Expansions and renovations are a necessary part of life at continuing care retirement communities (CCRCs), but handling them properly can make all the difference. Long-Term Living’s Editor-in-Chief Pamela Tabar spoke with key members of a major, four-year renovation/new construction project about building toward the future without destroying the current business—or driving the current residents out the door.
Laclede Groves, a Lutheran Senior Services CCRC, has been operating on its 65-acre campus in St. Louis, Mo., since 1972. The hallmark building on the site is a repurposed 1920s convent, complete with a stunning vault-arch chapel. But Laclede’s housing environments and service lines needed major overhauls, despite the fact that the CCRC was still enjoying a near-full occupancy rate.
The site’s skilled nursing (SNF) section, housed in the old convent, was still “ward-based,” with narrow, institutional corridors and shared rooms—worlds away from the person-centered care model predominant today. The project team also wanted to rethink the site’s assisted living units, add memory care beds and therapy spaces and expand with a new independent living structure—all actions that Laclede’s executives believed were necessary to keep the CCRC marketable within the greater community. Despite the many business drivers contributing to why the campus needed major changes, the project needed to be sensitive to the 700 residents who already lived there.
Four years later, Laclede had built 80 new independent living apartments and an underground parking garage, added 45 new memory care beds, created several new dining venues and had completely renovated the old convent SNF space using a neighborhood model while also adding rehab/therapy spaces as an expanding business segment.
In the following roundtable discussion, Laclede Executive Director Valerie Cooper, Lutheran Senior Services CFO Paul Ogier and Dan Cinelli, FAIA, principal and executive director at the design firm Perkins Eastman, describe how they got the overhaul done and what lessons they learned along the way.
Laclede’s executives realized that accomplishing the primary goals of new independent living and new memory care spaces—not to mention a complete overhaul of the SNF wing—would impact the entire campus. Hiring an architect is one step, but managing a project like this can be another matter.
Valerie Cooper: We had an amazing reputation that kept us full. But we very much had a community siloed by levels of care. We had our independent living residents and the residential care and the skilled nursing, but community crossovers didn’t happen very often. We worked hard to create a sense of community.
Paul Ogier: We were content with [our site] back then, but when we look back now, it was pretty horrible. It was a thoroughfare with no privacy in the care center. To get anywhere, you had to go through the rehab area. We also were lacking the amenities that our competitors were bringing in for different types of care. We had good outcomes and great quality of care, but it wasn’t really an acceptable physical environment, and we were surviving on our reputation. As others were building “nicer and newer” [sites], they may not have been providing the same care we do. But so many people don’t understand that, and they’re sold on perception.
Dan Cinelli: [The site] had an independent living building, then it had the convent and the skilled-care wing, but to get to that you had to go through the old bowels of the building. So there really was no sense of “where does everyone get together?” You have a continuum of care, but you felt like there were distances, both psychologically and physically, between all of these pieces. And then, the most beautiful space in the entire campus is the old convent chapel—an incredible building that you couldn’t really get to.
Cooper: One of the main focus areas was on our skilled nursing and converting that from an institutional model to the household model. We also wanted to create common spaces both inside and out for people to congregate for socialization and friendships. We also wanted to add amenities, larger independent living apartments and dedicated memory care environments.
How did you stay focused and avoid scope creep?
Cinelli: Many times, when projects first come to the table, everybody has their own list of what they want done. There’s immediate scope creep, and everybody wants the world and the sun and stars. And then Paul [the CFO] comes along and says, “Yeah, but we have to be able to afford all of that.” When it comes down to it, [the executive team members] have to get together and say, “Here’s what we want, and here’s what we feel we can do.” We also have to deal with the fact that we have a lot of residents who are living here every day, and we can’t just toss everyone out.