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A behind-the-scenes look at four outstanding projects

March 1, 2009
by Long-Term Living Editors
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We are proud to present the 2009 DESIGN Citation of Merit winners. The four projects that follow were deemed “the best of the best” by our panel of jurors which included architects, interior designers, providers, and regulators. The highest honor, Best of Show, went to Three Crowns Park, Evanston, Illinois, AG Architecture, Inc. The winning projects range from a county-owned facility to a residence for elderly nuns. The DESIGN entry and review process is detailed and exacting. All entrants had to supply a binder filled with a detailed written description of the project, photographs and illustrations, plans with legends, obstacles and solutions encountered, questions and answers developed by the review panel, and facility and firm profiles. After a two-day review process by our jury, four Citation Award winners were chosen. The winners showed exceptional use of master planning and settings/designs that promote seniors' highest levels of physical and cognitive functioning and emotional well-being in ways that support their dignity, self esteem, and quality of life. These designs enable owners/operators to provide innovative programs and solutions that transcend aging in place and designs that facilitate caregiving functions. Our congratulations as well as those of DESIGN co-sponsors SAGE and The Center for Health Design, to Rick Moore, Horty Elving; Gene Guszkowski, AG Architecture, Inc.; Terry McLaughlin, Community Living Solutions, LLC; and Julie Heiberger of Hoffman, LLC. We have also included entries our jurors chose as Honorable Mentions and the distinctive features that gained them special recognition.

Three Crowns Park, Evanston, Illinois

Gene Guszkowski, AIA, Principal, AG Architecture, Inc.

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One could say Three Crowns Park had “good bones” to begin with. The over 100-year-old main structure is situated in a mature neighborhood in Evanston, Illinois, nestled among beautiful homes and adjacent to a school with a forest preserve. It is on the city's historic register. So when Executive Director Susan Morse became the lightning rod for converting the skilled nursing facility into households and undergoing a complete culture change, architect Gene Guszkowski already had a leg up. The project became a combination of new construction and renovation.

“We knitted two existing buildings together with some new construction,” explains Guszkowski, a principal with AG Architecture, Inc., Wauwatosa, Wisconsin. “The bottom line was what we needed to do was create additional space to give ourselves the ability to expand the nursing home in a meaningful way. We couldn't accomplish all we wanted to do given the framework of the existing building. We used a portion of the third floor of our new construction to expand our nursing home.”

Photography: ©2008 FotoGraphix

Resident-centered care advocate Steve Shields was brought in to help make sure the household concept was facilitated as well as the culture change needed to support it. Shields, a well known consultant in the Midwest, runs Meadowlark Hills, a CCRC in Manhattan, Kansas. Morse took her staff to Meadowlark Hills twice to get buy-in and show them how the household model works. Shields is a disciple of “rampant normalcy” in long-term care building and design, a phrase that became Guszkowski's guiding light throughout the project.

Gene Guszkowski

“You have to start by asking, ‘What is a home?’” explains Guszkowski. “In our society whether you call it a condo, a house, an apartment, or a co-op, you start with a sense of entry, you have a social space such as a living room, you have a place where you dine, a place to prepare food, and a private bedroom. What we were trying to do was take that idea and adapt it to create three, 18-bed households.”

It was felt from a staffing point of view, that if households of 18 could be created, it was a workable number for the staff. The way the existing building was laid out situated the elevators in the middle, so the architect broke the existing layout into two separate households, each with its own front door. “The addition was designed in a way that as one comes up a new elevator, you get off and now you're going through a sequence of being on someone's front porch. You ring the bell, come inside, and you experience a progression of rooms that are like a living room, and a kitchen, then a bedroom,” Guszkowski says.

Next came Guszkowski's biggest challenge. “The client insisted there should be absolutely no service-related crossover,” Guszkowski explains. “For example, if you're in a single-family home, your neighbor doesn't cross through your living room with their dirty laundry to go to the basement. We had to work very hard to separate the zones where people live and socialize and keep them separate from the back-of-the-house area. It was a very disciplined exercise and Steve held our feet to the fire.” That discipline, Guszkowski admits, was the aspect of the project he is most proud of.

Another challenge was how to create outdoor space. Guszkowski says this is an ongoing problem with skilled nursing care, especially on the third floor. “What we did was a bit of a compromise,” Guszkowski says. “Our ‘outdoor’ space is an enclosed sunroom on the third floor. It has large windows on either side that gets a good cross breeze from east to west. There is a hard finish on the floor so it makes it feel more outdoorsy. It has a great view to the drop-off area of an elementary school so the residents can look down at the children and reminisce.”