Prominent senior living providers have been rolling out ambitious wellness programs in recent years. Many of these try to promote different facets of wellness—such as physical, spiritual, and social wellness—through diverse programming.

Increasingly, senior housing providers are not only creating programs but new spaces dedicated to wellness. Known as centers for healthy living (CHLs), these spaces are starting to fundamentally change senior housing design.

“As [senior living] communities have evolved, there’s been this concept of the village center or town center,” Claire Dickey, an associate at architecture firm Perkins Eastman, tells Senior Housing News. “I think that over time, the CHL will replace that town center concept, and we’ll do a better job of integrating wellness into our everyday routine and activities of daily living.”

Dickey bases this belief on information gathered for a recent Perkins Eastman report on CHLs, which she co-authored. Senior Housing News recently spoke with Dickey to learn more about what a CHL is, what benefits it offers to providers, and what the future may hold for this innovation in design and operations.

Defining a Center for Healthy Living

Centers for healthy living come in various shapes and sizes, but Perkins Eastman offers a general definition in its white paper:

“A center for healthy living (CHL) is a new building typology that supports seniors through all the dimensions of wellness; it may be one program and building or a collection of programs/services and spaces … A typical CHL provides places for social interactions, preventative health care and medical treatments, wellness education, counseling, healthy dining, continuing education lectures and discussion groups, arts programming, fitness training, spa/beauty treatments, and/or many other activities and services.”

One example is the CHL at Moorings Park, a life plan community in Naples, Florida (pictured above). The nonprofit has approximately 580 units offering a mix of independent living, assisted living, and skilled nursing.

Moorings Park constructed a 37,000-square foot CHL three years ago. It consists of seven main areas: a medical clinic, physical therapy area, gym, spa/salon, lecture hall/theater, classroom, and cafe. In addition, it features outdoor spaces such as a garden and rooftop terrace, and a retailer of health, fitness, and nutrition products.

The whole CHL occupies a single floor above a parking garage. The design elements include partial height walls, glass partitions, and planters filled with bamboo. The idea is to separate spaces while maintaining a sense of unity. Building materials include wood and stone, and abundant natural light furthers the sense of being connected to the outside world.

CHLs do not exist exclusively at life plan communities, but this is the most common setting for them currently—and the Moorings Park example gives a sense of why this is the case. With a large footprint, high-end features, and multiple amenities, this type of CHL requires significant capital to construct.

Dickey declined to share the total cost for the Moorings Park CHL, but $130 per gross square foot is a reasonable estimate, according to the latest senior living construction cost report from construction firm Weitz. That puts the construction cost around $4.8 million. Smaller senior living communities simply may not have the resources for this type of CHL, notes Dickey.

With cost in mind, providers are betting that the benefits of a CHL also will be substantial—and they are finding that this indeed is the case, Dickey says.

Wide-Ranging Advantages

The Moorings Park CHL was not an immediate hit, and the community had to put forth a concerted effort to drum up interest, Director of Wellness Celeste Lynch told Perkins Eastman. But after holding a variety of events in the space, such as health fairs, educational sessions, and multicultural gatherings, the CHL began to see an influx of visitors. Now, more than 1,000 people use the CHL each week, including residents from all levels of care and Moorings Park employees.

There is a long list of benefits that Moorings Park is seeing from its CHL, according to survey responses that the community provided for the Perkins Eastman report. The list includes: improved quality of life for CHL users; improved sense of community on the campus; positive marketing/referral outcomes; and increased opportunities for partnerships with other organizations. The CHL also has had a “moderately positive” effect on staff recruitment and retention.

These benefits are seen across the board in CHLs, the Perkins Eastman survey found. The survey gathered responses from 26 participants, including 13 senior housing and care providers, as well as designers, industry consultants, and neighborhood resource/community centers.

The success of CHLs suggests that they will become even more common in the future, and it also supports the idea that they appeal to a consumer base that values and is seeking out support for full-person wellness at all stages of life.

“One of the main ideas of the paper is that we’re moving into a new era,” Dickey says. “We’re starting to look beyond [the idea] that just being physically fit is being well. We’re starting to understand how the mind, body and spirit are all interconnected.”

However, given the challenges in constructing an elaborate CHL, the model likely will adapt in the future.

CHLs Evolve

There are a variety of potential CHL models that might catch on in the future, Dickey and her co-author, Emily Chmielewski, wrote. One possibility is having a CHL “hub” at a life plan community and a “spoke” CHL in the community at large.

The “spoke” location could be a hub for home care programs run through the life plan community and also be a center of engagement for those who are not yet residents.

Another possibility could be a CHL embedded in the community at large, serving a population health function. This is building on Affordable Care Act policies encouraging health systems and providers across the continuum to coordinate with each other to maintain the health of their patient population. This model would be less senior-specific and cater more to a multi-generational cohort, perhaps by being an anchor tenant in a mixed-use development.

Yet another model is a “virtual” CHL that leverages technology such as Skype to bring services into the home and apps like Uber to help seniors leave the home to interact.

The point is, there are no hard-and-fast rules for what a CHL has to be, and senior living providers now have an opportunity to get ahead of the curve, says Dickey.

“There’s no one-size fits all solution or right answer or wrong answer,” she says. “It gives you an opportunity to customize for what that community or customer needs.”

For instance, an independent living or assisted living provider might not construct a CHL that addresses every aspect of wellness, but instead might create a space to fill in a particular gap in services for that market, or to specialize in one or two particular areas of wellness. This could help keep costs down; another way of doing that would be through partnerships.

“Partnerships could be a great way for an assisted living community, skilled nursing, or independent living community to put together put some resources into building a CHL with another group, where everybody would have access to it,” Dickey says. “We haven’t come across a lot of that yet, but as we place more focus on how to maintain wellness as opposed to dealing with a more clinical setting, I think those things will be developed.”

Written by Tim Mullaney