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THE ARCHITECT'S ANGLE
October 2013
Greetings!  

This month we are focusing on Community Senior Centers.  In our companion article Building Expansions: The Solution Next Door, we discuss the potential for expanding your existing facility.  Please let us know what you think. We would love to hear from you.

Community Senior Centers - A Key Component in Managed Long Term Care

  

This is the third installment in a series on how Managed Long Term Care (MLTC) is impacting Senior Care Organizations.

 

Our first installment discussed the role of Accountable Care Organizations (ACO's) in creating heavier case mixes for Nursing Facilities, making them "More Sub-Acute". We followed that discussion with an article on how MLTC and its shifting care levels are creating a need for assisted living and supportive housing.

 

This month, we are focusing on how Senior Care Organizations are adapting their networks to create a new continuum of care through the creation of their own PACE and MLTC Plans/Centers. 

 

PACE stands for Program of  All-Inclusive Care for the Elderly.   

"PACE provides a comprehensive system of  health care services for members age 55 and older who are otherwise eligible for nursing home admission. Both Medicare and Medicaid pay for PACE services on a capitated basis. PACE members are required to use PACE physicians who along with an interdisciplinary team develop care plans that include primary hospital and long-term care services. PACE is approved by the U.S. Centers for Medicare and Medicaid Services".1

 

"Managed Long Term Care plans provide long-term care services  (like home health and nursing care) and ancillary and ambulatory services (including dentistry and medical equipment) and receive Medicaid payment.  Members get services from primary care physicians and inpatient hospital services using their Medicaid and/or Medicare cards".2  MLTC members must be nursing home eligible.
 
Footnotes 1 & 2: New York State Department of Health Website
 

Building Expansions: The Solution Next Door

  
In today's complex and competitive health care arena the only constant is change. As health care facilities struggle to keep up with the demands of regulatory and market forces, space continues to be "the final frontier."

 

Across our client base, we see similar needs: office space, storage, parking and space for new programs and initiatives. In an urban setting where land is at a premium, the problem of enlarging a facility is made more difficult by restrictive zoning.

 

Through our recent project work, we have found that the solution is often right next door. Most Health Care facilities are located in low to medium density residential zones where land costs are still relatively affordable. In many cases, facilities already own residential buildings or abutting parcels that are being used somewhat inefficiently for storage and office space.

 

Local zoning limits the amount of health care space that can be built on a given according to floor area ratio (FAR). FAR is essentially the total permitted above ground floor area expressed as a multiple of the land area.

 

A strategy we have successfully employed to increase the yield of a parcel is to classify a health care addition as a free standing ancillary services building or community center.

  

Continue Reading    

We hope you enjoy this month's issue. Do you have questions or feedback about the information provided or regarding your facility that we can answer? Contact us at info@jwbarch.com and we will be happy to provide you with any additional information you may need. We want to continue to offer content that interests you, our readers. Please drop us a line and let us know what topics you might want to learn more about. As always, we love hearing from you. 

 

Sincerely, 

John Baumgarten
John W. Baumgarten Architect, P.C.
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