| Ask This Critical Question Before Retrofitting a Building | <p><img src="/Articles/PublishingImages/2025/senior_room.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:200px;height:200px;" />One of the most important questions to ask before starting a facility retrofit project often goes unanswered: “How are people actually using the building?”</p><p>It is easy to make assumptions. Residents spend the majority of their time in their rooms or apartments, the dining hall, and social areas. Visitors follow residents and staff work on dedicated floors or wings. But what if these assertions were only partially true?</p><p>What if data tells you when residents are most likely to want to socialize or are more susceptible to falls. Similarly, you may learn that the first stop for visitors is in one-on-one meetings with medical staff or the business office manager. Further, staff are often pulled in to help residents all over the community, instead of a dedicated floor, to fill ongoing staffing gaps. Those insights can shape the resident, staff, and visitor experience and influence retrofits.</p><p>Yet when it comes time for the building or community to undergo a retrofit, these assumptions are carried out in the planning and construction because real data on actual behaviors is not used.<br></p><h3>The Impact of Relying on Assumptions During Retrofits </h3><p>While the building and amenities get an appealing facelift, a retrofit based on assumptions miss an opportunity to optimize the human experience within the building.</p><p>Here are a few examples of what happens. Dedicated visiting areas feature expensive new furniture that goes unused. The latest tech tools and digital apps looked great and easy to use during the demo, but months later your staff still faces a steep learning curve. Meanwhile, residents find it difficult to adapt to the changes, impacting their quality of life. These issues can be avoided by having a better understanding of how the building is used before the retrofit starts.</p><p>With 42 percent of senior care communities in the U.S. being at least 25 years old, there is a pressing need to upgrade and modernize facilities. This is becoming increasingly critical as demographics shift. By the year 2030, there will be more adults over 60 than there are under that age.</p><h3>Getting Real-Time Insights Without Compromising Privacy</h3><p>Without real insights into how residents, staff and visitors use the buildings, retrofit investments won’t pay off. But how do you get that information?</p><p>You can monitor behavior but that is time consuming, invasive, and lends itself to personal bias. Or you can look at research, but it is often an additional cost and is based on empirical data as opposed to intel specific to your community. Another option is to ask people to participate in a survey, but that, too, is time consuming and opinion based.</p><p>Lately, one way that senior care communities are resolving this issue is by capturing real data on how humans interact in buildings using newer technologies that ensure privacy.</p><p>For example, using thermal heat-sensing technology provides insight into human movements in a space without knowing the individuals that are present. The thermal technology depicts humans as small circles that are moving or stationary. This technology can come in the form of a sensor that goes on the wall, blending into the retrofit design.</p><p>What senior care administrators can infer from the sensor data are insights such as the best location for a visiting area, or when residents are most likely to engage in social activities based on their behaviors as opposed to a scheduled time. From a health perspective, being notified of changes in a resident’s movement allows staff to respond faster to emergencies. These urgent notifications, often a text, reduce technology learning curves because the complex computing is done behind the scenes.</p><h3>The Benefits of Building Insight: Safety, Compliance, and Revenue</h3><p>Having insight into how humans use a building before investing in a retrofit creates an opportunity to boost safety, ensure compliance, and improve the continuum of resident care.</p><p>It can also deliver better returns on the retrofit investment, according to administrators at Ranagård Community, which is using privacy-friendly heat-based sensors in over 700 apartments.</p><p>The sensors work with nurse call systems and immediately alert staff to incidents such as wandering, falls, or an increase in trips to the bathroom. This makes better use of staff time that was previously spent doing scheduled resident check-ins. They also have a digital record of activities, care, and responses in the event of an inquiry.</p><p><span><img src="/Articles/PublishingImages/2024/Honghao-Deng.jpg" alt="Honghao Deng" class="ms-rtePosition-2" style="margin:5px;width:124px;height:171px;" /></span>The community estimates they save $1,875,000 per year by reducing 0.5 falls per year based on an average cost of $5,000 cost per fall, which requires two nurses to accompany a resident to the hospital. With safer buildings, they believe they can increase occupancy by 250 beds, resulting in an additional $2,160,000 per year.