Building Type Basics for Senior Living

Building Type Basics for: Senior Living
Contents
Preface
Acknowledgments
1. Senior Living Today
State of the Industry
Demographics
Accessibility
Solutions
Design and the Aging Process
Biological Aging
Social Passage
2. Programming & Planning Guidelines
Understanding the Marketplace
Programming Space Guidelines
Community Based Options
Typical users
Sponsors, Settings, Payments, and Reimbursements
Geriatric Outpatient Clinic
Adult Day Care
Long-Term Care
Typical Users and Care
Sponsors and Owners
Settings
Program and Design
Housing Models
Long-Term Care Programs
Program and Design
Hospice
Users and Services
History of Hospice
Sponsors and Owners
Purpose-Built Hospice Care Settings
Program and Design
Payment, Reimbursement, and Regulation
Assisted Living Residences
Typical Users
Sponsors and Owners
Settings
Program and Design
Resident Unit
Unit Features
Unit Amenities
Planning Approaches
Payment, Reimbursement, and Regulation
Regulation
Trends and Innovations
Residences for Persons with Alzheimer's and Dementia
Typical Users
Sponsors and Owners
Settings
Program and Design
Design Considerations
Payment, Reimbursement, and Regulation
Trends and Innovations
Independent Living with Services
Typical Users
Sponsors and Owners
Settings
Program and Design
Unit Features
Key Planning Issues
Payment, Reimbursement and Regulation
Trends and Innovations
Continuing Care Retirement Communities
Typical Users
Sponsors and Owners
Settings
Organization
Program and Design
Market Considerations
Program Components
Assisted Living Residences
Long¥Term Care
Payment, Reimbursement, and Regulation
Trends and Innovations
Active Adult Communities
Typical Users
Sponsors
Settings
Program and Design
Payment, Reimbursement, and Regulation
Marketing
Ownership
Summary
3. The Future of Senior Living
Demographics
Population
Health and Services
Ethnic and Cultural Diversity
Consumers' Expectations
Privacy
Choice
Value
Non¥Institutional Environments
Security
Integration into Existing Communities
Lifestyle Changes
Future Consumers
Fitness and Wellness
Lifelong Learning
Lifestyle Apartments
Service Partnerships
Economic Pressures
Existing Housing and Care Facilities
Evolving Staffing Patterns
Sustainable Design
Leveraging Assets and Brand
New Housing and Care Concepts
Green Houses and Small Houses
Culture Change
Affordability
Reducing the Cost of Housing for Seniors
4. Project Process and Management
Planning, Design, and Implementation Process
Strategic Planning and Preliminary Definition of Need
Feasibility Analysis
Selection and Organization of Project Team
Programming and Predesign
Schematic Design
Obtaining Approval and/or Financing
Design Development
Construction Documentation
Selection of the Construction and FF&E Installation Teams and Purchasing
Construction and Installation
Occupancy
Common Problems and Cautions
Failure to Plan
Unclear, Timid, or Unrealistic Goals
Inadequate Client Leadership
Selecting the Wrong Project Team for the Wrong Reasons
Ineffective Project Management
Tackling Issues Sequentially, not Concurrently
Poor Management of the Public Approval Process
Not Prioritizing Quality
Failure to Plan for Maximal Staffing Efficiency
Poor Cost Management
Failure to Plan for Maintenance
Conclusion
5. Site Planning, Parking, and Landscape Design
Site Size
Relationship to Adjacent Land Uses
Vehicular Circulation
Parking
Landscape Design
6. Building Codes
Codes and Regulations
Federal
State
Local
Reference Standards
Energy Codes and Sustainable Design Standards
Regulatory Issues
Life Safety
Space Standards
Building Systems and Construction Practices
Public Policy
Accessibility
Enforcement
Fiscal and Bidding Controls
Land Use Policy
Waivers
Conclusion
7. Sustainability
Market Expectations
Calculating Cost Benefit
Years to Payback
Life Cycle Cost
Strategies for Sustainability
Create Sustainable Sites
Save Water
Reduce Use of Fossil Fuels
Heating, Ventilation, and Air¥Conditioning
Lighting and Daylighting
Alternative Energy Sources
Smart Use of Materials and Resources
Adaptive Reuse
Indoor Environmental Quality
8. Structural Systems
Considerations
Program and Concept
Applicable Codes
Potential Code Changes
Flexibility
Soil Conditions
Lateral Forces
Impact on Finished Ceiling and Building Height
Material Delivery and Construction Timing
Local Construction Industry Preferences and Capabilities
Ease of Construction and Schedule
Life Cycle Cost
Cost Impact on Other Systems
Appearance and Aesthetics
Structural System Types
Wood Frame
Structural Metal Studs
Masonry Bearing Wall
Steel Frame and Concrete Plank
Composite Steel
Precast Concrete
Concrete Frame
Long-Span Structures
Pre-Engineered Structures
Combined Systems
9. Mechanical, Plumbing, Fire-Protection, And Electrical Systems
The Interior Environment and Comfort for an Aging Population
Mechanical/Hvac
Plumbing
Fire Protection
Electrical
Program and Concept
Applicable Codes
Mechanical and Hvac
Plumbing
Fire Protection
Electrical
Program Impact on System Selection
