Situated on the Chicopee River, the close-knit community of Ludlow boasts a rich industrial history. Constructed between the 1870s and the 1920s, most of the town’s historic mill buildings located along State Street and the Chicopee were built by Ludlow Manufacturing Company when operations were at their peak. Today, the historic site is part of the Ludlow Mills mixed-use district, and is considered the largest brownfield site under redevelopment in New England.
A half-mile from the abandoned mill’s stock houses that once processed jute fiber into rope, cloth and twine, HealthSouth had outgrown its existing leased space in Ludlow Hospital, built in 1908. Portions of the building had become unusable, and the aging infrastructure no longer supported the needs for new technology or the group’s physical therapy practices. Moreover, a limited amount of windows, a lack of outdoor areas and cramped spaces within the facility all added up to a subpar environment for both patients and staff.
Renowned for its high-quality, patient-focused rehabilitative care, HealthSouth had established itself as a vital part of the Ludlow community, and for many had become a place where they reclaimed their independence. Recognizing the need for growth presented an opportunity to not only replace and modernize its existing hospital, but also help sustain a chapter of the town’s unique history, HealthSouth Corporation solicited GS&P to design a new 74,000-square-foot, state-of-the-art replacement hospital, to be prominently located in the heart of the new Ludlow Mills mixed-use development.
“GS&P’s relationship with HealthSouth began about 25 years ago, and since then, we’ve designed close to 100 facilities for them around the country,” says Robert Murphy, senior architect and principal-in-charge. “For this project—which is unique for HealthSouth’s model because it involves the brownfield redevelopment of a former mill site—we were asked to expand and incorporate LEED principles into our previously developed 40-bed rehab hospital prototype.
“HealthSouth’s old facility was woefully undersized and completely dysfunctional from the standpoint of how they operate. It consisted of 73 beds, on approximately four and a half floors, in an odd building that had very short floor-to-floor heights and extremely compact spaces. And several of the wards accommodated up to four beds. In contrast, our expanded hospital prototype places the entire facility—all patient care, administration, therapy areas, public facilities, nursing units and patient rooms—on the one level, and consists of private patient beds, which adheres to HealthSouth’s most current patient-care delivery model.”
“The Ludlow Mills project is the first rollout of what HealthSouth refers to as the ‘DeNovo greenfield hospital prototype,’ and it’s a whole new arrangement of their spaces,” adds senior architect and planner Eddy Alonso. “Our team essentially developed a kit of parts that consists of modules which can be attached in multiple ways depending on the site configuration. And going forward, these standard components can be used interchangeably at different sites. The prototype also allows for future growth without adding to the building, and will serve to develop a 100-bed design.”
Along with private beds—70 in total, including 17 beds shelled for future expansion—HealthSouth’s goals for the new facility included: creating an open, efficient and patient-friendly environment; employing the sustainable features necessary for LEED Gold certification; minimizing the number of nursing stations while maintaining visibility of patient corridors; an emphasis on providing daylighting, views and access to outdoor spaces; and a design that pays homage to Ludlow Mills’ distinctive architectural character.
A Sustainable & Historic Legacy
A key part of the Ludlow Mills preservation and redevelopment effort, HealthSouth’s new replacement hospital had the unique distinction of being the first building to be constructed on the former mill site.
“Because it was set to be the flagship building inside the redevelopment, we knew the hospital would be setting a precedent for the rest of the site moving forward,” explains Alonso. “So capturing the history of the location was extremely important because there’s a real sense of pride in Ludlow about their past. And that was one of the driving elements of the design—preserving that history, while also moving them forward into the future in terms of what the new Ludlow could look like.
“To help accomplish this, we immediately explored the possibility of reusing the original brick from the demolished stock houses so we could incorporate the historic legacy of the site into the building, and at the same time support sustainable design efforts. HealthSouth ultimately purchased the brick from the developer, and each individual piece was hand-picked, hand-cleaned and hand-stacked, and then secured for our use in the new facility. The design ended up reusing 100,000 salvaged bricks from the old mill buildings.”
“The plan to reuse the existing brick actually became quite a challenge,” adds Murphy. “It turned out that the structural capability of the original brick was fairly diminished and extremely hard to calculate. So instead of using it as the primary structural barrier for the outside of the building, we turned it into a unique accent component, and then selected a compatible brick that we could use for the majority of the structure. It certainly wasn’t our original plan, but it worked out beautifully.”
In addition to repurposing the historic brick, more than 240 linear feet of wooden beams were salvaged from the stock houses, refurbished by a local mill, and then used to clad the interior walls of the main lobby.
“We explored multiple ways to reuse building materials to improve the sustainability of the site and the building, and also to obtain LEED credits,” says project architect Trevor Lee. “In the end, approximately 95 percent of everything that was torn down remained on site—including stone, excess brick and concrete, which were crushed and used as fill.”
Also helping the facility reach the LEED Gold benchmark, more than 28 percent of the total building materials came from sustainable resources, and roughly 10 percent of all finishes used in the interiors contain recycled content. In addition, the hospital was designed to reduce the baseline water usage by up to 45 percent, and rooftop photovoltaic cells produce almost 60 kilowatts of electricity, providing more than 10 percent of on-site renewable energy. Designers also maximized natural open space and reduced stormwater runoff by using landscape elements such as bioswales.
“This effort was ultimately the perfect marriage between the LEED component, the design concept and what the design team had to bring to the table,” says Dexter Carty, project interior designer. “The LEED element really directed us to make some of the design decisions we made, and also helped us think about how we could incorporate these building reuse materials in an interesting way. I often wonder if it wasn’t for the LEED component, would we have gone that particular route because it was such a key driver for the design.”