</p><p>Each community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used.<br><br><em>Honghao Deng is CEO and co-founder of </em><a href="https://www.butlr.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><em>Butlr</em></a><em>.</em><br></p> | 2025-03-25T04:00:00Z | <img alt="" src="/Articles/PublishingImages/2025/senior_room.jpg" style="BORDER:0px solid;" /> | Design;Architecture | Honghao Deng | Each community must determine their own return on investment on retrofits. Yet as the need for senior care rises and residents demand modern buildings, the retrofit process should always start with a clear understanding of how the building is being used. |
| 10 Elements of Safe, Functional Bathrooms | <p>In a senior living facility, the bathroom is arguably the most important space to providers and their residents. Studies show that most incidents and falls occur in the bathroom. The independence, hygiene, dignity, and safety that occurs in the bathroom is all pivotal. That is why it’s so important to create an environment that supports aging over time and promotes independence for seniors.</p><p><span><img src="/Articles/PublishingImages/740%20x%20740/bathroom.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:250px;height:250px;" /></span>Here are 10 key elements to making a safe, comfortable, and pleasant bathroom environment. </p><p>1. LIGHTING. The amount of lighting the elderly need increases due to changes in aging eyes. Often, mature adults are most disoriented in the middle of the night. The ability to see clearly, and do so seamlessly, is vital for seniors. Automatic lights and night lighting can aid the sense of security and reduce risks throughout the bathroom. During the day, adequate lighting in the shower and tub increases the ability to see faucets and toiletries, reducing the likelihood of slips and falls. Also, it is important to provide proper lighting around the toilet and within the shower area in the event that staff assistance is necessary. </p><p>2. FLOORING and FINISHES. Non-slip flooring and textured finishes reduce the risk of falls. Flooring, especially in wet areas, is critical to meet requirements for slipping as the introduction of rugs or mats can be a tripping hazard. Providing flooring that is glare-free and provides for some level of altering color and contrast improves vision clarity. Be very mindful of transitions from carpet to tile or vinyl to ensure that there is little to no elevation change that may increase the likelihood of a fall. </p><p>3. SHOWERS/TUBS. When it comes to showers, low-threshold showers and collapsible vinyl shower dams are preferred in resident rooms compared to tubs. Weighted shower curtains are key to keeping water where it needs to be along with vinyl collapsible dams that not only assist in keeping water inside the shower but allow for feet and assistive devices to “crush” the dam versus a non-zero entry shower with a fixed 4” lip. Ideally, barrier free entry is the best option. Adequate floor pitch to drains also prevents “ponding” of water, especially if a barrier-free shower area is provided. Moveable shower seating is appropriate for the majority of those in an independent living situation. For all, we must ensure non-slip flooring, and placing grip strips is an optional additional safety measure. However, mats placed on the floor should be avoided in the tub/shower area. Adjustable shower heads and handheld showers, with fixed and multiple docking locations for flexibility allow for staff assisted bathing and ease in resident use. When tubs are desired, specifically designed step-in models with fixed seating are ideal for independent and assisted living and even some skilled care situations. </p><p>4. NURSE CALL SYSTEMS. Be sure to provide emergency pull cords or buttons, strategically placed near the shower/tub and toilet, with no clutter around them. Be certain the location of the call buttons is paired with proper automatic lighting to ensure they can be found in the most difficult of times. </p><p>5. TOILETS. There are several factors related to toilets that we need to be aware of to provide safety and comfort. The American with Disabilities Act (ADA) requirement is that toilets are between 17” and 19” from the floor to the top of the seat. The high end is often too high for older women. We suggest setting the height at the mid-end of the ADA range. We must decide about the type of seat. A closed front establishes a more residential sense, but for toileting assistance an open front is better for staff. Another feature that is helpful to aging vision is to provide contrast of the toilet to the wall and flooring. Most toilets are white, and providing a darker wall helps with visibility.