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The Big Build-out

Practical construction designsare popular in seniors housing With a variety of new building products on the market today, seniors housing facilities are being built more rapidly using modular construction and quicker assembly methods.

An interesting and sensible variety of new and established building products and designs are helping to make today's senior housing facilities more attractive, inside and out; faster, easier and cheaper to produce; simpler to maintain; more comfortable and effective for residents; and more productive for owners and developers.

Lavatories are one of the areas being manufactured for quicker building, such as this Lavtec seamless bathroom module by Amtech. One notable product is the Lavtec Seamless Bathroom from Amtech Corp. of Yelm, Wash. Originally designed for ships and introduced to the assisted living market last year, Amtech's one-piece fiberglass Lavtec bathroom unit comes complete with all framing, wiring, plumbing, electrical and fixtures in place, including lights, mirror, medicine cabinet, towel bars and grab bars. It meets UBC codes and is ADA approved, including its one-hour firewall.

"The main advantage of a Lavtec Seamless Bathroom module vs. a stick built bathroom is that the Lavtec's floor and walls are all one piece, eliminating the cause for mold, mildew, bacteria and water damage," says Larry White, sales and marketing manager at Amtech. "The seamless unit helps reduce the high cost of maintenance and repair and extends the practical life of the bathroom. It also makes cleaning easy: Just hose it down, and the water leaves through a built-in drain. The units contain no ledges or steps and are spacious enough to accommodate wheelchair mobility. Placing a complete bathroom module can expedite project completion time by 30 to 45 days, which also reduces labor costs. Our bathroom modules are so complete, all you need are towels and a shower curtain."

Cervitor Kitchens Inc. of El Monte, Calif., manufactures a complete, compact kitchen unit including refrigerator, cooktop, oven, sink and storage area for use in assisted living apartments. "Today Cervitor's ADA-compliant, barrier-free kitchenette unit is ideal for the assisted living market, because it looks like a regular kitchenette but is totally accessible to wheelchair bound users," says Dennis McCurdy, vice president of sales and marketing. "Its clear approach space of 30 inches by 48 inches accommodates a single, stationary wheelchair and meets ADA requirements for both forward and side reach; its countertop height is fixed at no greater than 34 inches; its sink size, undersink clearance space, faucet mechanisms and bowl size meet ADA standards; storage requirements are ADA-specific; and its refrigerator/freezer is UL listed and within the reach range specified by ADA." Cervitor manufactures its own refrigerator units and has obtained UL listings for both freestanding and recessed installations. "Some contractors in the assisted living market, in an effort to cut costs, may install a freestanding refrigerator unit in a recessed space, a dangerous electrical code violation. They may also build smaller cabinets to save space, which ultimately clashes with the ergonomics and function of assisted living residents' needs," says McCurdy. "Many seniors have held onto their families' silver, china and other heirlooms that require ample storage. Cervitor kitchenette units provide plentiful cabinet space for these important possessions, in addition to meeting all ADA requirements."

An important construction consideration sometimes overlooked in the senior housing market is carpeting. "Senior housing developers concentrating on a residential look often neglect the requirement for commercial performance, specifically on the floors. Wheelchairs, walkers, food spills and incontinence heavily challenge and can quickly wear a residential-grade carpet," says Mark Thomann, business manager at Calhoun, Ga.-based Mannington Commercial. "I believe owners and developers have to look more strongly toward performance-backed products that also provide an acceptable aesthetic value."

"The majority of residential carpets have a water-based backing chemistry that retains blemishes; though some spills may be wiped from the surface, they may seep into the backing, causing a very persistentstain and odor. Urine, for example, can stay moist for six months when soaked into some residential carpets," says Thomann "Commercial-backed carpet systems provide better long-term performance in a senior housing application, while also providing a warm, residential look.

"Robert Cottone is executive vice president of Malvern, Pa.-based IMC Construction, a general contractor and construction management company now building assisted living, skilled nursing and independent senior units on the East Coast. "We definitely see a greater use of carpeting that is colorful and attractive, but is a commercial-grade, low loop pile that's simple to travel across and easy to clean. We also see lots of vinyl siding applications, which cost less than brick and stone while delivering a warm, residential feel," says Cottone. "Vinyl flooring is also popular; some good quality vinyl products look like wood but may be mopped and cleaned in a commercial manner. A plethora of commercial-grade products are being applied in warm, residential environments, especially in the assisted living arena, where a multitude of commercial applications like meals, laundry and administration are taking place in one residential setting."

"The mix of residential and commercial construction requirements demands an experienced blend of services: the sophistication of a commercial contractor, and the economical advantage of a residential contractor," says Cottone. "For most residential contractors, the HVAC, fire sprinkler and electrical service work for a 50,000 sq. ft. building would be too great a challenge. But for most of the interior and exterior finish work such as awnings, millwork, wall coverings and siding, a residential contractor might be more economical. Contractors accustomed to townhouse/tract housing developments often are more competitive and versatile on these types of projects than the typical subcontractor."

