While sharing a common mission to provide a safe, nurturing long-term care environment for their residents, Skilled Nursing Facilities (SNF) and Long Term Acute Care Hospitals (LTACH) function quite differently and have unique and specialized requirements. Typically a SNF will offer a more residential experience, whereas an LTACH will focus on more rigorous clinical care and observation. In the case of the Goldwater North LTACH renovation, one of our current projects in New York, there are 111 (of 201) patients on ventilators. While the goal is to wean them off ventilators, that is not always possible. In addition, there are medical patients with chronic and often numerous health issues requiring coordinated care.
The following descriptions offer a basic overview on approaching this specialized type of healthcare design:
SNFs are designed to fulfill basic healthcare needs of residents while offering a level of activity not typically associated with a traditional hospital environment. Since the residents tend to be more mobile, there are community living and dining rooms on all the resident floors and additional centrally-located spaces for therapeutic and recreational activities. At Goldwater North, since the patients tend to be more mobile, security systems including patient wandering technology are being employed to ensure patient freedom and safety within the facility.
The patient rooms offer amenities and a level of privacy that is in approximation to an apartment. Wall colors tend to be bolder and more inviting and the living areas are often carpeted. In many ways, SNFs are designed to allow their residents to “own” their living spaces, which is a luxury that usually isn’t achievable in an LTACH.
An LTACH needs to be designed to deliver more complex clinical care than a SNF because LTACH residents are in poorer health and less able to care for themselves. An LTACH is a hospital; consequently there will be a greater need for charting and provider work stations. In addition, clinical support spaces as required by hospital codes must be provided, however many of the typical hospital diagnostic spaces such as an emergency department and surgical suite are not required.
The resident room is typically designed similar to a hospital environment with implementation of best practice technology and safety initiatives. For example, in the Goldwater North project, a new clinical patient headwall will be installed on the corridor side of the patient for ease of nursing access. In addition, hand washing sinks are being added to renovated rooms. Interior finishes, including wall coloring, will be muted and the construction materials throughout the facility will be specified to meet healthcare demands.