</p><p>6. GRAB BARS. There are many types of grab bars, and their function and placement are crucial. Inside the shower, along the bathtub, and beside the toilet area are all important. In the area of the toilet, those that pivot up when not in use are usually preferred by both staff and residents. With the swing-up types, toilets are placed 24” away from the wall versus 18” for a side wall-mounted grab bar. This allows for more area for staff assistance with double transfers. Another advantage of the swing-up type is that those affected by a stroke, where strength is impacted on one side of their body, can use one side or the other. When non-flexible rear bars or just one grab bar is the only type available, it might not serve them adequately. Additionally, properly placed and enforced towel bars (with textured surfaces) that double as grab bars can provide an additional source of security at sink areas and between the shower and toilet.</p><p>7. FAUCETS. Easy-to-use faucet handles, being mindful of those with arthritic hands, are important. Single-lever faucets are recommended as they are easier to use for arthritic hands with the benefit that residents don’t have to try to blend the two faucets for just the right temperature. Also, the height and distance off the sink ledge is important for infection control. Providing plenty of clearance to properly wash hands is key. Sharper contrast of fixtures, such as contrasting sinks to countertops, provides greater visual clarity to our aging population. </p><p>8. VANITY AREA. Tilt mirrors allow for shorter persons and those in wheelchairs better coverage and visibility. Mirrors should be lower to the sink/backsplash if not the tilt type. Adequate lighting at the mirror reduces leaning in or to one side to gain a clearer view, providing better lighting at the face. The height of the sink should be no greater than 34”, and under the counter should include 27” of clearance to allow for knee space when operating a wheelchair. </p><p>9. ACCESSORIES. In real estate, it is all about location. That is true for the placement of accessories too. Medicine cabinets should be placed on the side wall and lower for better access. Outlets should be placed closer to the edge of the counter so that cords can hang instead of creating a hazard on the counter and closer to the water source. Towel and soap dispensers may differ depending on if they are used by staff or residents. Staff will use single-use paper towel dispensers, where residents may have their fabric hand towels hanging on the front edge of the sink for easy access. Toilet paper dispensers, soap shelves in the shower, and staff care accessories such as glove box holders, are all part of the overall layout. Maintaining the residential feel of the bathroom can be difficult, but it is possible to place these more institutional accessories in spaces not readily visible.</p><p>10. STORAGE. Be sure to provide adequate storage for both residents’ personal belongings and for staff. Staff often need to have access to such items as incontinence products and personal protective equipment). Also, consider the need for secure storage for such items as medicines or cleaning supplies. Proper storage reduces clutter, keeping the floor space clear for walkers, assistance, and more.</p><p><img src="/Articles/PublishingImages/2024/JulieHeiberger.jpg" alt="Julie Heiberger" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" />Be sure to create a senior-friendly design. As we all age, our vision, mobility, strength, range of motion, and cognitive abilities decline. Increasingly, we’re impacted by glare, less contrast, and eye disease. We have a greater need for assistive devices such as canes, walkers, wheelchairs, and grab bars. Our ability to reach heights or step over barriers changes. We might experience greater weakness on one side of our body. Cognitively, we may have greater confusion, forgetfulness, and less desire for social activities. Being mindful of these 10 elements will provide our residents with the ability to safely age in place, maintaining independence to do their daily tasks. <br><br><em>Julie Heiberger is a senior project architect and the Senior Living Market Leader for <a href="https://www.hoffman.net/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Hoffman Planning, Design & Construction, Inc</a>. With more than 25 years of experience, she is a member of the American Institute of Architects and the National Council of Architectural Review Boards. She received her Master of Architecture from the University of Wisconsin–Milwaukee. Email Heiberger at <a href="mailto:jheiberger@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">jheiberger@hoffman.net</a>.</em><br><img src="/Articles/PublishingImages/2024/JonRynish.jpg" alt="Jon Rynish" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /><br><em>Jon Rynish is a senior project architect with Hoffman and a Leadership in Energy and Environmental Design (LEED) accredited professional. A graduate of the University of Wisconsin-Milwaukee with a Bachelor of Science in Architectural Studies, he has more than 15 years of experience in the design profession. Email Rynish at <a href="mailto:jrynish@hoffman.net" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">jrynish@hoffman.net</a>.</em><br></p> | 2024-03-19T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/bathroom.jpg" style="BORDER:0px solid;" /> | Design;Caregiving | Julie Heiberger and Jon Rynish | In a senior living facility, the bathroom is arguably the most important space to providers and their residents. Studies show that most incidents and falls occur in the bathroom. |
