Hillview Health Care Center: One Building, Many Needs—A New Model for Integrated Community Care

Located in La Crosse County, Wisconsin, Hillview Health Care Center Campus has been a community cornerstone of long-term care services for decades. Over time, however, the underutilized 120,000‑square‑foot facility was plagued by building rehabilitation needs and costly repairs. In addition, there was a growing need within the campus for memory care as many existing consumers were being discharged to this type of care setting. There were also several unmet community needs, such as childcare and supportive housing. Rather than pursuing separate construction projects to meet skilled nursing demand, behavioral health services, intergenerational programming, and transitional housing, county leaders embraced an ambitious vision: transform this single building into a fully integrated community hub. 

A Program Built Around Community Need 

At the center of the transformation is the right‑sizing of Hillview’s Skilled Nursing Facility (SNF). The redesign creates a more personalized and dignified care environment—an essential step toward modernizing the campus. The former 113 double‑occupancy room institutional model is being reshaped into 36 private rooms. This scale better matches present‑day demand while improving privacy, comfort, and staff responsiveness.  

In addition to the SNF, the County is establishing a 39‑bed Community‑Based Residential Facility (CBRF), which includes a specialized 4‑bed Crisis Stabilization Unit. Rising behavioral health needs made this component a top priority. Rather than simply carving out rooms, the design team ensured that the CBRF spaces were purpose‑built—complete with appropriate safety features, a secure but calming environment, and layouts that support both staff oversight and resident autonomy. 

The Intergenerational Day Center adds another meaningful layer. Designed for both adults and children, it includes its own safe entrance, dedicated outdoor spaces, and flexible activity zones. These features allow children and older adults to interact naturally throughout the day, fostering mutual joy and connection. 

Meanwhile, the addition of ten supportive transitional housing apartments provides short‑term stability for individuals working toward independence, all with direct access to essential services housed within the same building. 

Working Together: Collaboration as the Foundation 

Executing a project of this scope required collaboration well beyond typical design and construction engagement. County leadership, healthcare administrators, long‑term care committees, behavioral health partners, design teams, engineers, contractors, and community organizations such as the YWCA all played integral roles. More than 150 design and coordination meetings were held to align expectations, resolve challenges, and refine the operational plan. 

From the start, Hillview’s leaders emphasized that building decisions needed to follow operational needs, not the other way around. Facility assessments identified which components could be revitalized, which required replacement, and which needed full revisioning. This thoughtful analysis ensured the renovated spaces truly supported the programs being delivered. 

Navigating regulatory requirements was another key challenge. The CBRF was required to meet new‑construction standards despite being located inside an existing building. Close collaboration with state authorities, paired with creative design solutions, allowed the County to achieve compliance without compromising the integrity of the integrated vision. 

Greater Than the Sum of Its Parts 

The real strength of the Hillview project lies in how its components work together. Intergenerational interactions enrich daily life for seniors, providing uplifting moments and renewing purpose. Operational efficiencies emerge as staff, kitchens, therapy areas, and maintenance services support multiple programs under one roof. Shared resources, from courtyards to community rooms, create a vibrant, activity‑filled environment. In many ways, Hillview functions as a small community within a larger one, where residents, day visitors, families, and staff contribute to the rhythm of daily life. 

Kelly Kramer, Campus Administrator for Hillview Health Care Campus, shared, “We recognized that long-term care was rapidly evolving, and many of our current customers were choosing more affordable, home-like care options that were not yet available on our campus. The Evergreens allows us to meet that need and complete the full continuum of care on the Hillview Campus. By introducing The Evergreens and resizing our nursing home, we were able to staff both areas appropriately while also creating more modern, comfortable, and home-like environments—enhancing the experience for both residents and employees.”  

A Blueprint for the Future 

The Hillview Health Care Center redevelopment shows what’s possible when innovation, collaboration, and community needs align. It is a complex project made feasible by strong leadership and a willingness to rethink long‑held assumptions about service delivery. Its success offers a model for other counties and mission‑driven organizations: reuse what you have, design for the needs of today and tomorrow, and build partnerships that make transformative ideas attainable. 

Julie Heiberger is a senior project architect and the Senior Living Market Leader for Hoffman Planning, Design & Construction, Inc. (www.Hoffman.net). With more than 25 years of experience, Julie’s expertise centers on designing sustainable senior living facilities that address the latest care models and industry trends. A member of the American Institute of Architects and the National Council of Architectural Review Boards, Julie received her Master of Architecture from the University of Wisconsin–Milwaukee. Email Julie at jheiberger@hoffman.net 

Jon Rynish is a senior project architect with Hoffman and a Leadership in Energy and Environmental Design (LEED) accredited professional. A graduate of the University of Wisconsin-Milwaukee with a Bachelor of Science in Architectural Studies, Jon has more than 15 years of experience in the design profession. He has collaborated on numerous senior care facility projects for a variety of clients, specifically those for religious congregations, county providers, and non-profit senior living providers. Email Jon at jrynish@hoffman.net. 

Terry Ellenbecker is Hoffman’s director of field operations, who also serves as a senior project manager. With nearly 40 years of experience in the construction industry, Terry’s diverse project expertise includes senior living, corporate and professional, health care, and women’s religious facilities. A graduate of North Central Technical College with an Associate degree in Architectural Design, Terry serves as the conduit between Hoffman and the client to ensure they have a comprehensive facility upon completion. Email Terry at tellenbecker@hoffman.net.