on site that provides Lutheran Home’s long-term care services.

Similar design elements as MyRehab can be expected within Olson as well upon its completion come Spring/Summer 2016, with the intent being to facilitate a smooth transition between various buildings and care settings at Lutheran Home.

“That helps the family as well and gives them comfort and calm,” Anderson says. “There’s nothing more empowering than knowledge and feeling like you have some idea of what’s coming next. And this will make it just that much easier.”

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