Nursing Home Design Guide
2006
Charting facilities and implications of
3.4
Resident Unit Design
electronic systems
and Operations
Call lights
Continuous handrails
3.4.1 General Considerations
Nursing Home layouts and facility
3. Operational Considerations
appearances have been transformed by
Facilities are increasingly organizing
merging residents' needs with a better
residents in a series of smaller clusters
understanding of staff operations. It is
and neighborhoods for care during the
the residents' needs that shape
morning and afternoon and larger units
schedules and services. Design must
for nursing coverage at night. Units of
correspond with how residents and staff
36 to 48 persons also may function as
circulate within the occupied areas, thus
sub-units (neighborhoods) of 18 and 24
producing smaller group living
respectively, based on daytime staffing
experiences. Considerations include:
ratios. For states mandating units of 60
beds, sub-units of 30 beds may be
Smaller resident neighborhoods
operationally more practical.
Increased resident to staff contacts
Nursing assistant(s)' need for
4. Special Populations, Smaller Units
support facilities
When facilities identify services with
Better gathering spaces
very distinct populations and staffing
Equipment space for staff
requirements, they can elect to provide
smaller units. This is accomplished by
3.4.2 Planning Considerations
dividing a typical 30 to 48 person unit
Jurisdictional and regulatory factors
and operating a portion of that unit as
affecting unit size(s) are as follows:
specialized care.
1. Minimums
5. Staffing Patterns
Staffing minimums are often stated as a
Staffing patterns based on resident
ratio of licensed nurses and nursing
needs may contribute to the design of
assistants to the residents. Unit design
units. In addition, the licensed nurses
should correspond to regulated
available for direct care at night should
minimums as well as the staffing levels
help establish the unit size as there are
that meet the needs of the residents.
generally more licensed nurses
available on days than on night.
2. Plan Review
Functionally appropriate design
6. Combining and Linking Units
responses may require advance review
The points at which resident units attach
with jurisdictional authorities. These
to one another provide ways for
include the following:
streamlining operations. (See Table
3.5) Examples are:
Sight lines
Plans illustrating staff functions on
Unit-to-Unit - Judicious placement of
various shifts
activity and therapy suites, meeting
Communication systems
rooms, porches and similar
Reference points for walking
"destinations" may provide
distances
Office of Facilities Management
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