Thursday, June 18, 2009

Nursing Home Planned For Medical Campus Not Without Controversy
Story from the Buffalo News

Kaleida Health is preparing to build a 300-bed nursing home, another big project connected to the Buffalo Niagara Medical Campus that advocates say will significantly improve services for the elderly in the inner city.

The $64 million building, planned for the block bounded by Michigan Avenue and Maple, East North and High streets, will be the first nursing home built in Buffalo in many decades.

It will rank as one of the largest nursing homes in the region and will fill a gap in long-term-care services resulting from the disappearance in recent years of Grace Manor, Nazareth and other facilities in the city.

James Kaskie, president and chief executive officer of Kaleida Health, said the project will benefit the Fruit Belt neighborhood, the hospital system and the medical campus.

“When you step back and think about the investments that are being made, if you understand facilities, what we’re planning is so much more efficient and improved for medicine than what we have now,” he said.

The project will replace two nursing homes operated by Kaleida Health — the 242-bed Deaconess Center on Humboldt Parkway and a 75-bed skilled-nursing unit in Millard Fillmore Hospital at Gates Circle.

The Deaconess buildings date from 1920, and the portions used for nursing home care were constructed in 1959 as a hospital. The facility is antiquated, with obsolete building systems and floor plans.

A state commission ordered Millard Fillmore Hospital closed as part of an effort to reform the region’s inefficient hospital industry. Plans call for moving its hospital services to Buffalo General Hospital and to an adjacent center for heart and vascular care on which construction is expected to start this summer.

As proposed by Canon Design, the nursing home would consist of four connected structures with 20-bed clusters of semi-private rooms and courtyards on each floor. Its four stories are intended to provide a visual transition between the taller hospital buildings on one side and the residential neighborhood on the other side.

It will consist of 200 long-term- care beds, 40 beds for patients with memory impairment, 30 beds for short-term patients rehabilitating from hospital care, 20 beds for children with profound disabilities and 10 beds for residents on ventilators.

Dr. Bruce Naughton described the home as a significant improvement, offering residents green space, smaller groupings of rooms and greater privacy.

“The city needs a quality nursing home. This is where people live. The environment can influence mood and behavior,” said Naughton, chief of the geriatrics division at Kaleida Health and the University at Buffalo.

A new building also should be considered an opportunity to adopt the principles of culture change, he said.

Culture change refers to a growing reform movement that — through staff training, better design and operational changes — is trying to move away from the passionless, poor quality, built-for-efficiency experience that has come to define too many nursing homes.

The construction site in the Fruit Belt neighborhood sits outside the official boundary of the medical campus. The project does not exactly fit the goals in a Fruit Belt Urban Renewal Plan, but advocates say it will redevelop a block that contains 22 vacant lots and an abandoned gas station.

Kaleida Health recently purchased one of the six homes remaining on the block — it paid $180,000 for 316 Maple St. — and officials said they have contracts to buy the others.

Two of the homes, all of which Kaleida plans to demolish, were built in the late 1800s and are eligible for listing on the National Register of Historic Places, although one of them has been altered from its original condition, according to last year’s environmental review of the project.

What criticism the project has received has centered on its design, location and demolition of the historic-eligible homes.

Preservationist Timothy A. Tielman said the design looks too institutional for a neighborhood. He also suggested Main Street as a better location because of its proximity to bus routes and subway stations, as well as nearby businesses.

“I know the block isn’t what it once was. But I look at houses like those and see Queen Anne Victorians or beautiful Italianates that can be restored with some loving care,” said Tielman, executive director of the Campaign for Buffalo History, Architecture and Culture.

A larger concern is with the medical campus and whether designers of the nursing home and other buildings are paying attention to creating a walkable, mixed-use community that includes retail and residences.

The environmental review concluded that the block has lost most of its historic character and that the benefits of the project outweigh the value of attempting to save the homes.

Kaskie said he understood the concerns but defended the design as “pleasant and community- friendly.”

“These people [preservationists] are great stewards of our historic treasures, but the need in this instance trumps that issue,” he said.

Officials at Kaleida Health anticipate construction will start in the fall, after a financing package is completed and final approvals received.

The state Office of Parks, Recreation and Historic Preservation has yet to have a final say. The project also requires rezoning of the Maple Street parcels and city approval to consolidate the parcels into one lot.

Kaleida Health plans to pay for the building with a $12.4 million state grant coupled with debt financing — slated to be part of a larger funding package for medical campus projects — through the sale of bonds insured by the Federal Housing Administration to investors, including banks, private institutions and possibly pension plans.

The future of Deaconess and Millard Fillmore remains unclear, although Kaskie said Kaleida plans to set aside funds to raze Deaconess.

“Deaconess is very old and past the point of rehabilitation. There will have to be a community discussion to talk about reuse of both sites,” he said.

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