Interior designers debate solid surface flooring vs. carpet in long-term care

Lisa Robbins, Allied Member ASID, Ritz Associates:
I thought Lisa Cini’s blog, “Solid surface flooring versus carpet in skilled nursing,” was great. Some of my favorite discussions with designers and end users are about finishes. Much like lighting, I believe flooring can make or break a space. It's one of the first things noticeable when walking into a facility. What's interesting about this topic is that everyone can have an opinion about it and I can't imagine any one opinion being right or wrong. Although it is absolutely a highly debatable subject!


I would lead by commenting that I challenge the 'homey' feel. I'm not sure I want my Acute Care Hospital to feel like home unless it is a nurse's residence. Carpeting could give me that warm sense of not being in an institutional space in that instance, except that I've seen some great vinyl flooring which looks like wood and I love wood floors at home … so, I'm curious, which one would you choose?

Lisa Cini:
Thank you for the response, Lisa. For me there are many ways to achieve a ‘homey’ feel and I would like to counter that Acute Care has done a better job of this than the Long-Term Care industry. I have been an in-house designer in both environments. We added carpet in the hospital long before skilled nursing even considered it and several factors led us to using carpet in Acute Care.


First, patients were starting to drive where they stayed vs. the doctor or insurance company. This started with labor and delivery units, then moved to heart and then to the ER. From a clinical standpoint, there was a reduction in noise from the traffic outside of a patient’s room and therefore sleep and agitation were less, which in turn helped in the healing process. That being said, we did have to make modifications to mobile technology to accommodate the loads (i.e., portable x-ray machines) and understand fiber technology, backing systems, and cleaning schedules.


Another positive was that from a life-cycle costing standpoint the carpeting was much less costly to maintain even with replacement factored in. Outpatient surgery centers have also bought this “homey” feel to the extent that even they are customizing catering, having fireplaces at the check in and fluffy robes. On a personal note, I have had carpet, hardwood, tile and linoleum in my living spaces and I like them all. I see the benefits to most of them except tile. However, I do notice in Long-Term Care that if carpet is on the correct maintenance schedule and toileting is taken care of then my preference is for carpet.

Lisa Robbins:
I think it is very interesting that you would go with carpet. Building materials in general have changed dramatically for the healthcare environment. There are many hospitals in the New Hampshire area who have adopted the ‘homey’ feel and when you walk into the main part of the hospital they feel incredibly comforting upon entering. These hospitals have used carpeting in the lobbies but for patient area, they still show VCT which I would still opt for myself. I just wonder about infection control, long-term cleaning, and maintenance, particularly for patient areas using carpet.

In way of technology and machines, I understand most technology and furniture come with various options of casters depending upon flooring. The solutions are endless and I imagine that a checklist of options is handy during the design process.

Recently, I had a conversation with a carpet tile representative who admitted sales for healthcare for him were declining. He agreed with me that most acute care hospitals are specifying VCT tiles and there were more opportunities for him for outpatient, long-Term care, assisted living, and hospice. Ironically though, as I visit these locations, the exam areas and patient rooms are still not finished with carpeting. Maybe it is a trend? Maybe it has something to do with cost? Maybe it is infection control? Whatever it is, evidence-based design is probably the best thing for us to turn to for more information about the patient experience. If the patient is healing faster and the carpeting has a positive effect as well, maybe you are on to something. You have my wheels turning and I will be diving into learning more about the statistics. It's certainly a great conversation.

Lisa Cini:
In an effort to not drag acute in the discussion, but to address your comments, in corridors, waiting areas, and lounges we used carpet. Patient rooms we moved to sheet vinyl vs. VCT. VCT we used rarely in new specifications due to the high cost to maintain over sheet vinyl or carpet. It is the cheapest upon installation but the most clinical and costly over the long haul compared to the other options mentioned above. It could possibly be a geographic difference in what is getting specified. On a side note, ER, ICU, and cancer units are still hard surface. I agree that evidence-based design will be key in determining the patient benefits of the materials. It’s always a balance between what is best for the patient or resident, staying in budget, and being able to maintain the product in a cost effective manner.

On the long-term care side, we see carpet in all applications with the exception of back of house. We are still using some VCT in the back of house but it is minimal. To respond to an earlier mention we are not seeing rubber flooring in long-term care with the exception of stairwells.


I would like to hear more reader thoughts on this issue, so please use the comment box below to continue the dialogue.

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