508-22-105 AE SOW_Redacted.pdf

508-22-105 Construct 6th Floor Short-Stay CLC 20-Beds April 3, 2021

Martinson

STATEMENT OF WORK

PROJECT NO: 508-22-105

PROJECT NAME: Construct 6th Floor Short-Stay CLC 20-Beds

ESTIMATED GROSS SQUARE-FEET: 22,656 GSF

CONSTRUCTION COST LIMITATION (CCL):

I. General Description:

Provide all necessary professional services to perform planning and design of the systems for project # 508-22-105, Construct 6th Floor Short-Stay CLC 20-Beds. The A/E is responsible and liable for the professional design in accordance with the contract, good engineering practices, VA standards, VA project-specific requirements and applicable codes.

II Project Scope:

Design Services: Prepare construction bid documents (Plans and Specifications) to provide the following:

A. Project Overview: This project will convert existing Building C, 6th Floor administrative space to and construct two (2) embedded Community Living Centers (CLCs) or “Small Houses”. Each embedded Small House will house ten

(10) patients with short-term skilled nursing care and rehabilitation. Refer to Attachment #001, Functional Concept Diagram and Space Program.

I. Residents – Each Small House will be designed to meet the operational needs of the individual home. The demographics and acuity levels for the types of residents in both houses are defined as follows:

1. Short-Term Residents: Short-term residents are those who stay at the house 90 days or less while recovering from an acute trauma or illness. They often require rehabilitative services such as physical and occupational therapy.

2. Residents with spinal cord injuries (SCI/D) or traumatic brain injuries (TBI): The SCI/D resident has special needs that have been developed in the SCI/D Design Guide. Please refer to the SCI/D Center, Long Term Care (LTC) sections in VA 104 PG-189 & PG-18-12 for the SCI/D resident.

II. Enhanced Design Concepts – Features supporting enhanced designs may include:

1. Safety features that are not imposing

2. Reduced background noise

3. Enhancements of visible access

4. Signage and wayfinding tools or cues

5. Carpets that are textural and not patterned, to avoid the appearance of objects sitting on a field.

6. Contrasting color finishes on walls to help define space

7. Floor materials and colors with complementing and limited contrast.

8. The CLC (small homes) will include a shared PT/OT exercise gym.

III. Staff - Operational efficiency is important to maximize the time staff are in direct contact with residents. To achieve this, the small house uses minimal back-of-house support spaces to allow staff to spend as much time as possible in the common areas with residents. The intent is to maximize visibility from staff work areas to resident common areas and resident room entries so that staff are quickly alerted to any problems.

The small house concept assumes a “universal-type” worker. The universal worker is a caregiver who provides a wide range of services, including meal planning, cooking, activity planning, laundry, light housekeeping, and personal care.

Space for staff respite, break space, is provided in the House and staff shall be considered in the design of landscaped spaces around the facility.

IV. Food and Nutrition Services - The VA prefers that Small House do all food preparation and cooking in each House. The pantry and home kitchen are designed with the flexibility to accommodate the following:

1. Food is delivered in bulk to the House and then moved to the pantry and home kitchen. Dry goods are stored in the pantry; refrigerator and freezer storage is located in the kitchen and pantry. Food is then prepared, cooked and served in the kitchen.

Dining is one of the most important aspects of the resident’s day-to-day experience. Resident-focused dining involves offering food choices, developing appropriate menus, and planning the production and distribution of food. It may also include allowing residents to be involved in the activity of preparing the food. The Small House must respond to residents’ dietary preferences and individual dining schedules as part of resident centered care. Cooking and food preparation is a Home activity for residents that is about more than just eating, it is an essential part of their social interactions and activities of daily living.

Snacks are accommodated and available to residents at all times of the day.

Residents have access to a refrigerator and microwave for personal food items.

V. Medication - Medications will be delivered directly to the medication room.

Some medication storage shall be provided in lockable casework at each resident room, adjacent to the resident room entry for ease of access by staff.

The use of carts will be kept to a minimum. If use of carts is required/preferred, care must be taken to reduce the impact on the home environment by utilizing non-institutional looking carts and those that create minimal noise. Cart usage will be controlled or regulated and only utilized at times of day that are least disruptive to residents, as determined by the nursing staff.

VI. Linen and Materials Management - The management of linen and materials in the House operates in the background with minimal disruption to the residents as a result of using the “off-stage” approach.

1. Clean Linen and Supplies: Frequency of cart use is lessened by decentralizing the storage of clean linen. Main linen and supply storage will be located in the Neighborhood Center when available, or in a clean linen room in the home. Secondary supply will be in decentralized closets in the House, and in casework in each resident room.

2. Soiled Linen: Each resident room will contain a soiled linen hamper.

Soiled linen will be transported from the hamper to a cart housed in the soiled utility room in each House. Other biohazards and soiled linens such as those from the dining room will be transported in a closed hamper or cart directly to the soiled utility room. These hampers are then brought to a central soiled linen room in the Neighborhood Center.

3. Oxygen: An oxygen storage room will hold portable tanks for when residents are out of their rooms and require portable oxygen.

VII. Trash - Trash will be held in trash receptacles throughout the House and brought to the soiled utility room in the House. It will then be transferred to the Neighborhood Center soiled utility room before being moved off-site.