| Designing Therapeutic Gardens for a Senior Population | <p><img src="/Articles/PublishingImages/740%20x%20740/garden.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:250px;height:250px;" />Therapeutic landscape gardens (TLG) are often designed for elders in nursing homes and senior housing to provide a soothing experience for the resident that brings them outside, closer to nature, and closer to the beauty of a well-designed garden. This senior population may exhibit a series of invisible disabilities (IDs), such as dementia, autism, PTSD, ADHD, sensory processing disorder, blindness, and deafness. These IDs can be found in up to half or more of the typical population and at least 80-90 percent of the elder population.</p><p>There are many articles about the design of these TLGs, but not many deal with the two main challenges in designing these gardens: a lack of instructions and reduced perception.</p><p>The first issue is the lack of an instruction set on how to design an elder therapeutic garden. Most books on TLG show all kinds of images of wonderful gardens, but none of them have an instruction set that will help a designer understand the steps that must be taken in order to design one correctly for elders. By 80, the typical elder has 20 percent of their visual performance range; by 90, it drops to 10 percent. Visual acuity is low, they cannot see clearly with sky brightness, colors are not easily distinguished, adjustment from dark to light takes 10-15 minutes. Vision can be very limited.</p><p>The second issue, which is even more important, relates to aging and sensory deprivation. Elders in nursing and dementia homes are generally coping with very limited ranges of sensory sensitivity. An older resident has perceptual sensitivity dramatically lower than when they were younger. By age 80-90, the sensory sensitivity of an elder is about 10-20 percent of what it was when they were young. Thus, their vision, hearing, tactile sense, thermal and olfactory sensitivity is very low. Their experience of the sensory garden can be limited compared to young designers who design these gardens, because that have a hard time seeing the garden, dealing with sky glare, recognizing color ranges, and smelling the flowers. Audible insensitivity can mean that they cannot hear the sounds of unsteady walking, low level talking of nurse aides, and other sounds over the environmental noise of the site.</p><p>To the elder resident, the gardens look less clear and more out of focus. They see groups of plantings, not individual plants. Colors blend together, as color vision is limited in range, resolution, and sensitivity. The design of the garden must take account of the fact that many elders have visual acuity in the 20:100 or greater (they see at 20 feet what younger folks see at 100 feet).</p><p>If the site is noisy or busy, the sounds of traffic, idling car engines, and people are all of concern. And areas that are light versus dark can cause visual failure due to slow adaptation (visual adjustment from light to dark). These areas can also cause a cognitive load due to complexity that is too great for the elder to process, as too much information is presented in the perceptual and cognitive fields. The experience is often unnerving and overwhelming. Overstimulation of the senses affects our sense of vestibular equilibrium (balance) as well. </p><p>Well-designed environments can alleviate these problems, via the use of scientific sensory and cognitive design principles. Yet most design schools do not teach about human perception or the science of human-centered building design.</p><p>Design schools believe, as the American Institute of Architects suggests, that expert intuition comes from a design education, and that this alone is adequate training to solve most architectural problems, which is far from correct. Intuition only works when designing for people who are like the designer, and those with disabilities are not often like the designer.</p><h3>Reducing Sensory Noise </h3><p>The experience of disorientation and discomfort are important to avoid when designing for people with invisible disabilities. Unlike physical disabilities, over 70 percent of disabilities cannot be seen or inferred by observers. Cognitive and emotional sensitivities often negatively impact the experience of the garden by masking the experience by causing complexity to take focus away from what we’re looking at.</p><p>Overstimulation in any of the primary senses (hearing, sight, thermal comfort, touch, taste, and smell) creates mental and emotional “noise.” Less sensory stimulation means more clarity in surroundings. Designs should be simpler and more obviously what elders would expect. It is the first priority to understand their sensory and cognitive perceptions.