| James Beeler, Administrator, Maplewood at Cheshire County: “This was actually a combined new construction and renovation that resulted in 20 new assisted living units, renovated support spaces and new nursing stations for the nursing home, and a new therapy pool and solarium. Although the original building had been built in 1977 and was well maintained, it was clear the industry had changed when I arrived here in 1996. The era of the ‘plain vanilla’ intermediate care facility was over. I had always been a big fan of assisted living; when I was an administrator in Colorado, we had an assisted living facility attached to both the nursing home and the hospital. At the nursing home here, we had all the support services in place to sustain assisted living, and it seemed natural that we could tie the nursing home and assisted living together. People could visit each other, and husbands and wives could occupy one or the other facility, depending on their needs-and several couples have done this.|
“What has made tying the facilities together work, though, is the new solarium. It is located between the nursing home and assisted living wing, and has become a focal point for residents of both facilities to come together to play bridge and attend horticultural classes. Residents in assisted living are also invited to partake in the nursing home’s very busy activities program. There are still people in assisted living who are afraid of nursing homes, but the solarium has given them a nonthreatening place to mingle, and a lot of that fear has subsided.
“We are a county-owned facility for low- to moderate-income elderly. Our assisted living rate of $1,300 to 1,600 a month does not cover costs when debt service is included; that figure would be closer to $2,000 a month. But in New Hampshire, the county pays 25% of the costs of Medicaid, with the state paying another 25% and the federal government half. The county has elected to subsidize our assisted living because public officials realize that they can pay for two or three people in assisted living for the same cost as one in the nursing home.
“We don’t compete with the fancy assisted living chains in terms of amenities. We’ve found, though, that in design, it’s the small things that count the most. Architect Charles Michal paid a lot of attention to ‘the little things,’ and it’s really paid off. For example, closets and bathrooms have pocket doors for ease of access by people using walkers or wheelchairs. The showers have fold-down benches and one-inch entryway ‘lips’ for ease of use. The apartments are not only fully wired for phone and cable TV, but they all have call alarms installed in their living areas and bathrooms. These aren’t very expensive, but they mean a lot to people.”