I. Project Basis of Design: Each Small Home shall have their own unique characteristics. The type of setting, number of residents, expansion potential, and physical restrictions will be different for each.

II. House - The House is the basic building block of the community; grouped together with other houses, it forms the neighborhoods and the Small House as a whole. The House’s layout in relation to other homes will have the greatest effect on the overall design of the community, see Attachment #001 Functional Concept Diagram and Space Program. The House is where residents will spend most of their time and have the most amount of interaction with the physical environment. The planning of the House considers the daily lives of the residents, staff flow and processes.

The basic components of the House are resident areas, support, areas, and staff and administrative areas.

1. Guidelines for Resident Areas Layout and Character:

a. Kitchen: The Kitchen is located at the center of the House. The Kitchen will function as the “hearth” of the House.

b. Residential Character: The House must be residential in character and scale. Use a design philosophy based on minimizing institutional aspects, for example avoid use of medical carts and pre-fabricated medical headwall units for oxygen supply.

c. Corridor Length: Corridor length has been minimized to support a more residential environment. Double loaded corridors only occur in “off-stage” staff areas.

d. Dead-End Corridors: Avoid dead ends at corridors, especially in Memory Care environments. Dead ends have been shown to frustrate or confuse those with dementia, which can lead to agitation among those who are wandering. If possible, avoid dead ends by connecting paths. End points of corridors should be a destination, such as the living room or another common area.

e. Views to the Outside: Views to the outside are to be used to help facilitate wayfinding, provide natural light, and Regulate sleep/wake patterns for residents.

f. Families and Visitors: Families and visitors are likely to come into the home often. The den, the family visiting space, is placed in a semi-public area of the House.

g. Resident Rooms: Resident bedrooms are grouped into arrangements of rooms with access through a seating alcove. There are 30 single occupancy resident rooms (10 resident bedrooms for each house). All bedrooms are sized to accommodate the requirements for bariatric and special needs residents, including spaces for mobility and equipment clearances, the 323 SF space shown for each resident area includes resident bathroom, bathroom with walk-in shower, and closet.

h. Resident Room Adjacency: Consider grouping resident rooms together in a private zone of the House while still retaining staff visibility from public spaces.

i. Resident Common Areas: Resident common areas are to be open and easily accessible spaces with direct access from the resident bedrooms. Common areas should have natural light and views from at least two sides.

j. Common Areas: Common areas include both highly active and less active social areas for spontaneous interactions. Active social areas include the den, living room, and dining room. Spontaneous social interaction areas include resident room seating alcoves and circulation zones.

k. Medical Waste: Medical waste is generated in medical exam rooms or in resident bedrooms where it is bagged, collected, and transported using specially designated, closed containers, to the Soiled Utility rooms. The waste is held there until it is transported to the medical waste handling facility.

l. General Waste: General waste is generated in all spaces and is held in waste containers for collection. It is then collected by environmental services staff and transported to soiled utility rooms located in service areas or at outdoor trash collection areas.

m. Recycling: Means of sorting, collecting, transporting, and disposing of recyclable materials should be analyzed by locality, and modified to suit local conditions and practices.

n. Reusable Medical Equipment (RME): Any washable items incorporated into the plan of care are transported to and held in the soiled utility awaiting pickup for transport to Sterile Processing Service for cleaning and reprocessing.

o. Records: Resident medical and financial records are maintained and accessed electronically.

p. Specimens: Specimens are collected at the home and are transported to the parent facility laboratory or to an off- site reference laboratory for processing and reporting. Effective means are necessary for maintaining and transporting specimens to ensure integrity.

q. Pharmaceuticals: Pharmaceuticals, including narcotics, are transported in locked transport containers by pharmacy staff to the homes. Narcotics are delivered to a locked medication cabinet or Pyxis MedStation in the medication room. Medication carts are used in the Home to bring medications to residents when necessary. Some medications can be stored in Resident Bedrooms to reduce the frequency of cart traffic.

r. Supplies: Supply traffic (material) is separated from resident and visitor traffic. Clean supplies are transported via supply carts to the clean utility rooms in the home where supplies are accessed by staff.

s. Linen: Supply traffic (linen) is separated from resident and visitor traffic. Clean and soiled linens are transported in linen carts.

t. Sterile Supplies: Sterile items used are transported via dedicated closed carts. Sterile items also may be stored in the clean utility rooms.

u. Energy Conservation: Energy conservation is emphasized in all aspects of the design. Refer to the most recent version of ASHRAE Standard 90.1, as well as DOE Regulations, Codes, Standards & Executive Orders.

v. Disaster Planning: Situations can arise when it may not be feasible to evacuate residents for extended periods of time. In those cases, emergency power is required to maintain food service, heating, ventilating, and life safety systems.

2. Guidelines for Support and Staff Area Layout: Support spaces are treated as back-of-house space. Minimize views from common areas to support doors and into staff and support spaces. Supply is decentralized in closets to minimize the usage of large carts. Good visibility is provided from the kitchen work area and home office to the living room and dining room. Also consider visibility to resident room doors from the kitchen, where possible.

