Best of Skilled Nursing Design 2014: The Post-Acute Trailblazer

Wellness and technology. Those two elements are buzzwords in the post-acute care space, and one skilled nursing facility is putting a whole new twist on what it means to achieve those goals in a high-end setting.

Wellbrooke of South Bend, The Center for Health and Wellness, features high-end amenities. The community opened its doors in August 2014.

Wellbrooke of South Bend is located on a commercial corridor. The 100-bed, 66,560-square-foot building features a movie theater, game room, pubs, restaurants, bistro, and an on-site chef — to name a few of the amenities that create a sense of boutique hotel.

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The two-story building, in South Bend, Ind., provides post-acute care (short-stay rehabilitation and therapy), and assisted living in a service-oriented environment. The majority of rooms are private rehab suites.

The community features a mix of 70 post-acute beds and 30 assisted living beds, among other distinct features, and is as part of partnership established last year between Health Care REIT (NYSE: HCN) and Mainstreet. HCN entered into a partnership with Mainstreet to acquire 17 properties under construction for $369 million and another 45 properties in the Carmel, Indiana-based developer’s pipeline, representing a $1 billion acquisition and $2.3 billion in total.

“We want to change the way care is being delivered to aging Americans, and part of that is changing the perception of what transitional care is,” says Laurie Schultz, director of development with Mainstreet.

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Mainstreet’s refreshing approach to skilled nursing design positioned Wellbrooke of South Bend to be best in class for skilled nursing in the 2014 Senior Housing News Design & Architecture Awards contest.

“They have stepped out and created a hospitality experience for Medicare residents that all designers in the industry are trying to create,” says Jeff Anderzhon, senior planning/design architect at Eppstein Uhen Architects, one of the judges for the 2014 SHN architecture design awards. “They are the skilled nursing trailblazer.”

The Concept

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In the early stages of planning for Wellbrooke of South Bend, several factors were considered, including proximity to nearby health organizations.

“We wanted to be as close to major health care campuses as we can in a skilled nursing community,” Schultz says, noting that Wellbrooke of South Bend in a highly visible retail corridor of South Bend.
Referring hospitals include St Joseph Regional Medical Center is Mishawaka, Ind. and Memorial Hospital of South Bend, also in South Bend.

In addition to partnerships with surrounding health providers, relationships with Wellbrooke of South Bend’s next-door neighbors was key — and played a role in its interior design.

“Mainstreet had received indirect feedback from Christ the King Catholic Church, a neighbor of the project site, that it would be nice if Wellbrooke of South Bend could somehow reflect the community’s strong sense of faith,” Schultz says.

Home to the University of Notre Dame, South Bend has deep religious roots. Catering to this desire, Mainstreet incorporated a dedicated reflection room into the center of the building’s design.

Part of the community’s boutique hotel charm also comes from its wellness center, which creates a “destination spot,” says SHN design award judge David Dillard, principal at D2 Architecture, who said that among other elements led him to give the community high marks.

“We wanted to combine the physical therapy gym, rehab, and salon/spa into one area of the building to create more of a retail wellness feel,” Schultz says. “There is a small lobby that creates a communal space outside of the physical therapy gym. The salon has shelving for retail items. A daughter can come in and take mom to do joint manicures. It has a retail feel to it.”

The retail and concierge-style amenities of the community make it all the more appealing, Anderzhon says.

“The experience that they’re trying to sell the residents, and the experience they’re trying to provide is hospitality,” he says. “When someone is discharged from the hospital and needs to go to rehab, he wants to spend as little time as possible there — but wants his time there to be enjoyable. This community does a wonderful job of that.”

And Wellbrooke of South Bend’s relationship with its neighbors, and the surrounding landscape played a big role in its exterior design as well.

“Mainstreet needed to balance the unique and new with the community’s traditional and conservative ways,” Schultz says. “In the end, the award-winning design boasts a contemporary take on the traditional with bright colors on the exterior and bold, geometric patterns on the interior.”

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The Construction

Construction started in July 2013, and while its opening the following year in August was on target, the development team did hit a few speed bumps along the way.

The site previously featured a mall, which was demolished in 2010. Since then, the property had remained vacant. But what Mainstreet didn’t know was that prior to the mall, the site was home to a hotel, which had an underground pool.

“When we started site work and grading, the general contractor discovered a buried swimming pool structure when the site had a hotel in the past,” Schultz says. “The structure needed to be removed and filled in before site work could commence to ensure stable soil conditions.”

After the mall’s demolition the site sat vacant, and one local business voiced concern that the new facility would block its signage.

“Ridge Auto Parts of South Bend, a NAPA Auto Parts store, was afraid the new building would obstruct their signage,” Schultz says. “Ridge Auto Parts threatened to remonstrate against the project.”

Mainstreet worked with the city of South Bend to modify the landscape buffer in an effort to make sure the store’s signage was not obstructed, she says about how the project successfully moved forward.

And despite those road bumps, Mainstreet adhered to its $14 million budget.

Also important to the building’s design was that it didn’t look too residential, as it is located in a commercial spot, say the project’s architect group Indianapolis, Ind.-based arcDESIGN.

“While the earth tones were there, we were able to add a punch of color,” says Alonso Arambula, project manager, with arcDESIGN. “Indiana is known for farm houses, and we wanted it to feel like home. Mainstreet is selling modern facilities with high-end amenities — so we were able to play between modern and rural aesthetics.”

Warm neutrals and pastel accents compliment the contemporized Tudor architecture, while its bright color accents and geometric patterning reflect is commercial location.Strategically placed large windows throughout the building also bring in a “flood of natural light, which extends onto the second floor,” Arambula says.

To awards judge Dillard, the building’s design is reminiscent of silos and farm houses — with an “edge.”

“They’ve hit the style sweet spot,” he says. “And the interior design [by senior living design firm Direct Supply Aptura] kept up step to step with the exterior with great colors and attention to detail.”

The Completion 

Since opening its doors last August, Wellbrooke of South Bend is at 42% occupancy and growing, says Leslie Farr Knox, vice president of communications, social media and creative services at Trilogy Health Services, LLC.

Trilogy Health Services, a Louisville, Ky. based provider of senior health and hospitality services, became the operator of Wellbrooke of South Bend — along with five other senior living communities in Indiana operated under the name Wellbrooke — on the first of the year. The previous operator was Life Care Services, a subsidiary of LCS.

“The combination of the Trilogy culture with the innovative Mainstreet design makes this a new and unique senior health and hospitality alternative for area seniors,” Knox says.
Services are built around the interests and schedules of guests – “a departure from traditional health care properties,” Schultz says.

Of those innovative features is the community’s Home Again post-acute rehabilitation program, which includes an extra-large health/rehab gym and state-of-the-art workspaces that mimic real-world environments, such as a kitchen, bathroom and bedroom.

The gym has an outdoor component to it, and different walking surfaces outside — including gravel — help guests to heal in a way that prepares them for some of the challenges they might face when returning home, Schultz says.

And since the building’s completion, it’s award-winning design has even boosted foot traffic to neighboring businesses and inspired those businesses to give their own properties a makeover, local media report.

“Wellbrooke of South Bend has been really well received by the community and neighbors,” Schultz says. “This is not the stereotypical nursing home. It’s an inviting place, with lots of activity — it’s vibrant.”

Written by Cassandra Dowell

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