4/28/2009 1
10th ANNUAL WESTERN HUD LENDERS CONFERENCEGolden Nugget Hotel – Las Vegas, Nevada
April 27-29, 2008
Western Mortgagee Advisory Council
SECTION 232 LEAN – LESSONS LEARNED
Culture Change and Skilled Nursing Design
Douglas Pancake, AIAPrincipal
4/28/2009 2
3
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Country Crest Skilled Nursing FacilityOroville, California
4/28/2009 3
California Building Code 2001 (CBC 2007)• 104.2.8 (111.2.4) Alternate materials, alternate
design and methods of construction. The provisions of this code are not intended to prevent the use of any material, alternate design or method of construction not specifically prescribed by this code, provided any alternate has been approved and its use authorized by the building official.
Alternate Method of Compliance• Alternate means of protection• Alternate methods of construction• Program Flexibility
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Country Crest Skilled Nursing FacilityOroville, California
4/28/2009 4
Specific Areas where this design deviates from the Code
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Country Crest Skilled Nursing FacilityOroville, California
4/28/2009 5
Great room and therapy kitchen
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.Country Crest Skilled Nursing Facility
Oroville, California
4/28/2009 6
Greenhouse for the Arizona Baptist Retirements CentersPhoenix, AZ
Shown w/ permission of the McCarty Companies
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DW
R /F
DW
R/F
R/F
DW
DW
1
2
34
5
6
7
8
910
11
12
13
14
15
16
17
18
1920
LO BBYSNF 10058 4 S. F.
STO RAG ESNF 101114 S .F.
UN IT 2BSNF 102523 S .F.
UNI T 1BSN F 103322 S. F.
UN IT 1BSNF 104327 S .F.
UN IT 2BSNF 105495 S .F.
UNI T 1BSNF 106353 S. F.
UN IT 1BSN F 107351 S.F.
UN IT 1BSNF 108351 S .F.
UNI T 1BSNF 109356 S. F.
UNI T 1 BSNF 110321 S. F.
UNI T 2BSNF 111634 S. F.
UN IT 1BSN F 112484 S .F.
UNIT 1BSN F 113
328 S.F.
UN IT 2BSNF 145500 S .F.
UNI T 2BSNF 146500 S. F.
UN IT 1BSNF 147322 S .F.
UNI T 1BSNF 116329 S. F.
UNIT 1BSN F 115
336 S.F.
UN IT 1BSNF 114337 S. F.
UN IT 1BSN F 113376 S .F.
STOR .SNF 11741 S.F.
SOI LED LIN ENSNF 117163 S.F. FAM ILY
SNF 118148 S. F.
STO RAG ESNF 119
26 S. F.
CLEAN LI NENSNF 120116 S .F.
ELECT RI CALSNF 121107 S .F.
LI VI NG AN D DIN IN G ARE ASNF 122
1,149 S. F.
CI RC ULATI ONSNF 123
2,317 S. F.
RES TRO OMSNF 124
89 S. F.
NU RSI NG O FFI CESNF 12572 S .F.
M ED RMSNF 12661 S .F.
COUN TRY KI TCH ENSN F 128
241 S.F.
NURS E S TATI ONSN F 127
107 S.F.
AC TIV ITY RMSNF 129266 S. F.
WAR MI NG KI TCH ENSN F 130228 S .F.
JAN.SN F 131
56 S. F.
BI O HZDSNF 13238 S.F.
HA LLSN F 1 3396 S. F.
CLEAN LI NE NSN F 134144 S.F.
LIV IN G AND D INI NGSN F 13 8
1, 739 S .F.
CO UN TRY KI TCH ENSN F 137241 S .F.
MED RMSNF 135
61 S.F.
NURS IN G OFFI CESNF 136
72 S.F.
ACT IVI TY RMSN F 13 9
256 S.F.
UNI SEX RRSNF 140
69 S. F.
ELEC TRI CAL RMSNF 141116 S. F.
STO RA GESN F 142
72 S. F.
SO ILE D LIN ENSN F 143114 S .F.
FAM ILY R OO MSNF 144234 S .F.
UNI T 1BSNF 148324 S. F.
UNI T 1BSNF 149324 S. F.
UNI T 1BSNF 150358 S. F.
UNI T 1BSNF 151324 S. F.
UNI T 1BSNF 152360 S. F.
UNI T 1BSNF 153358 S. F.
UNI T 1BSNF 154324 S. F.
UNI T 1BSNF 155324 S. F.
UNIT 2BSN F 15 6
470 S.F.
UNI T 1BSNF 157358 S. F.