III. Flexibility and Inclusiveness of Houses - The House may serve residents of all types and acuities. Residents with dementia require special considerations in the design of the environment. Such environments must help residents to cope with the effects of dementia and help reinforce the functions that the residents are still capable of performing. The following guidelines are beneficial to all:

1. Elimination of environmental stresses by not having an environment that is overly cluttered but still has focal points to retain interest, views to the outside, and artwork.

2. Inclusion of elements and activities that are familiar to the residents, such as:

a. Food Preparation/Eating

b. Bathing/Dressing

c. Board Games

d. Puzzles

e. Reading

f. Stretching

g. Piano/Music

h. Dancing

i. Housekeeping and Laundry

j. Vacuuming

Consider the effects of sensory over-stimulation, both auditory and visual.

The acoustics of a space shall be designed so that background noise that is distracting is minimized. Reduce visual stimulation from such things as loud patterns and glare.

Provide signage and wayfinding tools or cues that are redundant in that they use graphics, words, elements and views to assist residents in navigating the environment.

IV. Designing for Social Engagement - Social engagement of residents with one another and with their families is of fundamental importance to the residents’ quality of life. The environment can help facilitate that social engagement by offering a variety of social spaces in order for residents to participate at any level and degree.

There is a variety of spaces for both structured and un-structured, or casual interaction. These spaces should have abundant natural light and views to the outdoors, and are able to facilitate reading, conversations, media usage, family socializing, and spontaneous interactions.

While interaction and socializing with others is encouraged, choice for the resident of where and when to interact and/or participate is key. To aid in the resident’s empowerment, places like seating alcoves and niches are provided in the design. These alcoves are configured to allow residents to preview the larger activity that is going on as passive observers or have quieter more intimate conversations with another resident or staff member. Previewed spaces from the alcove may include the living room, dining room, or den.

V. Room by Room Descriptions: All resident areas must be free of impediments including mechanical and structural elements, controls, hardware, and other built-in items. All areas must comply with ABA/ADA Standards for Accessible Design (See VA Small House Model Design Guide, January 2017):

1. The A/E shall incorporate a bariatric accommodation into each Home.

2. Each home shall have a tornado safe room.

B. Project Specific Design Criteria:

I. Architectural Design-

1. Life Safety Plan –

a. Project Location: Decatur, Georgia

b. Occupancy Classification: Existing Health Care (Nursing Home)

c. Interior Finishes:

i. Wall and Ceiling Finishes - Class B for fully sprinkled buildings, except Class C is permitted for individual rooms having capacity not exceeding 4 persons and the lower portion of the corridor wall.

ii. Interior Floor Finishes – Floor coverings (other than carpet), shall have a minimum critical radiant flux of 0.1 W/cm2 for fully sprinklered buildings.

d. Any area with a hazard of contents classification higher than that of the health care occupancy and located in the same building shall be protected. Hazardous area Protections includes:

i. Central/Bulk Laundry Area > 100 SF (1 Hour)

ii. Rooms with Soiled Linen >64 Gal (1 Hour)

iii. Combustible Storage Rooms > 50 SF and ≤ 100 SF (Smoke partition).

iv. Combustible Storage Rooms > 100 SF (1 Hour)

v. Rooms with Trash > 64 Gal (1 Hour)

vi. Residential Cooking – Residential cooking equipment is used to prepare meals (NOT for “warming or limited cooking”) for 30 or fewer persons.

1. Residential cooking equipment is not exempt from protection and requires specialized extinguishing equipment requirements defined under NFPA 96, constituting a hazardous area.

2. Residential or commercial cooking equipment to prepare meals for 30 or fewer persons can be open to the corridor provided they meet the requirements of NFPA 101.

3. Residential or commercial cooking equipment to prepare meals for 30 or fewer persons are also allowed provided they are separated from the corridor and meet the less stringent requirements of NFPA 101.

e. Evacuation Standards: A percentage of residents may suffer from some degree of cognitive impairment. Those afflicted can become frightened by an evacuation alarm. It is therefore suggested that fire alarm systems use private operating mode. Horizontal evacuation plans, (also known as “defend-in-place” strategy) is a requirement for all healthcare and ambulatory healthcare occupancies. All facilities must plan for horizontal evacuation through smoke barriers to a safe area. Designers should refer to NFPA 101 for guidelines including but not limited to the following:

i. Designing the facility so that each floor is divided into at least two smoke compartments, not more than 22,500 sq ft. separated by 1-hour fire rated smoke barriers.

ii. All penetrations in smoke barriers are to be protected using UL-listed firestop systems.

iii. Cross-corridor doors in smoke barriers are required to be a pair of opposite swing double egress doors, equipped with fire-rated vision panels and astragals. This will allow occupants in either smoke compartment to safely egress to an adjacent smoke compartment on the other side of the barrier.

iv. Travel distance from any point in a smoke compartment to a smoke barrier door should not exceed 200 feet.

v. Ducts are permitted to penetrate smoke barriers without the use of smoke dampers in fully ducted HVAC systems (due to complete sprinkler protection requirements).

