Best Skilled Nursing Design 2022: LTC, Rehab, Memory Care Neighborhoods with Southern Charm

Some things about life in Charleston, South Carolina are slow to change. Known for its cobblestone streets, southern cuisine, and rolling beaches, the concept of preservation is celebrated by the historic city.

Yet in the years leading up to the pandemic, Sarah Tipton, CEO of Bishop Gadsden, could sense that the 172 year-old Episcopal retirement community might need a little room to grow.

“We knew that we were going to face a time where we were not going to have the beds that we needed and not have the ability to grow our services in the way that we have hoped to be able to,” Tipton said.


Looking at the growing population in Charleston and considering their market, Tipton and her team devised a plan.

“We thought, we really have an opportunity not only to serve our residents in a substantial, new way, but also to serve the greater Charleston community in a way that was kind of lacking,” she said. “So we developed a program that would take care of our long-term care needs, our memory care needs, but also enable us to have a new program element: dedicated, post-acute rehab beds.”

For a couple of planning cycles, the idea was to revise and reconstruct existing facilities on the Bishop Gadsden campus. Yet the team realized the current site would limit the size and graciousness of the rooms they envisioned. So, they began looking at building a new facility adjacent to their current campus.


“We just got very fortunate that the property became available to us at the right time,” Tipton said.

The team broke ground on construction of the new Gadsden Glen in November 2019 and completed the project in May 2022. The facility consists of 32 memory care, 32 rehabilitation and 68 skilled nursing beds.

  • Bishop Gadsden bistro (click below to advance)

The project was so successful in achieving its vision that it recently garnered top honors in the skilled nursing/post-acute category of the 2022 Architecture & Design Awards bestowed by Skilled Nursing News’ sister publication, Senior Housing News.

The concept

While Gadsden Glen is centered around care, hospitality played a key role in the concept. Bishop Gadsden is a huge foodie campus, Tipton said.

“We’re very focused on our culinary programs, we’re really intentional about our activities, and all of our social and artistic and intellectual programming that happens,” she said. “And so we wanted to make sure we had great culinary opportunities, great programming opportunities for residents, and really gracious living spaces.”

Upon walking into Gadsden Glen, visitors and residents are greeted by an elegant, sunny two-story library and sitting area featuring a grand fireplace and skylight, next to an open-concept bistro and gift shop.

The building blends elements of the traditional lowcountry architecture found regionally and elsewhere on the campus with forward-looking contemporary design attributes like black storefront window frames and lapped siding, Tipton said.

She and her team wanted the space to feel open, and like a contemporary home. Resident rooms were designed around multiple floor-to-ceiling windows and a separate lounge area offset from the sleeping area.

The design features four long-term care neighborhoods of 16 residents each; two memory care neighborhoods of 16 private residences each; and two short-term skilled rehab neighborhoods of 16 private rooms each.

Each pair of neighborhoods has its own dining area serviced by the central kitchen, and a full kitchen as part of their great rooms. Resident rooms feature separate lounge area offset from the sleeping area, as well as private bathrooms with full showers.

“They have almost an anteroom that you walk into, and then the room for the bed is around the corner and around the bathroom,” said architect Chris Linkey, partner at RLPS Architects. “So when you open that door, the first thing you see is a window in front of you and daylight coming in.”

Tipton said executives also wanted to carry over the open and airy design concepts to staff areas. Gadsden Glen features a large employee lounge with a variety of seating and meal options, a bistro kitchen, lockers, showers and a mother’s nursing room.

“We allocated a great deal of square footage and culinary energy and programming to our team member space,” she said.

The construction

The building was designed by RLPS, and Samet Corporation completed the construction. Linkey said one of the leading values of the project was carrying over a warm and welcoming architectural design without an institutional feel. Even the oxygen tubes and other medical technologies featured in the rooms are concealed behind the walls, which are adorned with original artwork.

“Those were our beginning moves for that and then everything else kind of fell together from there,” he said.

Bishop Gadsden executives were heavily involved with even the smallest design choices.

  • Rehab gym (click below to advance)

“I remember them talking to us specifically about their memory care residents, and the concern over moving them into a new memory care environment,” Linkey said, adding that maintaining some consistent design cues from the existing communities aided the smooth transition.

Tipton said that while the pandemic presented challenges to the construction process, the team made it successful and even enjoyable despite the conditions.

“COVID was an unexpected challenge,” Linkey said. “So was keeping the project going with supply chain issues, staff availability, or sometimes when COVID would break out on the site and the whole electrical contractor would have to move off site because most of their guys were infected.”

But the team at Bishop Gadsden was consistent and involved, offering input throughout the process. The pandemic spurred Tipton to convert an entire unit to be fully negatively pressurized.

“Knowing that communicable diseases and easily transmissible pathogens could continue to arise, we felt like it was prudent to make that change,” she said.

The completion

Enjoying the past holiday season with residents and family members has been the greatest affirmation of the success of the project, Tipton said.

“What I hear from our family members is that they love the gracious spaces and they love that there’s a bistro right there,” she said. “When you come in, there’s a place to gather and grab a bite or get some coffee. It feels like a place you want to go, and so [resident’s] grandkids want to come and be in this space.”

Tipton has also received positive feedback from staff, who are enjoying the new dining space.

“I think the people in the old building are jealous of the new building staff,” Linkey said.

Eric Krull, a judge of the SHN awards program and Executive Vice President of THW Design, which specializes in senior living development, said the concept is unique because it isn’t often there is a chance to design many long-term care, rehab and memory care programs all under one roof.

“And it really feels like you’ve walked into someone’s home with a great room plan, if you will,” he said. “Just right off the bat when you arrive, it could even be a nice hospitality boutique hotel, which is not uncommon in Charleston.”