</p><p>Therapeutic gardens should be designed to produce calm, clarity, and the feeling of beauty. The places in the garden must be symbolic and familiar. The framework of a garden needs to be clear, predictable, intuitive, safe, and secure with a perceived sense of balance of freedom and enclosure.</p><p>A quiet perceptual sensory environment is needed for people to experience the environment with less anxiety and more clarity. And the garden must be a stronger and simpler stimulus than would be designed for younger visitors.</p><h3>Integrating Research into Designs</h3><p>Designers who incorporate scientific design information in ways that are perceptually and cognitively much clearer are more successful. Research-based design (RBD) is about applying research methods to determine the definition of what the design should accomplish and to measure and confirm that the final project actually achieves that goal.</p><p>The first step in RBD is to identify the problem and to develop a hypothesis for solving it through the limits of the person with dementia or other disability. People with dementia must be asked to rate their perception based on comfort and pleasure. Landscapes focused on the elderly must take into consideration perceptual performance. Design research has produced lots of data on sensory and cognitive perception of elders.</p><p><img src="/Articles/PublishingImages/2023/SteveOrfield.jpg" alt="Steve Orfield" class="ms-rtePosition-1" style="margin:5px;width:167px;height:189px;" />Consider the model of a monastery garden, as it evokes calm and peaceful emotions. A cloister garden is surrounded by walls that create an enclosure separated from outside distractions and uncomfortable sounds. The layout is simple and allows for walking around the edges of the garden space. Typically, central landmarks and clarified entrances can help with finding the way back to the entry. Visually it can be a simple structure with vegetation and greenery. Areas must be set aside for gardening and harvesting of flowers, herbs, and vegetables. </p><p>To achieve acoustic comfort, designers may create sound barriers, soft music, white noise, or birdsong. Olfactory comfort may be pleasant fragrances of the plantings, clean air, and limits on odors. Thermal comfort may include places that are sunny in cold weather and shady in hot weather, protected from wind but open to breezes. Visual comfort may be creating large plantings of color, familiar furnishings and plants, clear surroundings, and pathways, with control of bright light.</p><p><img src="/Articles/PublishingImages/2023/MarthaTyson.jpg" alt="Martha Tyson" class="ms-rtePosition-2" style="margin:5px;width:167px;height:190px;" />The end result of this therapeutic garden design process is a very simple, very clear garden that is uncomplicated, has little perceptual noise, and whose simplicity allows the elders to relax and clearly experience this simpler form of garden.</p><p><em>Steven J. Orfield is the founder of Orfield Laboratories, a multi-sensory design research lab in architecture and product development.</em></p><p><em>Martha M. Tyson is the author of the book The Healing Landscape: Therapeutic Outdoor Environments and numerous articles about garden design for seniors and people with compromised cognitive functioning. She is a landscape architect with over 30 years of experience in site design and campus planning.</em><br></p> | 2023-10-03T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/garden.jpg" style="BORDER:0px solid;" /> | Design | Steven Orfield and Martha Tyson | Therapeutic landscape gardens are often designed for elders in nursing homes and senior housing to provide a soothing experience for the resident that brings them outside, closer to nature, and closer to the beauty of a well-designed garden. |
| Innovation in Senior Living Facilities Design | <p>The pandemic shone a light on senior living infrastructure that has leaders and staff of assisted living and skilled nursing facilities looking for progressive and innovative design concepts. As such, senior housing providers from around the world are looking to learn from the successes and challenges that various models faced at the height of the pandemic. </p><h3>Early Adopters of the Green House Model in Rochester, NY</h3><p>Founded in Rochester in 1997 by a group of forward thinkers, the Pioneer Network has since evolved through a partnership with The Green House Project (GHP) into the Center for Innovation. The new alliance focuses on supporting eldercare reform initiatives and educating and advising eldercare organizations that seek to initiate changes to the cultural, organizational, and physical structures of the traditional nursing home. </p><p>Upstate New York is home to early adopters of the Green House model, giving the region two decades of experience with a model that others are now beginning to recognize, due to exceptional outcomes during the pandemic. <br></p><h3>Design Tenets of the Green House Model</h3><p><span><img src="/Articles/PublishingImages/740%20x%20740/innovation.jpg" class="ms-rtePosition-1" alt="RPH Creekstone Memory Care Small Homes in Perinton, New York" style="margin:5px;width:200px;height:200px;" /></span>The primary objective of the Green House model is to provide a culture and environment where seniors can continue to grow and thrive in a period when they may be experiencing physical or cognitive decline. The model strives to create meaningful life and purpose for both residents and staff, leading to enhanced quality of living and improved clinical outcomes for residents, higher levels of satisfaction among residents and their family members<sup>1</sup>, and greater workplace satisfaction and lower levels of stress for frontline caregivers.