Why Skilled Nursing Needs to Take Cues from Hotels

Ten seconds.

That’s how quickly some consumers make up their minds about a skilled nursing facility.

They make that decision upon entry, as they look at the lobby, the seating, the art on the walls. It’s the reason some skilled nursing design experts believe that SNF operators must pay more attention than they already do to the layout and decor of public areas in their buildings.


And it is just one of the reasons that providers should start taking more design cues from hotels and the hospitality industry, according to a new report from Skilled Nursing News and Senior Housing News.

“We are seeing a lot of health care properties look a lot more like the hospitality world,” said Zeke Turner, founder and CEO of the Indiana-based senior housing developer Mainstreet. “When you enter them, if you didn’t know you were there for a medical use, you would probably think you were walking into a hotel.”

The new report, “Inside the Future of Skilled Nursing Design,” offers SNF operators, architects, and designers a lot to consider about the benefits of embracing the hospitality ethic in the design of SNFs. Here are three lessons providers can learn from the world of hotels.


Lesson 1: SNF operators should pay attention to the design of public spaces, especially entrances and lobbies

The 10-second rule comes from Dean Maddalena, president of the Austin, Texas-based interior design firm studioSIX5. He recommends that skilled nursing providers think long and hard about the style and design in entry areas and main lobbies — places that will host not just residents and prospective residents but, crucially, their family members.

“In skilled nursing, with the financials that the owners and operators and developers have, we have to be extremely conscientious about designing spaces that give you the most bang for your buck,” he said.

There are two business imperatives at play, Maddalena says. The first is obviously the first-10-seconds rule, as it plays a role in skilled care choice. But the second is that comfortable, welcoming public spaces increase both resident socialization and outside visitors. These elements improve resident satisfaction. And because standalone skilled nursing is heavily driven by medical community referrals, the word gets around that the environment is hospitality-driven.

Lesson 2: Private rooms are becoming a must-have

Whether on a long- or a short-term basis, the day-to-day experience of SNF occupants is influenced heavily by their rooms. And more and more, residents are demanding private or at least semi-private rooms.

“One of the number-one factors when someone is choosing a nursing home is that they are going to choose a private room when they can,” said Martin Siefering, principal at architecture firm Perkins Eastman.

Long-term residents desire privacy because they are going to sleep in their rooms for potentially the remainder of their lives. Short-term residents want privacy partly for physical reasons — both because their stay is spent rehabbing and recovering, and because they are coming from a hospital and may be bringing germs into the SNF.

They also want privacy because they typically end up discussing sensitive physical, medical, and financial matters with the friends and family who visit during the course of a rehabilitation stay.

“More and more, when we are designing new, these private rooms have full bathrooms … so that residents aren’t in a common bathing or shower space, which is the norm for older facilities,” Siefering said. “None of us would choose that.”

Lesson 3: Providers must do more to meet the service expectations of today’s SNF residents

“The Depression-era generation was largely willing to accept what was available without a whole lot of complaint,” Turner said.

But the times, to use a baby boomer phrase, are a-changin’.

Boomers have a “very high level of taste” for what they expect from health care, Turner said, as do younger people who are entering short-term stays with an expectation of getting healthy and returning to work.

Combine these two groups and you see two pieces of a consumer profile. The first is a consumer who is more apt to decline an offering, even when being released from a hospital on a short-term basis.

The second is a consumer who interacts with skilled nursing more like a hotel than a hospital, showing brand loyalty and a willingness to travel further for a higher-service offering.

This consumer pickiness on both a long- and short-term basis can cause delays in care and added strain on the health care system. And according to Mainstreet’s proprietary research, 25% of people who have a rehab and therapy stay following a hospital procedure have a negative experience.

“The problem is that health care in general views that number as being really good, but consumer research says that it is actually a failure,” Turner said. “We need to have satisfaction ratings that are in the high 90s, and we have a long way to go there.”

This article draws from the new report, “Inside the Future of Skilled Nursing Design.”

Click here to access the complete report, which takes a deep dive into SNF design, and reveals how industry leaders are using design to improve care, increase resident and staff satisfaction, and build their brand awareness — all while remaining on budget.

Written by Jack Silverstein

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