MEC H BOO STE R RM .SNF 159336 S. F.
BATHT UB RMSNF 158
73 S. F.
CI RC ULATI ONSNF 160
2,505 S. F.
ACTI VI TY RMSN F 187260 S.F.
STO RAG ESNF 186
73 S. F.
UNI T 1 BSNF 161330 S. F.
UNI T 1 BSNF 162324 S. F.
UNI T 1 BSNF 163324 S. F.
UNI T 1 BSNF 163324 S. F.
UNI T 1 BSNF 164324 S. F.
UN IT 2BSN F 165478 S .F.
UNI T 1 BSNF 166329 S. F.
UNI T 1BSNF 167352 S. F.
UN IT 1BSN F 168352 S .F.
UNIT 1BSN F 16 9
324 S.F.
UN IT 1BSNF 170324 S .F.
UNI T 1BSNF 172324 S. F.
UN IT 1BSNF 173325 S .F.
UNI T 2BSNF 171594 S. F.
UNI T 2BSNF 174607 S. F.
JA N CL.SNF 18340 S .F.
MED RMSNF 18461 S .F.
NU RSI NG O FFI CESNF 18576 S .F.
NUR SE STATI ONSNF 188
N/A FAMI LY RO OMSNF 180169 S. F.
COU NTR Y K ITC HENSN F 181207 S. F.
WA RM ING K ITC HENSN F 182164 S.F.
LIVI NG AN D DI NIN GSNF 1761, 276S. F.
CLEAN LI NENSNF 178116 S .F.
SO ILE D LIN ENSN F 177117 S .F.
BI O HZDSN F 17964 S .F.
STOR AGESN F 15873 S .F.
STO RAG ESNF 158
73 S. F.
STOR AGESNF 17566 S .F.
LOB BYSNF- R 101
73 S.F.
MEN 'S RRSNF- R 115
184 S. F.
WO ME N'S R RSN F- R 116184 S.F.
SNF LOC KERSSNF- R 114
260 S. F.
EXI T S TAI RSN F- R 11 3
282 S. F.
STAF F R MSN F-R 111
307 S .F.
TH ERA PY RMSNF -R 110
130 S .F.
TREAT MEN T R OO MSSNF- R 109
528 S. F.
REC EPT IO N/ RE CEI VI NGSNF- R 102
258 S. F.
HA LLSNF -R 112
197 S .F.
WOR K/ FI LESSNF- R 104
223 S. F.
ELEC T R MSNF -R 106
67 S. F.
UN IS EX RRSNF- R 107
113 S .F.
EX IT STAI RSNF- R 108
73 S .F.
WO RKS TATI ONSSNF- R 103
218 S. F.
ELEV EQ .SN F-R 105
65 S. F.
SNF ENTRANCE
+2 3"
V E ND I N G
LO C K E R S
1 2
3
LOCK ABLE
LO C K E R S
M E N
WO M E N
BUILDING 5SEE OVERALL SITE PLAN
FOR IN FO RMATIO N
R/ F
R/F
R/ F
R/ F
FD C
• A true cluster plan provides home-like activities right outside the bedroom unit
• Open floor plan
• Maximum orientation
• Activities on demand
• Maximum supervision Centrally located Two Story Administration and Rehabilitation Building • Proposed Structural System for Two Story: Concrete Masonry Shear Walls ( or concrete ) Flat Concrete Slab Floor and Interior Concrete Columns
The Terraces at San Joaquin Gardens SNF Households
Household One
Household Two
Household Three
TWO STORY REHABILITATION
and
ADMINISTRATION
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4/28/2009 14
Pediatric Acute Care Rehab at Totally KidsSan Bernardino, California
4/28/2009 15
Pediatric Acute Care Rehab at Totally KidsSan Bernardino, California
4/28/2009 16
Pediatric Acute Care Rehab at Totally KidsSan Bernardino, California
4/28/2009 17
New Care Center at Desert Valley HospitalVictorville, California
4/28/2009 18
New Care Center at Desert Valley HospitalVictorville, California
4/28/2009 19
New Care Center at Desert Valley HospitalVictorville, California
4/28/2009 20
New Care Center at La Jolla Village Classic Residence by Hyatt, La Jolla, California
4/28/2009 21
10th ANNUAL WESTERN HUD LENDERS CONFERENCEGolden Nugget Hotel – Las Vegas, Nevada
April 27-29, 2008
Western Mortgagee Advisory Council
SECTION 232 LEAN – LESSONS LEARNED
Culture Change and Skilled Nursing Design
Thank you…
Douglas Pancake, AIAPrincipal