<sup><a href="https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf" target="_blank">2</a></sup> <br></p><p>There are multiple design elements that contribute to these results, including a small-scale environment, private bedrooms with private bathrooms, living rooms and other open public spaces, communal dining areas, access to outdoor spaces, and consistent staffing.</p><h3>Green House Model Benefits</h3><p>The pandemic in particular brought more attention to the benefits of the small-house/Green House model. According to a study published in the Journal of Post-Acute and Long-Term Care Medicine, the small-scale environments of Green House and other nontraditional nursing home models proved advantageous, experiencing significantly lower levels of infections and mortality when compared to traditional nursing homes with larger bed counts.<sup><a href="https://www.jamda.com/article/S1525-8610%2821%2900120-1/fulltext" target="_blank">3</a><br></sup></p><p>In addition to better clinical outcomes for residents, the Green House model offers many other benefits, including flexibility that allows for modification of occupancies as needs change (e.g., skilled nursing, memory care, rehabilitation, hospice), more private pay residents, daily costs that are lower than the traditional nursing home model<sup><a href="http://www.greenhouseproject.org/" target="_blank">4</a></sup>, and greater staff retention. Moreover, data collected by GHP reveals that even after the pandemic, Green House homes have reported significantly lower turnover rates for CNAs, LPNs, and RNs.<sup><a href="https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf" target="_blank">5</a></sup> This is particularly notable as staffing continues to be a critical concern and maintaining staff with a lower turnover rate may offer a competitive advantage.</p><p><img src="/Articles/PublishingImages/2023/RobertSimonetti.jpg" alt="Robert Simonetti" class="ms-rtePosition-2" style="margin:5px;" />Green House living represents a set of design criteria that reconfigures the operations and environments of a traditional nursing facility into an “intentional community” that offers person-centered care focused on relationships and people. Data is mounting that suggests this design initiative also provides several benefits, including better quality of living for residents, lower levels of infections and mortality, lower staff turnover rates, and lower daily costs. New programs and funding opportunities may encourage, require, and facilitate these innovative models further. </p><p><em>Rob Simonetti is senior living leader at LaBella Associates. He has focused the last 15 years of his career on small house models of care for skilled nursing occupancies. </em><br><br><span class="ms-rteStyle-Normal">References</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">1.    "Effects of Green House Nursing Homes on Residents’ Families" by Terry Y. Lum, M.S.W., Ph.D., Rosalie A. Kane, M.S.W., Ph.D., Lois J. Cutler, Ph.D., and Tzy-Chyi Yu, M.H.A., Ph.D.</span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">2.    "The Green House Difference: By The Numbers," <a href="https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf" target="_blank">https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf </a></span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">3.    "Nontraditional Small House Nursing Homes Have Fewer COVID-19 Cases and Deaths," Journal of Post-Acute and Long-Term Care Medicine, <a href="https://www.jamda.com/article/S1525-8610%2821%2900120-1/fulltext" target="_blank">https://www.jamda.com/article/S1525-8610(21)00120-1/fulltext</a></span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">4.    "Pilot Study Finds Meaningful Savings in THE GREEN HOUSE<sup>®</sup> Model for Eldercare," <a href="https://www.greenhouseproject.org/" target="_blank">www.greenhouseproject.org</a> </span><br class="ms-rteStyle-Normal"><span class="ms-rteStyle-Normal">5.    "The Green House Difference: By The Numbers," <a href="https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf" target="_blank">https://thegreenhouseproject.org/wp-content/uploads/The-Green-House-Difference.pdf</a> </span><br><br></p> | 2023-05-16T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/innovation.jpg" style="BORDER:0px solid;" /> | Design | Robert Simonetti | The pandemic shone a light on senior living infrastructure that has leaders and staff of assisted living and skilled nursing facilities looking for progressive and innovative design concepts. |