2. Accessibility: Current profiles of the VA residents indicate that a high percentage require assistance in activities of daily living such as toileting and showering. It is required that the Small House facilities adhere to the requirements of PG-18-13 and provide accessibility in 100% of bedrooms and resident toilets designed to accommodate both male and female Veterans.

a. Assisted Transfers: Small House’s empower staff and promote the use of overhead lifts to help in toileting and bathing. The A/E shall incorporate overhead ceiling-mounted lifts in all patient bedrooms and toilet rooms.

b. Bariatric Lifts: At least one room in each Home shall be provided with a built-in mechanical lift system (e.g., a ceiling rail system) capable of transporting a 600-pound (272.16-kilogram) patient from the bed to the toilet.

II. Interior Design -

1. Interior Room Finish/Plans/Schedules: The interior of the Small House must be welcoming and reflect the comforts of home. The geographic identity of each Small House can be reflected by a diversity of design and a variety of finish selections, as appropriate to the location of each facility across the United States.

The creative use of finishes, architectural detailing, lighting, furniture, wayfinding and artwork will ensure a quality experience for residents, staff and visitors. Each Small House will be designed and detailed to express a residential theme and provide a concept of Home to its residents. For typical interior finishes refer to VA PG 18-14 for additional information regarding Small House finishes.

a. Overall Selection Criteria: Individual perceptions differ according to diverse social norms and situations. The creation of a home and healing environment can greatly affect the resident’s perception of overall well-being and sense of control.

b. Perception is not based upon isolated responses to a particular stimulus, but rather as a reaction to the total stimulus field. Therefore, a variety of factors must be considered when planning the interior of the Small House.

c. The interior architecture, finishes and furnishings of the Small House should be designed and selected with the following goals in mind:

i. Achieve an environment that is comfortable, familiar and residential in aesthetic.

ii. Recognize and reflect the geographical region of the Small House.

iii. Ensure an ease of maintenance and durability for daily use.

iv. Appropriate for both safety and ergonomics.

v. Environmentally responsible, toward the interior environment of the Small House as well as the global environment.

2. A Familiar, Comfortable Environment: Interior architectural elements and finishes should reflect those typically found in a residential house.

Architectural elements such as chair rails, crown molding, door casings, and baseboards whenever possible shall be designed/detailed in a manner and scale similar to a private residence. Choose Finishes and Furniture that will enhance the residential aesthetic in all Resident areas while also maintaining commercial/healthcare grade levels for durability and maintenance.

3. Reflect the Geographical Area: Interior design and architecture for each House shall reflect and be appropriate to the geographical region in which it is sited, and sensitive to the local climate, quality of light, and regional materials.

4. Ensure Ease of Maintenance: Finishes should be selected with consideration to durability and maintenance practices of the VA Small House. Flooring tends to be the most time-consuming finish to maintain. The number of cleaning supplies and time spent to maintain these finishes can be reduced by selecting a family of floor finishes that have similar maintenance requirements. Designs that utilize a conservative number of paint colors throughout the community will likewise contribute to an ease of maintenance and reduced attic stock. These benefits can also be seen by specifying lighting fixtures with the same lamp types.

Wall protection can minimize damage done to walls due to everyday use and, used prudently, can avoid an institutional appearance. In determining the amount and type of wall protection to be used, consider the following:

a. Carefully consider the color, pattern and texture of wall protection. It should be selected to be integral with the overall design concept. Use full height corner guards.

b. Avoid the use of stainless steel except in service areas

c. Handrails should be designed as an integral part of the wall protection package.

5. Ergonomically Appropriate: The specification of ergonomically appropriate furniture, details and finishes should eliminate as many barriers as possible for daily living of residents. Standards shall be per VA Accessibility (Barrier Free Design Guide) at a minimum.

a. Visual Considerations:

i. Provide a color/value contrast between floor and wall planes and between hand-rails and walls

ii. Maintain a similarity of color value between different floorings

iii. Provide low glare surfaces, particularly on floors

iv. Provide wayfinding cues in the interior architecture

v. Ambient lighting should be augmented with focused task lighting

vi. Provide access to daylight and control glare

b. Physical Considerations:

i. Provide lean rails or hand-rails in resident hallways and other pathways to aid residents walking independently

ii. Provide slip resistant floors

iii. Provide minimal thresholds between changes of floor finishes

6. Environmentally Responsible: Provide a level of design that, at a minimum, is in compliance with the current standards and tenets set forth in the VA Sustainable Design Manual. This will ensure that the VA Small House support the VA mission in a manner that is socially, economically, and environmentally sustainable. The specification and implementation of sustainable finishes and materials supports the health of residents, visitors, staff and the larger community. When specifying finishes and materials give consideration to the following:

a. Low VOCs: Low pollutant-emitting materials and the protection of indoor air quality with regard to:

i. Materials and adhesives

ii. Installation of all materials

iii. Maintenance procedures and products

b. Recycled Content

c. Biobased Content

d. Life-cycle Costing

7. Design Language: The overarching scheme and style of the Small House is that of “home.” The residential design vocabulary for the Small House uses is to be taken into consideration when selecting the complement of products and architectural details. The theme and vocabulary shall be evident in the choices of materials, color, shapes, patterns, textures and layouts.

a. Color: Color can have a dramatic effect on the aesthetic appeal of an interior design. It can transform a plain space into an uplifting environment. As people age, cells in the retina that are responsible for normal color vision decline in sensitivity causing colors to become less bright and the contrast between different colors to be less noticeable.

