Preparing for a Post-COVID World: Inside a $41M Private-Room Skilled Nursing Facility Renovation

Even prior to the onset of the COVID-19 pandemic, the team at Vi at Bentley Village knew that a skilled nursing facility with all single rooms was a necessity for the future.

Leaders at the full-continuum senior living campus in Naples, Fla. set their sights on the conversion of their existing SNF about 18 months ago. Built in the 1980s, the SNF building had a total of 100 beds spread across 72 rooms, necessitating a certain portion of semi-private rooms at any given time.

As newly renovated independent living units sprung up elsewhere on the property as part of a campus-wide upgrade project, the need to address the aging SNF increased.

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“This was really the last big piece of what I would call our support infrastructure for the community,” John Hoover, vice president of project management at senior living operator Vi Living, told SNN.

COVID-19 threw some roadblocks in front of the renovation effort, with planning meetings moved online and additional challenges in securing the necessary permitting approvals from the Florida Agency for Health Care Administration. But after the pandemic exposed the clear need for better nursing home infrastructure, Vi at Bentley Village was able to announce plans for the $41 million project late last month, with a targeted start date sometime in the third quarter of this year.

Outside of resident safety, the goal of the renovation is to bring the operator’s skilled nursing and assisted living offerings in line with its luxury senior living products.

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“We’re not a typical senior living community, and we felt that we wanted to bring our care venues to have the same appeal to people as all of our independent buildings do,” Vi at Bentley Village executive director Penny Smith said.

That process includes the conversion the existing skilled nursing units to 84 single rooms, complete with private bathrooms, across two floors of the building. The extra 12 rooms come through the addition of a new wing to offset the reduced capacity that automatically comes with a private-room conversion; the new portion of the building will also help Vi maintain resident access to its SNF services during the renovation process.

Vi at Bentley Village will also expand its assisted living property, complete with the addition of 15 memory support apartments, as part of the project.

The work will continue in three phases, with residents moved as new units are completed, over the course of a planned 18-month construction period. The process isn’t without some disruption to residents, but Hoover and Smith said the reception has been positive — particularly for family members concerned that their loved ones may have been forced to sacrifice privacy if and when they required more intense skilled nursing care.

The company is largely following the same multi-tiered strategy that it used when upgrading its independent living infrastructure on the Naples campus over the last eight years.

“We knew we were going to lose unit count for a short period of time, but the gain at the end is really worth it,” Hoover said.

The push to private rooms has already emerged as a key strategy for operators looking to navigate a post-COVID world, both to bolster infection control and cater to the needs of residents and their families.

“Moving forward, private rooms will become non-negotiable, as will enhanced infection control and safety protocols that may not have been part of normal operations historically,” consulting firm Plante Moran observed in a recent report. “Take a look at your dining and common areas. How can you balance opportunities for social interaction with infection control?”

Neil Pruitt Jr., CEO of major nursing home operator PruittHealth, last month told SNN that a “very robust” renovation project, focused on increasing the total share of private rooms in its portfolio, was central to his company’s continued success.

“We do expect that [on] the census, people are going to demand private rooms. An operator’s ability to shift and meet those needs will depend how quickly they are able to recover,” Pruitt said. “To give you an idea, we currently have 14% of our inventory that is dedicated to private rooms. We think this will increase to 17% of our inventory within the next 12 months. Within two years, this will be 25% of our inventory, and it’ll be 32% within five years.”

Nursing home consulting firm Zimmet Healthcare Services Group even went so far as to suggest that operators should voluntarily surrender bed licenses — something of a heretical statement in an industry where “heads in beds” serve as the primary revenue stream — to both facilitate the creation of single-occupancy rooms and take advantage of some attendant cost savings.

“People look at you like you have two heads,” Marc Zimmet, president of consulting firm Zimmet Healthcare Services Group, told SNN back in January. “But it’s part of a bigger calculation.”

For Vi at Bentley Village, part of that calculation was realizing that despite having a license for 100 beds, the SNF typically had capacity to spare even before the COVID-19 pandemic required the creation of dedicated areas for coronavirus patients.

“Especially during COVID, with having our own COVID wing at all — it’s been years since we’ve been even close to being at that capacity,” Smith said.

In addition to creating dedicated isolation units that can help the operator withstand a future pandemic, the renovation process will also bring smaller touches that are still vital to the resident experience, from new outdoor balconies and common areas to a modern electrical system that can support tech like an audiovisual system, strong WiFi, and internal cell phone coverage.

The completed facility will also have a 5,700-square-foot therapy gym, with the goal of incorporating home health and wellness services into the existing SNF offerings.

“We’re taking a building that was built in the ’80s — it was an analog watch — and we’re turning it into a smart watch,” Hoover said.

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