Episode Transcript
[00:00:03] Speaker A: Hello and welcome to the Consulting Specifying Engineer podcast. I am your host, Amara Rozges, and today we're talking about assisted living facility conversions. The CSA podcast is now about to turn three years old and I'm excited to be here.
Thanks for joining me today. Sita and Brian, thanks for having us.
[00:00:26] Speaker B: Yeah, excited to be here.
[00:00:28] Speaker A: Good, good. And there is a lot of discussion about reclassifying a building, so I thought I'd talk to two experts on the topic. Here's a little bit of background. Brian even is a mechanical engineer at Wold Architects and Engineers. Brian's approach centers on working closely with clients to understand how their facilities operate, shaping mechanical system designs that align with their specific needs and goals. And he pairs that collaborative mindset with deep healthcare expertise to deliver efficient, reliable, and sustainable systems that support comfort and performance from design through construction.
Sita Chum is an electrical engineer at Wold Architects and Engineers. Sita approaches each project with a focus on understanding the unique needs of every client, tailoring each element of system designs to support how each facility truly operates.
He combines that client first mindset with sustainable strategies and close collaboration across project teams to ensure thoughtful decisions early on translate into successful outcomes in the field.
Gentlemen, we are hearing so much about assisted living conversions. What is driving this trend?
[00:01:48] Speaker B: Yeah, so I think a big thing that we see is just the population getting older. We've got all the baby boomers that are aging and they're now needing that next level of health care.
[00:01:59] Speaker C: And the other part too that we've been seeing is that the construction, the cost of new construction is really high and slowing down because you got to take into account land acquisition and all the things that go with building something from scratch. And if they already have an existing building that they can renovate, that helps a lot with that first initial cost.
[00:02:23] Speaker B: Yeah, we also see owners doing master planning for their overall entire campus. And one part of that is market analysis. So hiring a firm that looks at what you currently have in your community, you know, 10 years in the future, how's the demography going to change?
What are the competitors doing? And is there a need for a certain type of assisted or skilled or independent living?
[00:02:49] Speaker C: And then the final thing that we've seen too is the staffing shortages that a lot of facilities are going through. There just aren't enough workers for everything needs to be done. So by converting to assisted, you are able to use less skilled workers that have less licenses in order to be an RN or a cna. So that helps out be able to still serve the community, but with less staff.
[00:03:16] Speaker A: Okay. And this is a really complex topic. So when a facility moves from independent living or build nursing to that assisted living, what changes from an engineering standpoint?
[00:03:30] Speaker B: Yeah, so it really depends on location and which codes are enforced. In Minnesota, for example, assisted living facilities now have to meet the 2018 edition of the FGI guidelines.
And there's also Minnesota has additional adopted rules beyond that as well.
So it really is dependent on location and what codes are. But generally it's kind of an easier conversion going from skilled to assisted because you're going from a kind of the highest code level to something a little less.
And then going from independent living to al is typically a little bit harder conversion since you're going from a lesser code requirement to a higher code requirement.
[00:04:10] Speaker C: And that's usually where we see a lot of work involved is when you're going from independent living, because it basically is like an apartment building and a lot of stuff that's in there aren't conducive to assisted living. So getting ready to analyze that and having somebody who can help you through that process is key.
[00:04:33] Speaker A: Okay, so looking at that process, can you walk us through what happens when a building is reclassified under a new occupancy type and what are some of the most significant life safety or infrastructure upgrades that get triggered when that happens?
[00:04:51] Speaker B: Yeah, I'll hit on the mechanical first and I think I'll kind of talk broken down from aisle to ALE and then from skilled to ale, because there's kind of varying things there. So if we're talking independent living to assisted living, some significant things that we see is the building will need to be fully sprinkled. So that's not typically requirement for independent living. So that can be a big upgrade going from no sprinkler system to a full site fire suppression system. For assisted living in Minnesota, specifically, residents need access to an accessible bath in addition to a shower.
So independent living, you probably in your resident rooms will have a bathtub, but that's not going to be accessible bathtub. So we might need to add additional space that has a spa tub that's fully accessible for residents to use.
If we're talking skilled nursing to assisted living, a lot of the issues we come across have to do with older skilled nursing facilities. So they don't currently meet the current skilled nursing code. So we run into things like we need to have individual temperature control in each resident room. So a lot of times and really old skilled nursing facilities will come across where they have multiple resident rooms, are served by a single thermostat.