This is also described as a yellowing of the lens. This change in vision results in an intensifying of yellow hues and tones. People with a yellowing of the lens tend to confuse pale colors in the blue-green region of the spectrum with other pale colors. Blue and green become more difficult to tell apart than red, yellow and orange. In consideration of this effect, select a multitude of colors, not just blue and green.

b. Color Pallets: Color palettes shall be developed for both homes together as a whole. The palettes developed for Small House shall have an overriding theme while also providing variation to allow spaces within the community to be emphasize with different colors. Select neutral tones for some of the most permanent finishes such as flooring, doors, and casework. Accent colors can be implemented on walls, furniture, and in art, and elements that can more easily be changed. Color palettes and their implementation are to reflect the following color concepts:

i. Full spectrum of color – encompassing both warm and cool tones.

ii. Contrast - Contrast between floor and wall planes, between furniture seats and the floor to differentiate the planes from each other and assist with depth perception.

iii. Minimize value (light to dark) contrasts between adjacent flooring, as the elderly eye may perceive this as a step or a hole.

c. Textures and Patterns: Use pattern and texture to bring another level of depth, variety and visual interest to the Home design scheme. These aspects should reinforce the residential theme. Patterns and textures can also be used functionally to help to hide soil and conceal wear. Select Patterns and Textures with consideration of the following principles:

i. Use both large and small-scale patterns to reinforce residential design themes.

ii. Limit large patterns to one surface or furniture item.

iii. Sample large patterns in large-size samples to ensure that the pattern does not produce an optic effect.

iv. Review smaller patterns in large-size samples as they may not be visible by an aging adult eye.

8. Design Elements: Design elements include the surfaces, materials, furnishings, acoustical properties, lighting and positive visual distractions that will be selected to execute the interior design of the Small House. The principal finish surfaces are floors, walls, and ceilings. Refer to the VA PG-18- 14 and the Room Templates for further direction on interior finishes. These elements should be selected in accordance with confirmed project standards and reinforce the residential theme present as described for all VA Small House projects.

a. Floor Finishes: Flooring finishes are extremely varied in pricing, installation methods, and durability. Select a flooring appropriate to the space function and geographic location. Selection criteria include initial cost, life- cycle cost, sound absorption, slip resistance, and ease of maintenance. The levelness, texture and moisture content of the subfloor are also important considerations. The Design team should be aware of any special or recommended installation practices for a specified flooring material; including recommended backing materials or moisture barriers.

Flooring transitions and transition materials will be detailed and selected to achieve as smooth a transition between flooring materials as possible.

Subfloors should be sealed wherever there is a probability of incontinent residents. Balance the need for highly cleanable flooring against the goal of achieving a residential environment.

b. Wall Finishes: Interior walls comprise the single largest area of finish in a project and serve as the backdrop to a room. The finishes, colors and textures applied to them help to define the aesthetic of a space.

Selection criteria should include initial cost, maintenance cost, contributions to light levels and sound absorption. Select a wall finish that is appropriate to the space function. Balance the need for cleanable, durable wall finishes against the goal of achieving a residential environment.

c. Acoustics and Sound Control: Acoustics are important to the quality of life of the residents. Analyze sound quality and transmission both in a single room and between two spaces. Careful consideration must be given to the following aspects:

i. Design partitions between rooms to have an STC (Sound Transmission Class) rating that complies with VA PG-18-14 Room Template data sheets.

ii. Consider using acoustically absorbent ceilings, walls, floors, and furniture in all public spaces and where sounds privacy is desired.

iii. Acoustical finishes should support the residential theme.

d. Wall Protection and Accessories: The amount and type of wall protection should be an integral part of the project design. The extent must be balanced with the use and associated maintenance requirements. Care should be taken regarding the following:

i. Hand Rails: All resident and public corridors should receive hand-rails or lean rails. Color should contrast with wall color.

ii. Wall Protection: Consider sheet wall protection, especially on lower half of wall, in corridors with a frequent wheelchair traffic.

iii. Corner Guards: Corner guards, in a tone to match the wall color or be of a profile to suggest a residential aesthetic, at outside corners.

iv. Stainless Steel Wall Protection: Stainless steel wall protection is used only in back-of house support spaces, such as gas storage areas.

v. Wall Base: Wall base in resident areas should be of a resilient type for durability but of a profile that will match the residential aesthetic.

e. Ceilings: In addition to the typical gypsum board and acoustical tiles, ceiling material options include wood, fabric and metal. Ceiling modules can be used in either panels or planks. Ceiling systems designs can include integrated lighting fixtures and air handling grills. Ceilings can have a major design impact on a space, a variety of ceiling types in a Small House community can help differentiate spaces and reinforce a residential aesthetic. Refer to VA PG-18-14 Room Templates for preferred ceiling heights. Consider the following when designing and specifying ceilings:

i. Use monolithic ceiling material, gypsum wall board, in resident rooms and other resident areas.

ii. Consider the acoustical requirements of the space.

iii. Review ceiling access requirements of the space for utility maintenance, the ease of access of ceiling system options, and the appearance of access panels.

f. Lighting: As people age, their eyes undergo changes. These changes of vision typically cause less light to reach the eye and a sensitivity to glare.

