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Home My WebLink About150929 OIH Board of Selectmen MeetingARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com October 7, 2015 SMRT Architects and Engineers Ellen Belknap, AIA, ACHA, LEED AP, EDAC Richard Webb, ASLA, LEED AP Our Island Home Feasibility Study Nantucket Board of Selectmen 2 Agenda •Objectives •Skilled Nursing Today •Program Assessment and Prototype •OIH Existing Conditions Assessment •Site Analysis and Development Concepts •Existing OIH •Wannacomet Water Company Site •Fairgrounds Site (2) •Sherburne Commons (East and West) •Project Cost Discussion •Q & A 3 Objectives •Determine best approach to house OIH residents in the future •Understand current state care model for skilled nursing •Consider Three Options: 1.Renovate and expand in place 2.Replace facility on existing site 3.Replace facility on new site •Assess Systems and Infrastructure at OIH today •Assess potential sites for relocation of OIH ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Skilled Nursing Today 5 Skilled Nursing Today Skilled Nursing •Evolution of care model over the last 15 years •Shift from medical/institutional to resident directed model •Address boredom, loneliness and hopelessness •Restore resident capabilities, sense of purpose and engagement •Move to “small house” building organization 6 Philosophy of Care Philosophy of Care: - Resident Directed Care - Evidence Based Design - Patient and Family Centered Care Themes: - Residents participate in their care - Residents have choices and control - Residents are engaged and satisfied - Residents have a sense of purpose Outcomes: - Capabilities increase - Independence increases - Activity level increases - Functional decline reduced - Dependence on medication reduced - Behavioral issues diminish - Patients happier and healthier - Quality of life improves 7 Small House Characteristics •10-12 residents per “house” •Resident directed care model •Emphasis on building community and meaningful socialization •Clear zoning public to private •All private resident rooms •Dining area sized to accommodate “household members” •No corridors, resident rooms open into social space •Abundant natural light 8 Small House Characteristics Strong connections to nature •Secure terrace/patio •Walking paths •Raised planting beds •Sun and shade areas •Screened in porches •Balconies ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Program & Prototype Discussion 10 Program Discussion Number of Beds Unit Type Unit Size Resident Rooms (all private) •Sitting Area •Sleeping Area •Private Bathroom →Sink →Toilet →Shower Resident Program Spaces •Rehab Space/Therapy Gym •Bathing Room (with Tub) •Activities & Dining •Residential Kitchens •Outdoor Spaces 11 Program Discussion Support Spaces •Clean/Soiled/Linen •Med Room •Staff Work Areas •Staff Offices •Kitchen •Storage Staff Support Areas •Staff Break Room •Staff Locker Room •Staff Bathroom •Staff Conference Room Building Support Areas •Receiving (Adj. to loading dock) •Mechanical Room •Electrical Room •Storage •Facilities Office 12 Site Program Parking •Number of Spaces Total →Staff Spaces →Visitor Spaces →Resident Space →Handicapped Spaces →Assigned or Unassigned? Outdoor Spaces for Residents •Terraces •Enclosed/Secure Garden Spaces •Trails/Exercise Space Building Support Areas •Loading Dock •Dumpsters •Recycling •Equipment/Vehicle Storage →Snow Removal →Lawn Mowers/Tractors →Vehicle Storage/garage 13 Program Program Benchmarks: Small House Model: •800-1,200 SF/Bed •Assume 1,000 SF/Bed •45 Beds = 45,000 SF Institutional/Medical Model: •500-700 SF/Bed •Assume 600 SF/Bed •45 Beds = 27,000 SF •Existing OIH = 22,000 SF 14 Private Room Prototype 15 15 Bed House Prototype 16 3 House Prototype (45 Beds) ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Our Island Home Today 18 Our Island Home Today Building: •22,000 square feet •45 Beds – Skilled nursing beds •3 Private Rooms •21 Semi-Private Rooms •Medical / Institutional Model •Antiquated Systems •Aging Infrastructure •Inadequate storage •Inadequate common space •Does not represent a contemporary standard of care 19 Our Island Home Today Site: •2.57 Acres •Limited parking – negatively impacted by adjacent Landmark House •Limited harbor views 20 Our Island Home Today 21 Our Island Home Today 22 Our Island Home Today 23 Our Island Home Today 24 Our Island Home Today 25 Our Island Home Today 26 OIH with Addition ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Site Assessment 28 Overall Site Map 1 2 3 4 29 OIH – Existing Conditions 30 OIH Existing Site with Addition 31 Wannacomet Water Site 32 Fairgrounds Site Option 33 Fairgrounds Site Option 34 Sherburne Commons Existing 35 Sherburne Commons Option ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Cost 37 Cost Order of Magnitude Cost Projection: •Based on 45,500 s.f. building (including existing OIH demolition) •Assume “normal” site conditions •Expressed in “today’s dollars” •Project cost range: $30,000,000 – $35,000,000 ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com Q & A ARCHITECTURE ENGINEERING PLANNING INTERIORS ENERGY smrtinc.com October 7, 2015 SMRT Architects and Engineers Ellen Belknap, AIA, ACHA, LEED AP, EDAC Richard Webb, ASLA, LEED AP Our Island Home Feasibility Study Nantucket Board of Selectmen