A sustainable nod to the site’s history, the building’s design vernacular draws heavily from both the rhythm and proportions of the mill’s original stock houses—including the material color and glazing—creating a striking first impression, and complementing the character of building types, streetscapes and other community features found in Ludlow.
Planning that Promotes Mobility
As a leading provider of comprehensive rehabilitation for patients with a variety of ailments, including stroke, traumatic brain injury, spinal cord and orthopedic injuries, HealthSouth sought a new, patient-centered environment that not only aided in the physical therapy process and improved outcomes, but also promoted patient mobility.
“One of the reasons HealthSouth is so incredibly successful is attributed to patients’ short length of stay within their facilities,” says Alonso. “Not only is their patient turnaround fast, but it’s also backed by excellent results. So designing an efficient and cost-effective replacement facility for them was a key priority.
“Despite their previous physical therapy space—which was fairly dark and cramped and far less efficient—HealthSouth was still known for their quality of rehab care, and we collaborated with their physical therapists and operations team to create a spacious and well-organized therapy gym that supported the type of care they deliver.”
In distinct contrast to its predecessor, the hospital’s new therapy gym features floor-to-ceiling windows, which provide views to an outside therapy garden and courtyard, as well as natural daylighting for both patients and staff to enjoy. New equipment and technology—such as HealthSouth’s AutoAmbulator, which safely places a patient in a standing position while robotics assist the patient’s legs to walk on a treadmill—were incorporated into the space, along with floor patterns that promote a patient’s movement.
“One of the things we worked on purposefully was to marry the facility planning and design of the new hospital with the operations,” says Alonso. “And not only the operations, but the therapy that was being provided.
“HealthSouth’s physical therapy process relies on getting patients up and walking as quickly as possible, and the therapy doesn’t just end at the gym; it occurs throughout the entire facility. So the long corridors in the patient wings are purposeful because they allow for gait training by using the finishes to mark the flooring—as well as the patient’s progress—as they’re on their way to therapy, or even heading to dinner or group activities. It also allows staff to assess the patient in their daily activities in a more discreet manner as opposed to using very obvious markers on the walls. This way, they’re simply taking them for a walk, and they get more of an honest assessment of their progress. So getting a person up and walking from one point to the next actually becomes a part of a patient’s therapy, and the design facilitates that.”
Adhering to another key client goal, GS&P’s innovative design also minimizes the number of nurse stations while still maintaining clear visibility of the patient corridors.
“The program consists of two nursing units with support services, and we specifically designed the custom desks at the nurse stations to promote face-to-face interaction between patients and staff—so there’s less of a barrier and it’s far more inviting,” says Alonso. “Their centralized location also allows for patient supervision, reduces wasted steps, and greatly improves staff collaboration, including team nursing.”
Private Patient Rooms
Also greatly enhancing the patient-care environment was the advanced prototype’s layout of the private patient rooms.
“The plan works extremely well because of the way it’s adapted to the site,” says Carty, “and what’s really nice about the private rooms is none of them look out onto a public right-of-way—they either face an internal courtyard, or face out to the sides or back of the building, which is surrounded by natural vegetation and the Chicopee River to the south. So we essentially provided a 360-degree planning and design, and it works exceptionally well.”
In addition to offering river or courtyard views, as well as abundant natural light via large windows adjacent to the patient’s bedside, each private patient room is ADA-compliant and intentionally spacious to assist in patient mobility and staff access. Controls in each room are located convenient to the patient’s bedside to allow for personal operation of the lighting, TV and nurse call. A warm material palette carries from the patient room into the barrier-free in-suite bathroom (which permits easy wheelchair access to the toilet and shower), where design accents such as pebble stones and natural earth tones were used to simulate river stones found along the banks of the Chicopee.
The first HealthSouth facility to be LEED Gold certified, the new HealthSouth Rehabilitation Hospital of Western Massachusetts not only maintains the historical and architectural integrity of the city’s industrial landmark, but also provides a higher level of care for patients, employees, the environment, and ultimately the community.
“HealthSouth could have chosen another location to develop its new hospital, but they selected this particular brownfield redevelopment site because they were committed to revitalizing the city of Ludlow,” says Murphy, “and they wanted to continue to serve the community they had become such a pivotal part of by taking their rehabilitative care to the next level.
“Our expanded prototype allows them to do this by giving them what they so desperately needed, coming from an antiquated building that was more than 100 years old. They now have an open and efficient facility—all on the one level—that features clean lines and simple forms, which makes it much easier for patients and visitors to get around. And because the building maintains a strong connection to the outdoors, it’s filled with natural light. So it’s a far more welcoming environment, and it’s also quite striking in how it reflects the movement of the Chicopee River in its decor, color palette and sweeping floor patterns.”
“The new quarters is proof that a rehabilitation hospital can take your breath away and heal you at the same time,” says former patient Wesley Pippin in a letter to HealthSouth, congratulating them on the new hospital. “It’s difficult to encapsulate the many details and features within this very complete facility, and to truly appreciate all that HealthSouth offers to benefit the patient would require a voluminous book.
“Most obvious is that the entire layout has been designed with the patient in mind,” continues Pippin. “As I was wheeled into this unbelievable, highly functional building, I was astounded by its beauty, so carefully mixed with its purpose of design. ‘Modern’ and ‘up-to-date’ are not adequate descriptions—the new facility far exceeds those terms in every way.”