Providing higher levels of lighting from multiple sources will allow aging individuals to see detail and reduce glare. Innovative lighting designs and advanced technologies, including LEDs, photo sensors and occupancy sensors, can help residents both to maintain independence and create a more comfortable environment. An appropriate lighting design will contribute to safer rooms by reducing risks and minimizing falls. Lighting designs shall include the following aspects:

i. Locate lighting controls for ease of access.

ii. Limit glare from light fixtures through fixture lens position.

iii. Provide both ambient and task lighting.

iv. Provide higher illumination levels, per VA standards, particularly in bathrooms, for safety.

v. Provide low level motion activated light adjacent to each resident bed and in each resident bathroom.

g. Window Coverings: A wide range of window coverings are available:

drapery, shutters, mini blinds, vertical blinds, cellular shades, and solar shades. Each provides a distinct set of benefits and downsides, including cost and appearance. There can be substantial cost differences between the styles. Care should be taken in the following respects:

i. Determine the degree of sun control required on each exposure of the building.

ii. Determine the degree of visual privacy required in resident spaces both from the inside out and the outside in. Consider both daytime and nighttime conditions.

iii. Review the ease of operation for residents for each product.

iv. Verify that the window covering selected is compatible with the way the window opens and the associated window hardware.

v. Provide window coverings in resident rooms with room darkening capabilities.

h. Interior Furnishings: Comfortable, safe furniture is critical in order to encourage residents to leave their rooms and socialize. Provide a variety of seating types, configurations, and furniture styles. Many residents will lean on furniture for extra support when walking through a space, so chairs and tables must remain stable when used for support. In general, outside corners of furniture should be rounded to prevent injury from sharp edges. Care should be taken in the following respects:

i. Specify seating with higher and shallower than normal seats (recommended dimensions are: Seat Height: 18” - 20”, seat depth: 20” - 24”) arms that extend to the front of the seat (to aid in sitting and standing), wood or plastic arm caps, and an open space between the seat and back (crumb space) to make cleaning easier.

ii. Specify upholstered furnishings with firm foam, and seat cushions with moisture barrier inner wraps.

iii. Extra-large glides on dining chairs can make it easier to move chairs in and out from the table.

iv. Use only commercial grade fabrics with a high double-rub rating, and solution dyed or bleach resistant fibers.

v. Provide bariatric-quality seating (appropriate size and weight capacity) as required for the bariatric population of the Home.

9. Artwork: Art work adds interest and a residential touch to the community. It can provide an interesting positive attraction, or a point of conversation.

Care should be taken in the following respects:

a. Consider providing a space for temporary display of residents’ art.

b. Use a variety of frame styles and finishes. Mount to walls with security mounts.

c. Consider including art by local artists, veterans, and/or art that represents the region.

d. Consider using a wide variety of styles, both traditional to contemporary.

e. Avoid art with fuzzy or hard to discern shapes.

10. Wayfinding and Signage: Wayfinding should be integral to the planning of the community. Residents should, as much as possible, be able to intuitively find their way through the community via views, art, distinctive portals and colors. The AE shall utilize VA signage and wayfinding guides located at:

https://www.cfm.va.gov/til/spclRqmts.asp#SIGN. Care should be taken in the following respects:

a. Many residents will not be able to clearly distinguish colors. For those individuals the inclusion of unique forms can provide the necessary wayfinding cues.

b. Consider providing multiple cues at decision making points such as natural light, a significant piece of artwork, the size of the corridor, signage, and hierarchy of space.

c. As much as possible have clear views to destination points.

d. Consider color coding resident room areas.

11. Interior Finish Schedule: The following are possible finishes for the Small House. Designers must consider location, climate, and other project-by-project factors when making final decisions on finish selection.

12. Fixtures, Furniture and Equipment (FF&E) – Furniture and Artwork procurement packages shall be prepared for the VA and include a vendor https://www.cfm.va.gov/til/spclRqmts.asp#SIGN

Scope of Work, Schedule of Materials, Catalog Data Sheets, and Independent Government Estimate/Price Proposal.

a. VA Furniture Procurement Package

b. VA Artwork Procurement Package

III. Structural Design -

1. General:

a. Follow the VA Fire Protection Design Manual for fireproofing requirements of structural elements.

2. VA Structural Master Specifications: The A/E shall utilize applicable VA Structural Master Specifications (PG-18-1), located at:

https://www.cfm.va.gov/TIL/spec.asp:

01 45 29 TESTING LABORATORY SERVICES

02 41 00 DEMOLITION

05 12 00 STRUCTURAL STEEL FRAMING

13 05 41 SEISMIC RESTRAINT REQUIREMENTS FOR NON-

STRUCTURAL COMPONENTS

IV. Mechanical/HVAC Design - HVAC systems shall be provided to heat, cool, and ventilate individual rooms or areas as required to satisfy design criteria. The HVAC system shall comply with NFPA 72, 90A, 99, and 101, and the current version of Department of Veterans Affairs (VA) HVAC Design Manual, VA Design and Construction Procedures, VA Master Construction Specifications and VA Standard Details, where applicable. The current VA design and construction criteria are available on the VA Technical Information Library(TIL) at http://www.cfm.va.gov/ TIL/. Deviations from these VA guidelines may be made provided approval is obtained from the VA. Where specific VA requirements are not available or indicated in this document, design criteria from industry standards such as American Society of Heating, Refrigerating and Air- Conditioning Engineers (ASHRAE), National Fire Protection Association (NFPA), and Department of Energy (DOE), etc. should be submitted to the VA for review and approval.

