GVH hopes to break ground on new Senior Care Center this summer

$21 million project seeks to provide better care into the future

By Alissa Johnson

Imagine living your whole life making your own choices, only to find yourself in a nursing home where every choice is made for you. What you eat, when you eat, what time you wake up—even the time you bathe. You also have a roommate, perhaps someone you like, but maybe not. Perhaps someone with similar health concerns, but again, maybe not.

Now imagine moving into a facility where the staff and the building enable you to preserve as much of your independence as possible, from a private room to meal times to waking up. A place where you can go make cookies in a shared kitchen, visit with friends and watch TV, or seek peace and quiet in your room.

The latter is exactly what Gunnison Valley Health (GVH) wants to provide for residents in a new Senior Care Center (SCC), a facility that is estimated to cost around $21 million and would change the face of senior care in Gunnison County.

The health system hopes to break ground this spring, creating a facility that not only provides for residents’ medical needs but their overall wellbeing.

“This project will not just offer seniors a long-term care option for care but will be a leader in design and living that will be transformative in the state and across the country,” Rob Santilli, GVH chief executive officer, said. “The Gunnison twist will allow all the support of a caring team, coupled with a social environment and complementary services that I could personally choose as part of the Baby Boomer age group.”

The new facility will enable the SCC to continue a transformation it has already begun, going from an institutional model of care to a more resident-centered model.

Wade Baker, chief professional and senior services officer, explained that over the last few years, the SCC has built more choice into residents’ lives—they (or their family) have more say in when they want to bathe, how late they want to sleep, and even when they want to eat. There are, however, definite limitations to the current building, which was built in 1976 to function like a hospital.

“I call it the flyover. If I fly over, I can pick out a nursing home from the ’70s because they’re either Xs or Hs. They have these long corridors with a centralized nurse’s station, and that’s what the best people thought they needed back then—nursing care. Now the shift has gone to a home,” Baker said.

That shift includes private rooms, both for level of care and based on demand. Yet in the existing facility, only three of the 30 rooms are private, with one also designated for infection control. The rest are semi-private, which means that residents share a room, and a privacy curtain divides the space. Residents in these rooms share a bathroom. The atrium, which is used for social activities, is not centrally located, requiring that residents travel farther to reach it and making it virtually impossible for residents in nearby rooms to escape an activity when they don’t feel like participating.

“There’s that question of dignity where one of our care staff needs to visit someone in a room that shares a room, and they’re on the far side, they basically have to walk through the person’s living room to get to them,” said marketing director Tyler Hansen.

Some work offices are also scattered throughout the building, so that SCC staff are working in the middle of the residents’ home. And changes in the trends of long-term care have also changed the nature of roommate issues. Whereas complaints used to center on roommates who stayed up too late or played the TV too loud, there are now more chronic health issues and behavioral issues.

“Now we’re seeing psychological issues where a person has some diagnoses that make it hard to find somebody compatible with them… [That means] we have someone in a semi-private room and we can’t put a roommate with them, so we lose another semi-private room,” Baker said.

By contrast, Davis Partnership Architects has helped GVH design a new facility around a neighborhood concept. Rather than having long hallways with rooms on either side, there will be “pods” with several rooms around the outside and a shared space in the middle for socialization, including a kitchen area, a TV area and space for people to gather.

Residents will have their own rooms, but there will be options to allow couples to be together. They will also be able to personalize their rooms more easily, and continue to make more choices about their daily life. In essence, these features will further the work that the SCC has already done, so that the building mirrors the level of care.

“I’ve always said that the SCC makes a wonderful second impression,” Baker explained. The facility itself does not make a great first impression, but the level of care and staff warrant a closer look.

The new building will also be connected to the existing assisted living facility, making it easier to serve some of the needs of that facility as well as making for an easier transition when residents move from one to the other.

Getting to this point has been a long road. According to Baker, GVH began looking at senior care needs in 2009. A strategic committee, made up of board members and community members, and the board of directors worked with an architecture firm to conduct a market analysis and develop cost estimates for building a new facility as well as renovating the existing facility.

That process suggested that GVH can expect a need for 49 beds in skilled nursing, and a long-term trend where the demand for skilled nursing declines and the demand for assisted living increases. They also determined that it made the most sense to address the limitations of the SCC facility because the assisted living facility, which was built in 2001, is still a modern building and continues to serve residents well. And building a new facility made the most sense.

“To try to convert a hospital to a home is virtually impossible, and if you can do it, it’s incredibly expensive,” Baker said. At the time, the cost difference between a new facility and renovating the old one was only $40,000 and renovation would have required displacing residents for about 10 months.

The design of the new facility will also give GVH the ability to respond to changing needs. There is room on the property for expansion of either the SCC or the assisted living facility, and once the current SCC building is torn down, there could be space for independent living units as well. And the “neighborhood” approach creates flexibility within each pod.

According to Baker, the project will be financed through a long-term loan, looking at the USDA (U.S. Department of Agriculture) first but also looking at other options. GVH has also conducted three financial feasibility studies to ensure the project is achievable, including assessing the overall financial health of GVH.

Projections show that with a census of 47 residents, the SCC will be a self-sustaining facility, but the board of directors and leadership wanted to make sure the health system was strong enough to support the SCC as needed.

“We are fortunate to be in a position to afford this and have the land,” Baker said, though he did note that as a smaller facility, a small change in the number of residents can have a significant impact on the bottom line.

Currently, Baker says, GVH is determining how much the hospital and the SCC will contribute to the project and how much the GVH Foundation might be able to raise. In 2009, the SCC also received $900,000 from area rancher Ray Van Tuyl through his will. That has been invested through the Foundation.

Drawings are being finalized and final pricing is due from the contractor on May 12. At that point, the board of directors will make a final decision whether to proceed with the project, and the goal is to break ground in July.