How Benchmark, Onelife And Mcmillan Pazdan Smith Keep Old Buildings Alive With An Eye On Costs 

The senior living sector is dealing with an increasing number of older properties. Making these buildings more efficient for staff is one way to avoid expensive fixes, although doing so has its fair share of challenges.

Even so, building updates will remain top of mind for operators for years to come, experts say.

Renovating a building’s physical plant can be incredibly expensive. And, balancing such decisions with realistic margins becomes a struggle for operators, according to Onelife CEO Dan Williams.

A focus on small decisions – especially around changes to staff communication and coordination – can still have a meaningful impact, however. For example, decentralizing a nursing station into smaller, remote locations throughout a community can increase response times and cut down the distance nursing staff and caretakers have to travel to check up on a resident.

“You want to get care staff closest to the residents possible in the quickest time possible, and then you want to deliver the ADLs without having to run back and forth,” Williams told Senior Housing News. “Once you get into trying to remove load-bearing walls and get new plumbing and wiring … It’s expensive.”

As designers and architects work hand in hand with operators to see where efficiencies and conveniences for staff can be made, providers should actively seek to make such small, but mighty changes.

Scott Hendrix, senior associate at McMillan Pazdan Smith, said his team sits down with operators to see where to “trim the fat” from labor costs. This involves finding opportunities for reducing staff handoffs as a key target, he said.

Operators also have to identify where they can realistically make updates to technology infrastructure in older communities that weren’t originally designed with high speed WiFi in mind. After all, an increased use of handheld devices such as tablets and smartphones, and the prevalence of electronic health records, have allowed caregivers to respond more quickly.

From one station, many

One of the most common renovations operators make in older communities is splitting up the central nursing station into multiple scattered stations that are maintained by fewer staff. These older central stations were more prevalent when there were fewer regulations and requirements for assisted living communities, and at the time it was common practice for communities to be a single story and spread out with long hallways.

Now, however, the newer satellite station locations are within the long hallways where the residents are located.

“It has its own mini version of all of the things that used to live in the central court,” Hendrix said. “Nurses can stay in the units and walk less … I think a nurse with less tired feet is a happier nurse.”

Operators have also undertaken converting underutilized spaces within these older communities into something more useful for staff.

Erin Domian, senior vice president of operations at Waltham, Massachusetts-based Benchmark Senior Living, said when looking to renovate an older community, the entire location is evaluated to see where efficiencies can be made. Storage rooms, back-of-house spaces, oversized corridors or other support areas are typically the first to be changed.

For Benchmark, a recent example of such a change involved converting an electrical closet and surrounding area into a staff break room, complete with a window to bring in natural light, expanded square footage and upgraded finishes such as stainless-steel appliances, new furniture and a large-screen TV.

“This resulted in a comfortable space where associates can take a break, recharge, and feel supported during their workday,” Domian told SHN. “Though older buildings may have structural limitations, thoughtful space planning can create significant improvements for staff without requiring a full redevelopment.”

As for Onelife, the operator is mindful of turnover rates and has focused on creating positive changes for its nursing staff, including through improvements to physical spaces devoted to its nursing staff. While it may cut down on the amount of common space available for residents, it’s considered necessary to help the nurses do their jobs more efficiently, according to Williams.

However, at times there is just nothing that can truly be done in older communities. In those cases, operators simply have to accept losses or charge residents more to maintain those margins, Williams said.

Including tech solutions

Aging buildings are often in need of technology updates, and operators shouldn’t overlook tech solutions when renovating older communities. This isn’t a new practice by any means, but it can still make a difference, and operators have to weigh the costs of installing and retrofitting the necessary equipment to have stronger options.

In this regard, one benefit of older communities, according to Williams, is the drop ceilings that are a common design element from that era. These can be easy to run wires through and help extend the effective range of routers. Other low cost solutions come in the form of WiFi repeaters that are spread throughout the building, and routers do not need to be in every room, and in some instances operators can “piggyback” on existing wiring.

Benchmark’s Domian calls such tech upgrades “significant investments” to “make day-to-day operations more efficient and create a better work environment for staff.” These types of renovations include updating community-wide Wi-Fi infrastructure, modernizing emergency call and access control systems and incorporating more electronic medical records and new fall detection software.

“Together, these investments improve communication, support more efficient care delivery and enable associates to spend more time focused on residents rather than administrative tasks,” Domian said.

According to Williams, the industry as a whole is going to need to focus its efforts on maintaining the growing number of older communities, given the trend toward prioritizing acquisitions over new construction.

“If we want to still acquire buildings and not develop, we’re going to have to look at older buildings … We need to get good at being able to take these 25 year old buildings and convert them into the way that we deliver care now,” Williams said. “We better get pretty good at it, because I think that it’s going to be one way that you can grow as an operator is to go find older buildings and renovate them.”

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