1. Life Cycle Analysis: The HVAC system shall be selected based on an economic life cycle analysis performed as outlined in the current edition of the VA HVAC Design Manual.

2. Interior Design Conditions: Interior design conditions for each space shall be maintained throughout the year. Interior design conditions for all spaces shall be maintained in accordance with the current version of the VA HVAC Design Manual.

https://www.cfm.va.gov/TIL/spec.asp http://www.cfm.va.gov/%20TIL/

3. Supply Air Requirements: The supply air volume shall be established to meet the heating and cooling load requirements of the occupied space. The supply volume shall, however, be modified to meet a) minimum air change requirements if this air quantity is more than the heating and cooling load requirements, b) maintain proper space pressurization relative to room exhaust requirements. For all air systems the supply air minimum airflows shall follow the current version of the VA HVAC Design Manual.

4. Outdoor Air Requirements: The HVAC design shall provide each space with not less than the minimum recommended quantity of ventilation air indicated in the current version of the VA HVAC Design Manual.

5. Exhaust and Return Air Requirements: The HVAC design for spaces shall provide return air or exhaust air as required for the spaces to control the transfer of odors and provide proper room pressurization. At a minimum, exhaust air and pressurization shall be provided as indicated in the VA HVAC Design Manual.

6. Noise Criteria: The HVAC design shall provide resulting sound levels in occupied spaces not to exceed the levels shown in the current version of the VA HVAC Design Manual.

7. Design Features: HVAC design features such as the use of economizers shall follow the design criteria outlined in the current version of the VA HVAC Design Manual.

8. Temperature Control Criteria: The automatic temperature controls systems and the use of individual temperature controls for specific spaces shall be provided in accordance with the current version of the VA HVAC Design Manual.

9. Humidity Criteria: Humidity levels for the HVAC systems shall be provided in conformance with the current version of the VA HVAC Design Manual.

10. Cooling and Heating Load Calculations: Using an ASHRAE-based, public domain (DOE) or commercially available software program (Trane, Carrier, and/or other software meeting the modeling requirements needed for compliance with ASHRAE Standard 90.1-2016 or approved latest edition), calculate the cooling and heating capacities.

a. Exhaust and Outdoor Air For Ventilation: Use published data and parameters to estimate the highest required value for exhaust CFM and for outdoor air ventilation CFM. The minimum required ventilation outdoor air flow at the air handling unit level shall be the greater of the following two air flows:

i. The minimum required outdoor air flow to meet VA and / or ASHRAE ventilation requirements.

ii. A flow equal to the sum of all the exhaust air flows in the spaces served by the air handling unit in question plus additional excess flow to ensure the overall spaces are positive with respect to the outside air environment.

The A/E shall determine how much excess air is needed for item (ii) above the A/E shall take into consideration the building envelope and calculate how much excess air is needed to maintain the space differential pressure between 0.02 inches WC and 0.03 inches WC [5.0 to

7.5 Pascal].

Note that the baseline building pressure shall be the pressure maintained in the unrestricted access general circulation spaces of the building between the building entrances / exits and the clinical and / or functional areas. The pressure in these spaces, relative to the outside shall be designed to be 0.01 to 0.02 inch WC [2.5 to 5.0 Pascal] higher than outside of the building. This may require balancing multiple AHUs.

b. Room Data Output: The calculated HVAC design parameters for each space shall be shown in an EXCEL type spread- sheet. Provide a spread sheet for each air-handling unit for review and comment.

c. AHU Peak Cooling Load: AHU peak cooling load is the maximum load on the air-handling unit due to room sensible, room latent, and total outdoor air for ventilation cooling loads. Note that the AHU peak- cooling load is not the sum of the individual room peak cooling loads, which occurs at different times, in different months, and due to differing orientations. If a chiller serves a single air- handling unit, use the AHU peak load to select the chilled water system.

d. AHU Peak Supply Air Volume: AHU peak and minimum supply air volumes are calculated from the peak space sensible cooling load and from the space peak sensible heating loads. Enter load calculation results and space specific minimum air change per hour requirements into a spread sheet to calculate maximum and minimum flows. Apply a 5% leakage allowance and 5% safety factor to the maximum CFM and round off to the nearest 100 CFM. Use AHU peak supply air volume for selecting the air-handling unit and main air distribution ductwork upstream of the VAV box. For individual branch ductwork to a VAV box and for ductwork downstream of the VAV box, use the individual room peak supply air volumes. The return air duct shall be sized based on peak AHU supply air volume minus local and general exhaust CFM. The return air branch from the room shall be sized based on room peak supply air volume taking room air balance and local exhaust CFM into consideration.

e. Psychrometric Analysis: Provide psychrometric analysis for each air-handling unit by using software programs. The calculated and graphic display of the system performance shall include the following:

i. Outdoor and indoor design conditions.

ii. Mixed air conditions.

iii. Coil leaving air conditions.

iv. Heat gain due to supply and return air fans.

v. Heat gains and losses in duct systems.

vi. Supply air volume.

vii. Cooling, heating, and humidification loads.

