The Situation:

John Knox Village, a private, non-profit organization and the largest continuing care retirement community in the country consisted of 1850 independent living units, a 298 bed skilled nursing facility, a 100 bed community hospital and a wide variety of support services for it's 2200 residents whose average was 87. While Village services were excellent it's existing skilled nursing facility was not meeting the needs of the Village residents. In addition, actuarial projections indicated that even more beds would be required in the not-too-distant future. This need for capital investment in a new facility was occurring at a time when reimbursement from all sources - government, private and Village residents was under significant strain. However the Village also strained to honor its obligations to residents. At times as many as 45 residents were being cared for in outside nursing homes at Village expense.

 

The Solution:

An analysis, conducted internally, conclusively showed that over a ten year period it would be far more cost effective to abandon the existing 298 facility and construct a new, replacement, 420 bed facility on a new site. While detailed planning was begun, efforts were made to build Village resident support for the largest construction project undertaken since the Village itself had been built 17 years earlier.

The 2200 residents of John Knox Village belonged to 86 different clubs and organizations. During a one-year period, senior managers in the Health Services Division of the Village visited each of these groups at least once. Weekly articles were written for the Village newspaper and individual letters were sent to residents and their families. At the end of the year a non-binding vote was taken. Of the 1400 residents present only 6 opposed building the new facility.

With resident support at a high level, planning went forward on a unique, one-story design. A key element of this new facility was a 36 bed Alzheimer's unit. To assure that the latest research and real life findings were considered, senior management worked with the Swedish Gerontology Institute and reviewed Swedish care for dementia patients.

Finally, because early research indicated a risk of death for as many as 50% of the patients who would move from the old facility to the new, a team was established to find ways to prevent these deaths from transfer trauma. This team, made up of researchers from several universities as well as Health Service Division staff, worked for more than eight months to find solutions. Through the work of this group which was joined by volunteers, no cases of transfer trauma occurred and the new facility opened ahead of schedule and under budget.