Assisted living facility feasibility study : Laguna Honda Hospital and Rehabilitation Center : draft

2007·6.7 MB·English

by  San Francisco (Calif.). Planning Dept

SAN FRANCISCO PUBLIC LIBRARY
3 1223 07662 8594 Assisted Living
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San FranciscoPublicLibrary
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DOCUMENTS
San Francisco Public Library DEPT.
100Larkin Street. 5th Floor
San Francisco, CA 94102 AUG - 7 2007
REFERENCE BOOK
SAN FRANCISCO
PUBLIC LIBRARY
V
Not to be taken from the Library
August
1
Laguna Honda Hospital and 2007
toil tation Center
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I REF San Francisco
7 11.555 t of Public Health Anshen + Allen Architects / GORDON H. CHONG & Partners
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Team
Project
OWNER MEP
City+County ofSan Francisco Sato and Joson Engineers
Laguna Honda Hospital Neil Joson
Aria Escontrias FW&Associates
John Kanaley Munson Fong
John Thomas Victor Tong
Larry Funk
Liz Gray STRUCTURAL
Forell/Elsesser
ARCHITECTS Mark Moore
Anshen+Allen
Allison Ackerman COST
Benji Larance TBD Consultants
Erica Ross Gordon Beveridge
Karina Hernandez
Ian Slight
Marilyn Smith
Sharon Woodworth
EIR
Venus Wang
Impact Sciences Consulting
Zigmund Rubel
Audrey Darnell
Gordon H. Chong Partners
Larry Bongort
FINANCIAL
HFS Consultants
PEER
Richard Gianello
Patri Merker Architects Jim Gomes
Tom Harry
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This Feasibility Report represents discussions, ideas, and data exchanged
duringthe pre-design processforLaguna Honda HospitalAssistedLiv-
ing Facility. All information should be considered as part ofthis process
and not be taken out ofcontext. Use ofthis material, in part orwhole, by
anyone otherthanAnshen+AllenArchitects/Gordon H. Chong& Partners
requires written permission.

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Introduction
ExecutiveSummary
11- Definitions & Context
J' ModelsofCare 1
License&Codes
ConstructionType
37 15
25 Best Practice
Oregon
Washington
California
SanFrancisco
37 Benchmarking
Architectural Review
OperationalTours
CaseStudy
45 Space Program
59 FeasibilityOptions
87 Evaluation
ProjectSchedule
CostEstimateSummary
Financial Projections
Conclusion and Next Steps
g Abbreviations
1
-J
Appendix (separate volume)
NCBDevelopmentCorporationData
LongTermCareCoordinatingCouncilMemo
Services&AmenitiesQuestionnaire
EIROptions
CostEstimateTabulations
HFSReviewofFundingOptions&LicenseCriteria
EngineerNarratives
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IntroJduction
This feasibility study explores
options for an Assisted
Living Facility. Its purpose
is to present a picture of
financial, logistical, and
regulatory circumstances that
would shape the facility's
development.
The central finding of this
study is that spiraling
construction costs have made
theoriginaloptionsforplacing
assisted living on the Laguna
Hondacampusunsatisfactory.
The concluding section
identifies next steps that the
city could explore in an effort
to bring costs back within an
acceptable range, and to carry
out its mission to enhance the
continuum of care at Laguna
Honda.
The report is intended as
a vehicle for public input.
No final decisions on any
question of construction,
L
design, operation, or
-aguna Honda Hospital programming are presented.
and Rehabilitation Center It is a draft document for
is a skilled nursing facility public review, and makes no
owned and operated by recommendations. A final
_CCD the City and County of San version incorporating public
o Francisco. Proposition A, comments will be published
Q_
«3 a ballot initiative passed by in September, 2007.
O
Z voters in 1999, authorized the
o
x city to replace the hospital's The method used in this
u
x 1920s-era buildings with a study was to test the balance
O~Z-Z„ modernized facility on the of three competing factors,
QB same 62-acre site. facility size, site conditions,
and construction costs, by
^U2_ caE) In keeping with the city's examiningpotentiallocations,
«? 8 policy to encourage a range number ofunits, construction
t<ryi^-ao2) of options for people who schedule, cost estimates, and
co zs need long term care, Measure EIR impact of the several
+u! u—<j!Ss°- A envisioned both skilled options presented.
D3 + V nursing beds and assisted
Z °
O living units on the Laguna Additional factors such as
X
=
Z Honda campus. design details fall outside the
< 5O) scope of the study. They are
best considered at later stages of the project in order to give
them the full consideration they require. As such, operational
variables have been broadly assumed to maintain consistency
across the several options presented.
To ensureoperationalflexibility, the threefollowing principles
serve as a framework for the study.
Ensuring Continuing Care
An assisted living development on the Laguna Honda campus
reinforces the city's commitment to a continuum of care for
seniors and adults with disabilities. The city's intention in
exploring the potentialfor assisted living at the Laguna Honda
site is to expand city capacity to meet varying levels of need.
Residentsoftheassistedlivingunitswouldbethosewhodesire
orrequire alessintensivelevelofcarethanthatprovided by the
skillednursingfacility.
Recognizing the Changing Marketplace
Federal and state policies are changing to allow more
consumer choice in long term care. Government subsidy and
reimbursement allowances, though not yet entirely available
for the full range of choices, are becoming more flexible so
that individuals can pay for the kind of care that suits them
best, whether skilled nursing, assisted living, home care, or
community-based care.
uction
Greaterreimbursementflexibilityfollows atrendinthe market,
which has seen a 37.4% decrease in skilled nursing beds over
the last ten years.1 This decline has been accompanied by a rise
in assisted Living, which is fast becoming a preferred option
for many, as well as home and community-based care. As the
popularity of assisted living has grown, so have the services,
amenities, andoperational models.
This study maintains a broad perspective on available services
to allow for the emergence of a model that works best for San
Francisco. Each option envisions half of the residents in an
apartment model of care and half in a group model of care to
facilitate consideration of which model, or combination of
models, is most appropriate for the final architectural option
selected.
Assuring Dignity, Independence, Choice and Safety
An important goal of this study is to highlight best practices
for similar assisted living facilities, and to determine which
practices safeguardandvalue the dignity, independence, choice,
and safety of residents as defined in the guiding principles of
the National Center for Assisted Living. These principles are
furtherreinforcedbythefourteenguidingprinciples setforthby
the San Francisco LongTerm Care Coordinating Council.
'LongTermCareReform:TenYearsAfterLittle Hoover, California
HealthCareFoundation: IssueBrief,Dec 2006,pg4. Thepercentageis
derivedfromareviewofcaseloadtrendsdocumentedfrom1996-2006.