"Another construction trend is the design/build scenario. Rather than the architect designing for the builder, not the owner, with all three angrily meeting in the end with their lawyers, many owners today are contracting with design/builders that take total responsibility for the project from beginning to end," says Jim Stanley, vice president of marketing for the Embree Healthcare Group. "The architect works under the direction of both the owner and contractor, with a designated budget and design, to produce a profitable result. Design/builders like Embree can also bring financing to the deal."

At Koll Construction of Newport Beach, Calif., Don Eklund, senior project manager, notes his company works closely with both owners and design teams to assure the assisted living product is built in accordance with owners' expectations and budgets. "We strongly recommend to owners that they obtain architects experienced in assisted living, because we've seen many drawings that do not lend themselves to the way seniors live. Flow patterns with dead-end corridors, few circulation paths and intimidating barriers are among the inappropriate recommendations made by architects inexperienced in assisted living," says Eklund. "Owners also need to keep abreast of new changes in technology. Whether for administration, personal emergency response systems, security or fire alarm systems, new and better applications for technology are being introduced continuously."

At Rees Associates, a Dallas-based architecture firm, Robert Whitaker, director of retirement housing, notes the construction benefits of a floor system product called Epicore. "This is a product that allows us to provide the fire resistant separation between two floors with just the thickness of the material itself. We can run HVAC ducting along the corridors and have lights that are recessed without worrying about fire penetration," says Whitaker. "The resulting flooring thickness of about six inches of concrete total is much thinner than the two-foot cavity required by a traditional truss floor system. It also delivers a lower total building height, which provides a savings on total building surface materials."In the HVAC area, Whitaker notes a growing use of vertical condensing units that mount at the exterior of residents' suites, rather than traditional, hotel-like, under-window units. Vertical condensing units can also function as a self-contained split system that can serve more than one room in a suite, which under-window units can't do. "In states like Texas where the roofing system is required to have non-combustible construction, based on the licensing for senior housing, we're using packaged assembly products for the roof structure such as Load Master or Ply-Cem," says Whitaker. "These products provide a non-combustible roof with a metal deck surface."

"Whether it's roofing, flooring systems or even the curtains that separate two beds in a room, the code restrictions related to senior housing construction are specific and voluminous," says Marc Minotto, senior vice president of Basic American Medical Products of Atlanta. "How much and what kind of furniture is permissible in a senior facility varies with every state. There's even a code that specifies the size of a bedside cabinet. Private pay facilities also have a multitude of codes, though they relate more to fire and safety."

"Government regulation definitely is a big trend in senior housing construction. Senior development presents a great opportunity to tax, and Congress won't pass that up," says Stanley. "Codes are more stringent for nursing homes than assisted living residences, he says, because the government been involved in that segment for some time, but regulation is moving very quickly into the assisted living area."

"As the government becomes more involved in assisted living, more owners are building facilities that meet the requirements of semi-private, meaning a large enough bedroom to have two people in it even though it is now being marketed for one person," says Stanley. "These owners know that if the government does come in with a Medicaid waiver program, they can't be competitive unless they can put two people in that room. Most of these owners have been around the nursing home industry a while and have already been hurt by regulations."

Subassembly is another building trend in the senior market. "We used fully modular components to produce close to 400,000 sq. ft. of unitized component construction in 1997, including multistory buildings. Using subassembly, we can incrementally build a senior facility, easily adding components as needed without a tremendous inconvenience to residents," says Jimmy Krapf, chairman of Wilmington, Del.-based KrapfCanDoIt Construction. "An owner may build a 250-unit housing facility then worry about filling it. If incrementally built, one-third of the facility could be placed with reduced financial risk. Once brought online and stabilized, with administration and marketing in place and successful, the next phases could then be marketed, while the facility's existence in the marketplace helps support the success and affordability of those future phases."

Allen Kopelson of Nadaskay Kopelson Architects, a full-service firm located in Morristown, N.J., also notes the trend toward what he calls increased "socialization" space, particularly as assisted living facilities move away from a medical model to a social model. Referred to as a 50/50 building, the goal is to increase the size of common areas, or socialization space, while decreasing the size of residents' rooms to encourage residents to get out and interact with others."

Many of our senior projects today are in inner city areas, incorporating fewer amenities and aesthetic characteristics compared to suburban buildings. The approach is entirely different including how the financing, land acquisition, construction and other primary factors are all worked out," says Kolpelson. "You have to be creative. There are many people in these urban areas that can't afford expensive, upscale senior housing, and there's money to be made by developing housing for these urban residents."

"Tax incentives, grant programs and a host of other advantages make these urban sites interesting to explore," says Kopelson. "With land acquired at the right price, and tax abatements and other incentives allowing the building to be built at a budget reasonable for the whole project, proportionately the same amount of money can be made as with an upscale suburban project."

Stanley notes whether urban or suburban, an overall (and possibly negative) influence on senior housing construction is the trend toward going public. "In the last few years, the race has been on to go public. But once public, and you've sold Wall Street on how many units you can put into operation by a certain date for a certain price, you must meet those projections or your stock will lose money," says Stanley. "The danger of so many companies going public is oversaturation. Too much construction can be driven by the value of the share, with bad decisions resulting. Once construction starts where the market turns out to be too tight, most CEOs will continue to build and meet the projections on time, rather than pull out and go to a better market."

Lorna Pappas is a freelance writer based in Andover, N.J.

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