12. Room Temperature Controls: A space is defined as individually controlled only when a dedicated terminal unit (example: air terminal unit, fan coil unit, heat pump, or any other heating and/or cooling device) is used, with a dedicated room temperature sensor, to control the space temperature.

a. Individually Temperature Controlled Spaces or Rooms: Listed below are examples of individually controlled spaces with dedicated temperature sensors.

i. Patient Bedroom

ii. Kitchen

iii. Den

iv. Office

v. Therapy

b. Group Temperature Control:

i. Perimeter Spaces: A single air terminal unit can serve as many as four offices or a single patient bedroom located on the same exposure and with identical load characteristics. Do not combine spaces located on different zones to form a common temperature-controlled zone.

ii. Interior Spaces: A single terminal unit can serve as many as six interior office or a single patient bedroom with identical load characteristics.

c. Open Spaces: Open spaces with an exposed perimeter shall not be combined with interior spaces to form a common temperature control zone. A perimeter zone is defined as an area enclosing an exposed perimeter wall and 12 to 15 ft [4 to 5 m] width.

13. Perimeter Heating:

a. Requirements: A building thermal envelope with enhanced energy efficiency can eliminate the need for perimeter heating systems. Provide supplementary perimeter heating systems for:

i. Patient Bedrooms: When the room heat loss exceeds 180 Btuh/lin ft [173 W/lin m] of exposed wall.

ii. All Other Occupied Spaces: When the room heat loss exceeds 210 Btuh/lin ft [202 W/lin m] of exposed wall.

b. Heating System Description:

i. Hard to clean convective type heating units such as radiators and convectors shall not be used in patient care spaces.

ii. All patient bedrooms and associated exposed bathrooms and all patient care spaces that require supplementary heating shall use perimeter under floor radiant heaters; flat and smooth radiant ceiling panels, or flat and smooth radiant wall panels with exposed cleanable surfaces.

iii. During design development, provide coordinated details of the perimeter reflected ceiling plan, showing coordination between linear diffusers and radiant ceiling panels. Design shall optimize performance while maximizing aesthetics.

iv. For all other spaces such as non-patient bathrooms, exterior stairs, vestibules, and unoccupied spaces, thermostatically-controlled heat can be delivered by unit heaters, cabinet heaters, convectors or baseboard radiators.

v. Perimeter heating system controls shall be integrated with the space cooling system controls to achieve sequenced heating and cooling and eliminate the possibility of simultaneous heating and cooling.

c. Heating Medium: For perimeters heating and reheat coils in VAV terminals or in other duct mounted applications, the A/E shall consider the Total Life Cycle Cost (TLLC) for both heating water and steam as the heating medium. The TLCC must carefully consider the energy and maintenance costs as well as the first cost. Use two-way modulating control valves to control the hot water flow. Minimum hot water flow for each heating circuit shall not be less than 0.5 gpm [0.03 L/s]. For unoccupied miscellaneous spaces, steam or gas may be used. Use of electric resistance heaters shall be approved by VA Authority and may be permitted where other heating mediums are not available.

14. Fire and Smoke Protection: HVAC design and equipment shall be in compliance with VA Fire Protection Design Manual - 2015 or approved latest edition, and approved current edition of NFPA 72, NFPA 88A, NFPA 90A, NFPA 96, NFPA 99, NFPA 101, IMC, and other applicable codes with devices, such as, fire dampers, smoke dampers, and duct-mounted smoke detectors shown on the drawings where applicable.

a. Smoke Dampers and Detection:

i. Installation of smoke dampers and detectors shall be done in compliance with the manufacturer’s published recommendations for access, duct clearance distances and elbow locations.

ii. Provide electrical actuators.

iii. Smoke dampers and detectors shall be hard-wired.

iv. When smoke dampers are required in the main supply and return ducts to isolate the air handling unit, provide duct-over pressure protection either with smoke damper end switches or with duct pressure shut off switches or both hardwired to all applicable fans to protect ductwork when smoke dampers close.

v. Provide local audible and visible alarms and a remote alarm at the Engineering Control Center (ECC). The alarm shall operate both for smoke detector activation and for smoke damper closure.

vi. Show adequate access to the dampers and detectors on plans including duct access panels and access to the same.

vii. Coordinate with fire alarm system engineer to ensure room smoke detectors are not located next to supply diffusers.

b. Fire Dampers:

i. Show all fire dampers on floor plans.

ii. Show adequate access to the dampers on plans, including duct access panels and access to the same.

iii. Evaluate available fan pressures and provide duct-over pressure and duct-under pressure shut off switches hardwired to all applicable fans to protect ductwork when pressures warrant the protection.

c. Stair Pressurization: Stair pressurization is not used in VA facilities.

d. Engineered Smoke Control System: Engineered smoke control systems are not used in VA facilities.

15. Locations of Outdoor Air Intakes and Exhaust Outlets:

a. Outdoor air intake and exhaust air outlets shall be located in…