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Rethinking Long-Term Care Facilities Of The Future


Globally, we have watched long-term care facilities suffer from higher-than-average COVID-19 infection rates.

In Canada, the US, and the UK, the call is growing to strengthen protections around the most vulnerable who call these home. From sources of funding to design requirements and construction approaches, an overhaul is inevitable.

At Entuitive, we are looking at ways in which we can help evolve the built environment to suit a post-COVID-19 world. Offsite and Modular Construction is a fitting building method to accommodate a surge in planning for an increased demand for health- and long-term care facilities.

Modular construction has been around since the early 20th century, traditionally for small utilitarian buildings. In recent months, the need for emergency healthcare structures, testing facilities, and care facilities that can be quickly deployed could not be more apparent. Going forward, the need for expanded facilities in long-term care will continue to grow.

Our approach to Offsite and Modular Construction (OSMC) extends beyond the traditional to include larger, contemporary buildings. Our portfolio includes student residences, hotels, residential buildings, administrative offices, and healthcare facilities.


Buildings that allow for a cellular layout and are structured with a high degree of repeatability are well suited for offsite and modular construction. Affordable housing, student residences, hotels, and long-term care facilities are all cellular in nature and afford the opportunity for high levels of standardization and repetition, making them ideal candidates.

Speed to Market 

Projects can be delivered up to 50% faster than traditional builds because of scheduling efficiencies, such as the ability to manufacture the modules concurrently with the on-site foundation and podium work.

Cost Certainty

The integrated design and manufacturing processes allows for real-time feedback and the use of off-site labour within a controlled manufacturing environment improves productivity and eliminates weather-related delays and associated costs.


Production-style assembly and optimal construction conditions reduces overall material waste, leading to greener projects.

Increased Worker Safety

Risks are reduced under ideal construction conditions provided by an enclosed fabrication/manufacturing facility.

“By creating long-term care units off-site, owners can expect faster project delivery, sustainable construction, and lower costs.”

Cheatham Street Flats, a 143-unit, 234-bed student housing mixed-use development.


All buildings are designed for their final condition. However, buildings using OSMC techniques must be designed not only for the final condition, but each individual module must be designed with adequate strength and stiffness for all conditions they will experience, including during transportation and hoisting.

Crucial to the success of any OSMC building is the ability to develop details that allow horizontal and vertical interconnection of modules and load transfer while maintaining extremely tight tolerances so that erection is quick and accurate.

In the end an OSMC building does not need to look and feel ‘boxy’ or completely rectilinear when complete. A competent and experienced design team can create expressive architecture and varied interior spaces while achieving the benefits offered in modular construction.


The fire separations in OSMC projects are fundamentally different from conventional buildings as the assemblies are often created from two adjacent faces of modules.

OSMC projects often require that the approach to fire safety design follows a first-principles perspective since these buildings often fall outside the prescriptive clauses of current building codes. As well, we’ve started seeing some municipalities introduce a fast-tracked approvals process for temporary medical facilities, though it can place increased onus on the design team to provide a safe and accessible design.


Regardless of the building type or the method of construction, the functional requirements of building envelope remain the same. As the layer between a building’s occupants and the surrounding environment, the envelope is the most impactful component of any asset in relation to the built environment and the community it serves.

In OSMC each module, complete with finished drywall, etc., must be kept dry during storage, transportation, and hoisting, but also in the final building once complete.

Developing cost-effective details to manage moisture through the transportation and final construction is key. Strategic selection of materials and systems as well as cladding design should be part of the early design process to maximize the potential for envelope components to be installed in the manufacturing facility.

It is also key to select materials that provide durability and protection during transportation but that can also reduce rework and installation of envelope materials on site, including easing the connection of the modular units. Through our OSMC projects, we have developed an understanding of the options and strategies to assist design and construction teams make these decisions and develop the key details.


Offsite and Modular Construction has the potential to play a substantial role in pandemic preparedness in the future. The rapid and safe deployment of health- and long-term care facilities in an emergency situation will rely on the advance readiness of both designs and stock. In the case of LTC facilities, preparing for spikes in short-term needs will allow us to build out the stock both now and for the longer term.

Learning from COVID-19, we can ensure that the necessary civic infrastructure is in place or can be rapidly deployed to meet the needs of front-line workers and those affected most.

For more information, contact Tom Greenough.


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