HCSHQ_102021

October 2021 — Health Care & Senior Housing Quarterly — Page 17 www.crej.com SENIOR HOUSING — OUTLOOK T he COVID-19 pandemic has necessitated shifts in how we design, construct and prepare senior living com- munities for emergencies. The Facilities Guidelines Institute, an independent group that develops guidelines for the design of health care and residential care facilities, is currently reworking its guidelines to reflect these adaptations. Colo- rado is one of eight states that uses the FGI guidelines as a resource for designing health care facilities. In March 2020, FGI began to con- sider new guidelines for respond- ing and adapting to a number of emergency conditions. These condi- tions encompass four major areas, including: • Earthquakes/weather conditions, • Wildfires, • Pandemics, and • Hostile threats/trespass. In March, a draft of the new guidelines was issued. I had the pleasure of being asked to review these revised guidelines and offer feedback before the final release of the new recommendations. While some of the requirements, in their draft format, were not financially feasible for owners, operators or developers of residential care com- munities, many aspects of the proposed document deserve con- sideration as it relates to the design and repositioning of health care facilities, especially residential care communities. To date, the final guidelines have not yet been issued by FGI. As we await the new guidelines, we continue to investigate and imple- ment our own lessons learned from the pandemic to inform our designs with the ultimate goal of creating safer and more thoughtfully designed residen- tial care communi- ties. Following are our top five les- sons learned and recommendations for design changes or revisions focused on senior care facilities. 1. Touchless technology. This includes a variety of lighting con- trols, elevator controls, building entries, voice activation and hand sanitizers throughout the commu- nity. We also now know that auto- matic hand dryers are detrimental to the spread of germs, bacteria and pathogens through aerosol and rec- ommend the use of touchless paper towel dispensers. 2. Staff areas. This includes dedi- cated staff entry, a decontamination facility where staff can shower and change clothes, dedicated and sepa- rate staff work areas and entries, storage and access to personal pro- tective equipment, areas for respite and support services or staging areas for disinfecting needs, and holding spaces for deliveries. 3. Decentralized dining and social areas. Here we consider separate or distinct neighborhoods and rethink the size and scale of dining and social areas, as well as how they are staffed. This may increase staff- ing needs, and/or redundancies may need to be considered for this to be a viable solution. We also recommend designing or reconfiguring large spac- es with the ability to separate into smaller gathering or dining spaces. 4. Airborne infection. While required in skilled nursing facili- ties, we highly recommend using mechanical systems that provide adequate ventilation, filtration, and temperature and humidity control. We also advise the use of ultraviolet lights and/or bipolar ionization sys- tems. 5. Single-occupancy rooms. This has been a recent and ongoing dis- cussion as the market moves for- ward. We believe it is now a consid- eration for all communities related to infection control. LeadingAge and other organizations currently are working with Medicare to provide adequate reimbursement for single- occupancy rooms in Colorado and throughout the nation. We can expect changes to the FGI language based on what we have Emergency preparedness changes due to pandemic Gary Prager, AIA, LEED AP Principal, Hord Coplan Macht Max Kun Zhang | IRIS22 Productions LLC There is considerable rethinking about the size and scale of dining and social areas, as well as how they are staffed. Pictured here is Brightview Bethesda Woodmont. Please see Prager, Page 20