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Trends for New Construction or Substantial Rehabilitation of a Skilled Nursing Facility


Many for-profit and non-profit owners of skilled nursing facilities have been making improvements to keep their facilities marketable and increase occupancy levels. There has been a trend of skilled nursing facilities (SNF’s) moving towards short-term rehabilitation patients that have their costs covered by their major insurance carriers. 

A number of skilled nursing facilities have converted standard or semi-private rooms to Alzheimer or Dementia rooms with a secure memory care unit to increase income and their census. Others who currently are in a HUD 232/223(f) transaction have opted to add on wings to their existing facilities with a HUD/FHA 241(a) loan that insures mortgage loans to finance repairs, additions, and improvements to multifamily rental housing and health care facilities with FHA insured first mortgages or HUD-held mortgages. Facilities that offer memory care gain a competitive advantage over those that do not offer these units.

SNF Layout Trends

It is essential to furnish the skilled nursing facility with vinyl furniture and flooring that is easy to clean and can withstand the use of strong cleaning agents necessary to kill bacteria. Facilities must be kept as clean as hospitals, just without the institutionalized feeling, which is why furniture and décor choice is important.

A new trend in design layouts for short-term rehab is utilizing modern furniture and fixtures in lobbies, café areas and common areas, many times incorporating a large sitting area to watch a flat screen television. These common areas are oftentimes where caregivers engage with residents, and may include activity stations positioned throughout. This environment makes it more inviting for younger seniors because it appeals to a feeling of home, opposed to an atmosphere that feels like a hospital or long-term care facility that older, outdated facilities have.

Likewise, many skilled nursing facilities are moving from shared living space for their residents to individual rooms that have private bathrooms and may be used to visit privately with family members. Some skilled nursing facilities spaces also include a small living and dining area in the rooms that provides the feeling of a luxury hotel suite, or an efficiency apartment. In addition, many new facilities are making room for activities and crafts, exercise centers, as well as community pools. Many facilities are also implementing quiet rooms for residents who feel anxious or upset, where they can go to relax and be alone to calm down.  

SNF Lighting Trends

One of the most important things to think about when lighting a skilled nursing facility is the elimination of light and dark spots throughout a space. Dark spots can feel ominous to the brain and may cause distress to residents whereas even and consistent lighting will help residents move more easily throughout a space. Making sure lights are evenly spaced, and are providing the right amount of light, is key. Having many windows with as much natural light as possible is a growing trend.

The Dementia Center states that by the time people are about 75 years old, they need twice as much light as normal lighting standards recommend, and nearly four times as much as a 20-year-old, in order to see satisfactorily. The two implications for care environments are that twice the ‘normal’ light is required, and that the lighting level in spaces should be set by someone who is of mature years.

The eye sends signals which different parts of the brain interpret to form a visual construct. Therefore, some people with dementia are significantly disadvantaged compared to others because the ability of a brain affected by dementia to process visual signals is greatly diminished. Therefore, The Dementia Center insists that it is of utmost importance that higher light levels are delivered into the environment of people with dementia in order that their brain has some chance of performing reasonably.

When beginning a new construction project or a substantial rehabilitation of a skilled nursing facility, it is important to plan a space that is comforting and will feel like home to residents. It is also necessary to choose furniture and lighting that accommodates the particular needs of the residents in a skilled nursing facility. Keep these guidelines in mind when utilizing a HUD/FHA 241(a) loan for finance repairs, additions, and improvements.

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