Mechanical and Hvac
Plumbing
Fire Protection
Electrical
Finished Ceilings and Building Height
Mechanical and Hvac
Plumbing
Fire Protection
Electrical
Flexibility
Construction
Materials Delivery and Timing
Local Construction Capabilities and Preferences
Ease of Construction and Schedule
First Cost and Life Cycle Cost
Cost Impact on Other Systems
Appearance and Aesthetics
Noise and Vibration
Controls
Mechanical and Hvac System Options
Packaged Terminal Air-Conditioning Units
Packaged Rooftop Units
Air¥To¥Air Heat Pumps
Water Source Heat Pumps
Variable Refrigerant Volume Systems
Fan Coil Systems
Dehumidification Systems
Ventilation
Fresh Air Requirements
Filtration
General Exhaust
Kitchen Exhaust/Grease Ducts
Laundry and Lint Traps
Plumbing
Fixtures and Fittings
Hot Water Distribution
Metering
Rainwater
Fire Protection
Fire Alarm
Fire Pumps and Backflow Preventers
Wet Systems
Dry Systems
Electrical Distribution
Transformers
Switchgear
Metering
Emergency Power
Lighting
10. Communications and Low-Voltage Electrical Systems
Systems Proliferation
Emergency Response/Nurse Call
Movement Alarms
Access Control
Visual Monitoring
Telecommunications
Television
Internet Access
Networks and Intranets
Wireless Technology
Audiovisual
Point¥Of¥Sale Systems
Operations Systems
Trends
11. Special Technologies
Remote Biometric Monitoring Systems
Personal Locator Systems
Fall Detection
Telemedicine
Web Portals
Virtual Reality Therapy
Remote Learning
Circadian Lighting
12. Products And Equipment
Medical Equipment
Universal Design
Mobility Devices
Food Service
Adult Day Care
Long-Term Care
Assisted Living
Independent Living
Special Care and Dementia
Kosher Preparation
Bathing Equipment
Tubs
Showers
13. Acoustics
Key Acoustical Considerations
Noise Reduction Coefficients
Sound Transmission Class Values
Design Guidelines for Specialized Spaces
Lobbies
Dining Areas
Multipurpose Spaces, Spiritual Areas, Auditoriums, and Media Theaters
Bathing Areas and Other Hard¥Surfaced Spaces
Indoor Pool Spaces
Mechanical and Electrical Systems and Mechanical Rooms
Hearing-Impairment Guidelines and Code Requirements
14. Lighting Design
Light Levels, Reflectance Values, and Glare
Lamping Options
Linear Fluorescent Lamps
Compact Fluorescent Lamps
Halogen Lamps
Other Lamp Types
Windows and Daylighting
Design Guidelines for Specialized Spaces
General Guidelines
Common Areas
Corridors
Resident Living Spaces
Conclusion
15. Interior Design
The Design Process
Trends
Color Theory
Wayfinding
Materiality
Interior Design Guidelines
Flooring
Other Floor Coverings
Wall Coverings
Windows and Window Coverings
Furniture and Furnishings
Definition
Trends
Specifications
Sustainability
Process
16. Renovation, Restoration, and Adaptive Reuse
Long-Term Care Facilities
Assisted Living Facilities
Independent Living Facilities
Cosmetic Renovation
Moderate Renovation
Major Renovation
Key Questions
Integrated Scenario Planning
Adaptive Reuse
Key Questions
17. International Challenges
Service Development
Programming and Design
Service and Socialization
Process
Aging at Home
Country-Specific Issues
China
Japan
India
Thailand
The Americas
Europe
Conclusion
18. Operation and Maintenance
Introduction
Operations Costs
Ongoing Operating and Maintenance Costs
Durability, Useful Life, and Replacement Costs
Operational Efficiency
Cleanliness, Operations Quality, and Design
19. Cost Management
Cost Management Program
Relative Costs
Value Engineering and Life Cycle Cost Analysis
20. Finances and Feasibility
Ten Steps to Financing
Preliminary Feasibility Planning and Analysis
Potential Capital Structures and Sources of Financing and Equity
Financing Team and Method
Government Approvals
Financial and Market Feasibility Study
Underwriting
Preparing for Closing
Closing
Project Costs and Covenants
Ongoing Reporting of Performance and Covenant Compliance
Financing Variations for Senior Settings
Assisted Living
Skilled Nursing Facilities
Independent Living
Continuing Care Retirement Communities
Appendix A: Unit Types and Sizes for Senior Living
Appendix B: Building Net-to-Gross Factors for Senior Living
Appendix C: Geriatric Clinic: Typical Program Components
Appendix D: Sample Large Outpatient Clinic Program
Appendix E: Sample Enhanced Retirement Community Clinic Program
Appendix F: Adult Day Care: Sample Program for 50 Participants
Appendix G: Long-Term Care Gross Area per Bed Guidelines
Appendix H: Typical Long-Term Care Program Components
Appendix I: Sample Program: Long-Term Care, 126 Bed, 4-Story (and Basement) Neighborhood/Household Model
Appendix J: Freestanding 75-Unit, 3-Story Assisted Living Facility with 20-Bed Memory-Support Neighborhood
Appendix K: Sample Program for 40-person Memory-Care Residence
Appendix L: Sample Program for Independent Living with Services Building-150 Units, 4 Stories, 2 Wings
Appendix M: CCRC Program
Appendix N: Enhanced CCRC Therapy Program
Glossary
Bibliography and References
Index
Building Type Basics for Senior Living:
A Quick Index to Twenty Essential Questions
Supplemental Images