E01 – The Exchange Building Story… A Blueprint for Adaptive Reuse in Senior Living

Adaptive reuse holds enormous promise for reimagining cities and delivering cost-effective senior living - but the gap between concept and completion is where most projects stall. This session tells the real story of how a century-old office building in Harrisburg, PA became the Exchange Building: a vibrant community of middle-market rental apartments for adults 55+. Hear directly from the architect and the CEOs of Garden Spot Communities and Harristown Development Corporation as they unpack the playbook that made it possible. This unique project was built on a creative three-way partnership between a non-profit real estate and economic development organization, a non-profit senior living provider, and a third-party investor - a structure that unlocked financing, aligned missions, and kept the project moving forward through significant obstacles. Panelists will walk attendees through the full arc of the project: structuring the partnership, navigating building code requirements, determining structural and spatial viability, financing a middle-market model without sacrificing quality, and creating a community that genuinely serves older adults in the heart of a mid-sized American city. Whether you're an operator, developer, designer, or community leader, this session offers a candid and replicable framework for turning underutilized buildings into places people are proud to call home.

For more than two decades, designers, providers, and advocates have promoted household model nursing homes as alternatives to institutional long-term care environments. Yet implementation across the United States remains uneven, with some states advancing household model development while others continue to reinforce traditional institutional configurations. Drawing upon a national multi-phase policy analysis conducted through the Moving Forward Coalition's Financing Household Models & Physical Plant Improvements Workgroup, presenters will explore how often-overlooked policy, financing, regulatory, and planning frameworks influence the feasibility, scalability, and operational realities of household model environments. Using comparative state examples and a Household Model Environmental Taxonomy, the session will translate complex policy and regulatory systems into actionable insights for architects, designers, providers, and development teams. Attendees will gain practical strategies for recognizing how the alignment, or misalignment, of financing structures, licensure pathways, occupancy policies, and emerging planning and design standards can either constrain or accelerate residential, person-centered, and relationship-based care environments. The session will also examine how emerging FGI planning and design standards may create new opportunities for aligning environmental expectations with evolving operational, regulatory, and resident-centered goals across senior living and long-term care settings.

This session will review the Award of Merit and Honorable mention winning projects from the 2027 EFA Design Showcase. A small panel will be made up of one team member representing each award-winning project in addition to one member of the jury. The session moderator will introduce panel members, the submission and review process, and the winning projects. Panelists will describe each of the projects indicating how the project achieved excellence across the competition's four metrics: Innovation, Collaboration, Quality of Life, and Operations. The juror panelist will also discuss industry and design trends noted in this year's submissions, focusing on those that represent important ideas for the design community to incorporate into future environments. This presentation will be valuable to those operating and designing older adult environments as well as those considering entering a project into future EFA Design Showcase programs.