Or another requirement is that we need to provide cooling to resident rooms. And we've come across where there's just they don't have a cooling system for resident rooms.
So a lot of stuff that we see on the skilled side is the older skilled nursing facilities.
When you convert those to assisted living, it's the kind of out of date things and things that weren't code back when those were originally built.
[00:06:36] Speaker C: And it's a very similar process for electrical.
The things that we see on the electrical side is when the systems are outdated in a skilled nursing, for example, if they have a nurse call system that's, you know, been in use for 20 years, those parts are no longer valid anymore. You can't expand on it and get all the stations that you need without going to a secondhand dealer. So getting that up to date. And then the biggest part that we see is on the generator part because you need emergency power of some kind of and for skill that's usually already in place. It's just making sure that it still works. Generators last a long time, especially if they're indoors. Outdoors is a different thing. But as long as the maintenance staff has been taking care of it, it's okay. It's on the independent living side that we see issues come up because sometimes the generator they have there is just strictly like for an elevator or some minor emergency lights.
And depending on the emergency preparedness plan that the facility has in place, they may want to do cooking, you know, right away, instead of having somebody else bring it in. Which means there's a big load that needs to go on the generator to support all the kitchen stuff. Or they may need two elevators because it's a lot of residents on the 12th floor. So then that's another load that needs to go on the generator. So having that conversation early helps us figure out if these upgrades are needed or not.
[00:08:13] Speaker A: And you each touched on a couple of these. But specifically, what are the most common engineering hurdles that you encounter in these projects? I mean, Brian, on the mechanical side, CETA on the electrical side, what do those hurdles look like?
[00:08:27] Speaker B: Yeah, I think I touched on them. But definitely fire sprinkler system run into that one quite often.
And even AL to Al. I've got a client right now that has an existing AL off of the older code. So for example, here, kind of older building, they want to put a little addition on and that's going to kick in that the entire building needs to be sprinkled now. So we come across that pretty often it's just those older buildings.
And then, yeah, like we said, there's a lot of facilities that we can see in Minnesota especially that just don't have the room temperature control that's needed. So they either can't maintain the cooling requirements or they can't maintain the individual temperature control.
And that can really be potentially an easy fix. Or depending on how much the temperature control is, it could be a very expensive fix to redo that or add a new system overall.
[00:09:27] Speaker C: Yep. And then for electrical, the two things that we see quite a bit is nurse call. So it was an independent living.
They probably didn't have a system. And we got to add a nurse call system in there, which, you know, lets the resident call for help 24, 7, and then staff can respond.
And the good news is that with the technology that's come up, you don't need a hardwire system anymore. You do wireless system, which makes the work a lot easier because you don't have to run wires to all the stations.
So that way people can carry portable phones or portable pagers. And then all the stations are battery operated.
The other thing too, that we seen is on the fire alarm portion, if the building has been there for a while, the fire alarm system is part original, which then means once it gets to that 15, 20 years, the fire alarm manufacturer stops supporting it.
So if we're adding new devices, smoke detectors, pull stations, co detector, that's required by, you know, the current code for any place where people are sleeping, that gets really tough to do. So then we have to say, hey, we can't add additional devices. This entire fire alarm system needs to be replaced, which might mean it affects other parts of the building that we aren't planning on touching.
Okay.
[00:10:55] Speaker A: Okay. And we always talk about addressing things early with all parties.
So how can those early facility assessments change the trajectory of a conversion project?
[00:11:09] Speaker B: Yeah, so at wold, we've got a large team here, so we have architects, engineers, interior designers, technology team. So we get really a representative of each of our disciplines on site for these facility condition assessments.
And that's really to really, you know, identify any major infrastructure issues.
It's really, it's really notifying the owner of what it's going to take to make this conversion. What's the cost associated with that?
So that early assessment can lead to a budget that's not feasible for the owner. So having that understanding and that early assessment really helps nail down the budget and sticking with that.
[00:11:49] Speaker C: And part of that assessment is twofold. One is us Going out there and looking at the equipment and then just doing a visual inspection, seeing the age, seeing there's any issues. But the bigger part is us sitting down with the facilities team because they're the ones that work with it on a daily basis, and they can tell us things that we can't see with our own eyes.
So knowing those things, like, hey, this error handler looks really good, or this panel looks like it's in good shape, but then they tell us, well, actually, there's these other things that, you know, have been happening, and now that replacement cost needs to be included because we weren't to worry about it, because it's something that you won't know unless you're working with equipment on a daily basis.
