Project category: Project in progress (February 2008)

Chief administrator: Richard W. Newman, President, (336) 886-2444

Firm: SFCS, Inc., (540) 344-6664

Design team: Tye Campbell, PE, Project Principal; Vernon Feather, AIA, Project Designer; Scott Rasner, AIA, Project Manager (SFCS Inc.); Linda Bump, Culture Change Consultant (Action Pact, Inc.); Steve Shields, Culture Change Consultant

Total building area (sq. ft.): 68,220 (new); 64,075 (renovation)

Construction cost/sq. ft.: $157 (new); $102 (renovation)

Total construction cost (excluding land): $10,699,206 (new); $6,545,140 (renovation)

Change is a growing revolution in how nursing homes care for frail seniors. Physical changes to clinical-style nursing facilities are critical to successful culture change, creating separate households for residents and their dedicated team of caregivers. An example is Pennybyrn at Maryfield.

Pennybyrn was constructed 54 years ago on a typical model: resident rooms along hallways that converged in large common areas. Current designers are maintaining the layout of hallways and resident rooms—individual spaces—with each hallway becoming the residential backbone of its own household. The designers are subdividing the large common space among households.

People enter each household's front door through a community space that surrounds an indoor “town square.” The town square faces “storefronts” leading to the beauty salon, physical therapy center, clinic, gift shop, children's playroom, and post office.

Each household of 16 to 22 elders has a living room and a parlor. The living room contains an entertainment center and large group activity space. A cozy parlor with a fireplace provides a quiet alternative. Living areas connect to porches or outdoor courtyards.

The revolution of culture change includes dining. Meals are served family style, and a full kitchen allows caregivers to provide alternative dining arrangements. The dining room opens to the kitchen so that elders can enjoy cooking sounds and smells, stimulating good appetites.

Designers have provided freedom and kitchen privileges—while meeting codes—by creating two zones in each kitchen. One is a production zone for staff use and the other a residential zone for elders.