Our Lady of Peace: Lewiston, New York: Striking a Balance by Robert Volzer, CID, IIDA, Volzer Design Development.

TYPE OF FACILITY/SETTING: Skilled Nursing Facility (replacement for two existing homes)

OWNER: Mount St. Mary's Hospital and Health Center Lewiston, New York 

CHIEF ADMINISTRATOR: Angelo G. Calbone, President & CEO, [phone]

ARCHITECTURE/ENGINEERING/INTERIORS: Cannon Design, Inc., [phone]

PHOTOGRAPHY: [c]2003 Tim Wilkes Photography, Rochester, New York [phone]

RESIDENT CAPACITY: 250 Beds (90% semiprivate, 10% private) in six "households"

TOTAL PROJECT AREA (SQ. FT.): 155,000

CONSTRUCTION COSTS (EXCLUDING LAND): $34,000,000 for construction, equipment, and soft costs

COST/SQ. FT.: $220

Striking a Balance

"Striking a balance between 'privacy and community' was perhaps our greatest achievement as a project team," says architect John Hall, AIA, of Cannon Design, Inc. "With a comprehensive team, including gerontology/environmental psychology consultant Lorraine Hiatt, PhD, of Innovage Consultants; long-term care planning consultant Martin H. Cohen, FAIA, FACHA, Design for Aging; key staff of the owner's two existing and outmoded skilled nursing homes; and the numerous architectural, engineer lug, and design professionals involved, we all seemed to 'keep our eye on that ball' throughout the design process. Delivering a state-of-the-art replacement facility while working within the New York State Department of Health's guidelines for new construction required compromises between the team's members."

"Giving first priority to residents' bedrooms as the essential building block, we literally planned and mocked up this facility 'from the inside out,'" adds Mount St. Mary's Hospital and Health Center's President and CEO Angelo G. Calbone. "Then, in designing hallways, social, and eating areas, we used a household concept and focused the design around our care model, which includes universal caregivers and emphasizes the relationships between residents, staff, and the community."

Residents enjoy a high level of privacy in "split" semiprivate rooms, which have "toe to toe" rather than traditional "side by side" bed layouts. The extra-wide corridors create "great rooms" that offer social and activity space right outside bedroom doors instead of 100 feet away. Our Lady of Peace also has a chapel and additional program space for large group activities, PT-OT space, outdoor patios, and administrative offices. Departing from the "country kitchen" look, the dining areas were designed to function as open hubs with natural light, scenic views, and a sleek, restaurant-style servery.

The building's natural materials, site, and massing fit well into the context of the surrounding community. From the extensive use of stone, which reflects the residential character of the neighborhood and the vernacular of the Niagara River Gorge, to the simple, clean, contemporary interior design, the facility projects a bright and uplifting "sense of place" for its residents.

"Since our initial occupancy in July 2003, staff have reported that residents and families have responded very positively to the new environment, and they attribute noticeable resident weight gains to the dining/ servery concept," says Calbone. He adds, "I would have to say that our 'moving days' [one from each old facility] made our design and construction journey worthwhile, as we caught the looks of appreciation on the laces of residents and the hundreds of volunteers as they came in the door."

In contrast to so many new building projects that are all about the front lobby, it is a delight to see such a focus on the resident's dignity first, and then provision of the successive spatial context to afford them a level of environmental, psychological, and social balance in their lives.

ROBERT VOLZER, CID, IIDA, VOLZER DESIGN DEVELOPMENT