[00:12:35] Speaker A: Right. So there are a lot of things to think about here with an occupancy reclassification for engineers evaluating a potential conversion, what technical factors should be assessed early to determine feasibility.
And this is all under new occupancy classifications.
[00:12:55] Speaker B: Yeah, I think just what we talked about, that first step is really a complete facility assessment.
That's the way to fully understand how the existing building is functioning, how the existing facility operates.
Again, like Sita touched on, those interviews with the facilities team are so important because there's.
There's only so much that you can see with your eye or look at a piece of equipment, but there's all the. All the stuff above ceiling, behind walls, under the floor. You really need that perspective from the people that are in the space to know how things are functioning. And if we're going to have issues with the conversion by talking with them through it.
[00:13:36] Speaker C: And I mentioned it earlier, but for the electrical, the biggest part for us is just figuring out the scope on emergency power.
That's usually the biggest, one of the biggest costs, and it dictates on how the building is going to be functioning during an outage, which is when you have these residents that are most vulnerable, basically at the whim of, is there a power to run the lights, run the kitchen, do security, things like that. So we have to talk with leadership group and then figure out what's their preparedness plan when there is a disaster or emergency.
How are they moving folks from one side to the other side? Are they all getting into the community room and that's where they're going to huddle to wait things out, which then means we got to make sure we got enough lighting in there on backup power, enough heating, cooling.
Do they need any additional stuff that's not code required on that generator? Also, because that'll dictate the size of the generator, and then is the generator still functional or is it past a useful life of, you know, 25, 30 years? And now we got to replace it. So you just got to make sure that we have that included, which is all part of the facility condition assessment. So that way the scope can be aligned with whatever budget they got.
[00:14:59] Speaker B: Yeah, and I guess some mechanical, specific technical factors.
Again, verifying temperature control, zoning.
If there's existing plans, that might be easy to do. If there's not existing plans, it's a little more invasive. Or talking with facilities team to understand it better, you know, confirming what type of sprinkler coverage there is, if any.
Confirming and talk facilities on cooling, on heating. Are they able to maintain cooling and heating temperatures?
And then also resident toilet room accessibility. And, you know, do they have existing showers, tubs? Are they accessible and not accessible? Are the water closets accessible with handrails? Kind of just walking through all the spaces and getting your eyes on everything you can.
[00:15:47] Speaker A: Well, it sure sounds like you are both really engaged in these types of projects, but if you weren't engineers, what would you be doing? Brian, I'll start with you. What would you be doing?
[00:16:00] Speaker B: Yeah, so my wife and I have been doing a ton of landscaping and gardening at our house recently, and I've really enjoyed designing possible landscape layouts for kind of the front yard, converting it over into kind of a garden with maybe a water feature and all this stuff. So lately I've been thinking, you know, residential landscape architect could be a fun occupation.
[00:16:27] Speaker C: Yeah, for. For me, it would be.
So I kind of knew this because I always see it whenever I go to the museum with. Well, now it's my nieces and nephew, but when my kids were little, we were taking them to the Children's museum in downtown St. Paul. And to appeal to all the various ages of kids, they would have a bunch of, like, different activities they can do. Like pretend city where they could become, you know, a restaurant cook or postman. And then for the older kids, they had, you know, tunnels for to learn about how ants, you know, lived and talked to each other so they could call through the tunnels.
And I always thought that was a really cool job, that someone could design these sets and then basically build it. So it's a team of, you know, carpenters, electricians, whoever it is.
And I also thought from electrical side, it'd be kind of cool to design the mood lighting for that or do the programming where if they push a button that's got a lightning symbol on it. You know, the hair, thunder or lightning.
So it'd be a lot of fun to build these things for the kids to, you know, interact with, but also learn. I would just feel bad for the parents. I would have to crawl after them.
But that's part of being parents, so that's okay.
[00:17:47] Speaker A: Well, that sounds pretty awesome. And it sounds like you both have your next career cut out for you.
Well, thank you, Sita and Brian. I do appreciate these insights.
[00:18:02] Speaker B: Thank you.
[00:18:04] Speaker A: Yeah. And this is where we need to wrap things up. For more information about existing buildings and assisted living facility conversions, visit Consulting Specifying Engineer.
And don't forget to check in regularly for new podcast episodes.
Thanks for joining us and we will be back soon. Bye. Bye.
