When the operations staff at Asbury Methodist Village, a continuing care retirement community in Gaithersburg, MD, made the decision to renovate one of its skilled nursing facilities two years ago, they spent nearly a year assessing resident needs and deliberating over how to best meet them. Wilson Health Care Center hadn’t seen a facelift since the early 2000s, so they knew they had to do it right, says John Loop, operations manager at Methodist Village.

“Our philosophy of care is built around providing the best resident-centered care that we can, centered around respect and dignity, and we really wanted our space to reflect that commitment to creating a healing environment,” Loop says.

The project, which was unveiled at the end of March, involved the conversion of the facility’s traditional nurses’ station into a contemporary residential lounge for residents to relax, read, watch TV and visit with family and friends. The renovations also included the creation of a spacious spa treatment area with a state-of-the-art immersion tub, renovated semi-private, private and deluxe private rooms for transitional care and a multi-functional bistro providing round-the-clock access to healthy snacks and refreshments.

It was a massive project that required ongoing communication to residents and staff, weekly progress update meetings, support from donors and a lot of give-and-take, Loop says. Finding that middle ground can be a delicate — but necessary — step in any remodeling project, explains Bonnie Cauthorn, principal/manager of DesignSource Inc., a firm specializing in senior living space.

“Renovation is so much about compromise,” Cauthorn says. As more long-term care facilities look to remodel, here’s some real-world advice from those who have done it — or who help design long-term care renovations all the time.

Take a step back

One of the first stages of a successful remodeling project is making sure you know why you’re renovating in the first place, points out Chris Morgan, renovations national account manager for healthcare at HD Supply. 

“Revenue-enhancing projects will help ensure your long-term success, so weave in your company initiatives and include corporate goals in your planning process,” Morgan says. He recommends considering survey requirements, local competition, current and future care needs, safety, marketability, employee retention and efficiencies in labor or energy when thinking through renovation plans. 

Approach a renovation with an overall master plan, and then break it down over a two- to five-year period, advises Dean Maddalena, president and architect of Texas firm studioSIX5.

“This will assure that when the renovation is complete it is cohesive,” he says. “Resident rooms can be upgraded as they turn over, which minimizes disruption. Commons areas have to be carefully strategized with operations and the contractor to develop the most economical plan with the fewest inconveniences. Before work starts, it is imperative that all building materials and furnishings are in a local warehouse and readily available, so as not to cause delays.” 

Jane Rohde, principal and founder of JSR Associates Inc., a senior living and healthcare consulting firm, also says the most successful renovations she’s been involved in have been those where providers focus first on developing a strategic plan for their remodeling project. 

“Having a master plan discussing all the different things they’d like to do, even if they’re big things like eventually buying the property next door, helps providers be more strategic about how they do their renovation, and in how to target their money,” Rohde says. 

Listen to many

As part of the strategic planning process, it’s imperative to get input from all of your stakeholders, Rohde says. That includes holding focus groups with staff, residents and their families, even if it’s just to get their basic ideas or to let them air their concerns. Loop agrees, noting that Asbury realized early on that incorporating residents into the renovation project would help ensure a smoother process for all involved. 

“Any renovation causes disruptions, but we were able to get so much more buy-in by keeping our resident council group involved in the project,” Loop says. “They served as a mouthpiece throughout the remodel, communicating about the changes that people could expect and where things stood, which was incredibly valuable for us.”

Staff also can provide indispensable insights into important renovation needs, because they’re the most familiar with the day-to-day operations, says Lee Penner, owner of Penner Manufacturing. 

“One of the most important people to have on your committee is your maintenance engineer,” Penner says. 

It’s also a good idea to hire an interior designer that has experience in the area of senior living, says Lynn Vogeltanz, studio lead for Direct Supply Selections Studio.

“They can come in with fresh eyes to discuss ideas on how to best use your budget,” Vogeltanz notes. Listen to what they suggest for the facility, and use them and your corporate suppliers as resources for compiling supporting documents such as case studies, energy audits and solution-based design concepts, adds Morgan. 

In the end, it has to be a partnership between the facility and the design firm to talk through the various options and determine how to best move forward. 

Share your vision 

Money attracts money, Rohde notes, so letting potential donor and local partners know about your facility’s renovation plans, and the money you already have committed to the project, can help draw in additional funds. 

“If you already have a commitment of $2 million, it’s a lot easier to go to a foundation and say, ‘I have this much already, but if we had another $1 million, this is what we could finish out and have available for residents in the community,’” she says. 

Patrick O’Toole, director of development for the Asbury Foundation, also notes that those who have had a personal experience with the facility, including former residents and their families, are often generous supporters.

“Many former short-term rehab residents are back on their feet now and looking for a way to show their thanks for the care they received,” O’Toole says.

As the Wilson Health Care Center renovations began, O’Toole says they brought donors and community members in to see the progress, discuss naming opportunities and explain how their donations would help.

Rohde also suggests bringing in local partners to provide volunteer services or community-based resources where it makes sense.

“If you wanted to do a new garden or landscape area, talk to the local garden club and see if they might be willing to make that into their mission project, or ask the rotary club to come in and complete a portion of the renovation as part of a service project,” she says. “These can often be really good relationship builders and they don’t cost anything.” 

Prioritize choices

There are many items that come up as wish list items, but everything may not be able to occur at once, Vogeltanz says. Take time to determine wants versus needs, and whether they fit into your strategic plan, and then break it into phases.

When you’re prioritizing, it’s important to choose quality and function over look, Penner says.

“Be sure you don’t buy something because it looks ‘cute,’” he warns. 

That goes for everything from bathing equipment to the ovens you purchase for a kitchen renovation to the type of carpet you choose, says Marc Ahrens, vice president, commercial at Invista Surfaces.

“The right carpet fiber, backing and pile height can dramatically improve performance against stains, odors, resident mobility and ease of maintenance compared to a facility that does not specify carpet correctly,” he says.

 Of course, you’re never going to be able to do everything you would like, Loop says. At Wilson Health Care Center, replacing every single piece of furniture during their renovation just was not an option, so they took time to incorporate older furniture that was still in good shape into the new design. 

One way to cut costs is by purchasing dining room chairs that are non-wood, says Jack Armstrong, executive vice president of Cooltree. These chairs, whether steel, plastic or aluminum, have a longer lifespan than wood and can be reupholstered rather than replaced, saving significant dollars during a dining room refresh. 

“The money saved can go toward other products needed for the dining room renovation or refresh,” he says.

Resident safety and comfort are also key factors to consider when prioritizing your renovation wish list, adds David Daughtrey, J+J Flooring Group director of business development for healthcare. For example, finishes that reduce ambient background noise should be chosen to provide improved acoustics and a better atmosphere for hearing. Floor products that provide greater roller mobility and slip resistance will reduce the potential for trip, slip and fall injuries, he says. Renovations should reflect a positive environment.

“The interior environment should appear less institutional and create the appearance and feel of home,” Daughtrey says.

Invest in residents

Taking the time to focus on providing residents with a home-like environment can pay off, says Troy Rabbett, commercial marketing specialist at Flexsteel Commercial Furniture.

“Resident rooms can sometimes be overlooked in renovations, but taking the time to select a really comfortable and attractive resident room chair can show your residents and their families how much you care about the well-being and comfort of your residents.”

Finally, never underestimate the ability of small, inexpensive refreshes to transform a space and make a facility more marketable, Rabbett notes. 

“A fresh coat of paint and attractive new furniture can help make a great first impression in entry lobbies and other smaller public spaces such as hallways off the entryway,” he says. “You can even add in some new window treatments and accessories to fully update the space.”