In the United States, there are about 1.5 million nursing-home residents living in 17,000 facilities. In Hudson, N.Y., more than 80 of those residents moved into a new nursing home this summer. But what sets this facility apart from the others is that it is the only one in the country that cares exclusively for former volunteer firefighters.

The Firemen's Association of the State of New York bought 122 acres on the Hudson River about 30 miles south of Albany in the 1870s. According to one report, the home was started in 1892 to provide care for firefighters returning from the Civil War and later became a nursing home for volunteer firefighters.

Tom Castelein says the administration building dates back to the late 1800s and portions of the nursing home were built in 1910, with other additions built in the 1950s and 1960s. Castelein is an architect for Bergmann Associates and served as the lead architect on the new 126,000-square-foot, three-story facility. In neighboring New Jersey a similar home has existed for nearly as long. The New Jersey Firemen's Home was established in 1898 and is open to both career and volunteer firefighters, says Frank Infante, the home's administrator and superintendent. That home sits on 88 acres and is having one of its long-term care dormitories and its kitchen and dining area renovated.

These nursing homes, only 120 miles apart, are the only two of their kind in the United States serving firefighters.

The American Association of Homes and Services for the Aging has nearly 6,000 members, nonprofit, elder-care facilities. Its spokeswoman, Lauren Shaham, says there are numerous occupation- or interest-specific homes. Some of these affinity homes serve military, unions and religions, many have been operating for 100 to 150 years. One, she says, was established for those who worked in the film and television industry. “Communities saw a problem and came up with solutions,” she says. But she doesn't know of any other firefighter home.

Shaham says the nursing-home industry has a surplus of beds right now, but she expects that to change during the next decade as baby boomers require care services. And today's surplus has led more nursing homes to renovate, as the New Jersey Firemen's Home did, rather than build new facilities. But whether it is renovation or new construction, there are some emerging trends in what's going into nursing homes.

Homes are trying to create a sense of community and shrink that feeling to fit the facility, Shaham says. Some of the ways they are achieving this is getting away from an institutional-looking reception area and T-shaped corridors. There is also a move toward more single-occupancy rooms, sitting areas and patios.

“The trend is to be more nicely appointed … to look less like a hospital and more like an apartment,” Shaham says. These changes have been going on for about the last 15 years and are in part due to the competitiveness of the care industry and its desire to remove any negative connotations the public has when it thinks of nursing homes.

By those standards, the FASNY home is trendy.

“We worked very hard to try to convey the residential feel and atmosphere throughout the facility,” Castelein says. “We were constantly working against the fact that a nursing home is inherently institutional.”

Part of how Castelein made the home less institutional was replacing the T-shaped corridor with looping corridors. “Residents can walk around their floor without feeling like they are pacing up and down a corridor,” he says. The home also has a physical therapy pool and large physical therapy room. It has a multipurpose room, a chapel and a central dining area. The home was built with both single- and double-occupancy rooms; the double-occupancy rooms have private toilet and shower for each resident. There's a dementia wing for Alzheimer patients that has a secure outdoor garden.

Another thing that helped was the setting. The land is in a community with residential homes and a school close by. It also has open area that sweeps down to the banks of the Hudson River. Castelein says it is common to see wildlife, such as deer, in that area.

To create the feeling of community or neighborhood that Shaham spoke of, Castelein's team created several lounge areas in the residential corridors. They also created a quasi-main street with a commissary, hair salon, and offices for visiting dentists and doctors. The second-floor library has a gas fireplace and mantle. And, they recreated a cherished component of the old home that residents called the front porch.

“It was an enclosed-glass area … that was a really important piece of the social fabric. During construction, there had been a lot of sidewalk superintendents in the front porch watching the new building being built.” The new front porch has an indoor and outdoor area and is located near the shops.

In addition to serving its elderly residents, the home also is used for FASNY meetings and outside events such as firefighter softball tournaments; it has a regulation softball field on the grounds.

In many ways, this home is a Cadillac of nursing homes — the home's price tag was $27 million. Because facilities differ so much and construction costs change by locale, it is hard to put come up with an average price for a new nursing home. To put this in perspective, Castelein says, the average fire station can run between $2 million and $9 million.

With construction complete and the residents moved in, the only thing remaining is removing the old buildings. The administration building will be retained and used for office space for FASNY's 50,000-square-foot fire museum, which shares acreage with the home. Some of the space from the demolished buildings will be used for parking for the museum and the new home.

Rather than simply raze the buildings, the association recognized the structures' historical value. The Times Union reports that FASNY hired a firm to dismantle anything that might be of value, such as antique lavatory fixtures, stone, windows, even a barber's and dentist's chair.

But getting to the point of moving residents into the new building was no easy process. The first meeting between FASNY and Bergmann Associates happened in 2000. At that point, the association was trying to figure out what to do with its aging facility, whether to tear it down or renovate. By 2002, FASNY had decided to build new and was in the design phase; the project went out to bid in 2003. But Castelein says a lawsuit filed by neighbors that challenged the project's approval process delayed the start by about a year. The suit was ultimately decided in favor of FASNY and construction got under way in the spring of 2005. But that delay drove up costs.

“We presented (FASNY) with those facts and options for how things might be pared back,” Castelein says. “In almost every case, they elected to proceed with what they perceived as the highest quality.”

Given the competitiveness of the elderly-care industry, the new home couldn't have come soon enough. The old home was licensed for 120 residents, Castelein says. However, that number was based on dormitory-style living that would not be used today.

But the old home was nowhere near its 120-resident capacity. In fact, Castelein says, the census hit an all-time low of about 50 residents when the project began. The new home is near its 92-resident capacity and has a waiting list. Part of what helped bring the census back up was changing the admission policy in 2005 to accept firefighter spouses and members of the firefighter auxiliaries. Castelein says opening the facility to women meant only minor design changes.

Another anomaly, and one they share, is how both the New Jersey and the New York homes receive funding. Neither accepts Medicaid, which Shaham says puts them in company with 4% of the nation's nursing homes. “It is a pretty unusual model,” she says. “Being Medicaid-approved adds a layer of [government] oversight.”

Castelein says he saw this oversight in action during construction in New York. “At times it was difficult for health department inspectors to recall that the extent of their oversight was not the same as it is for other nursing homes,” he says. The facility is licensed through New York and is obliged to meet those design and program guidelines. However, “that the state does not provide any money whatsoever [for reimbursement] was something very difficult for the state bureaucrats to keep in mind.”

“We haven't accepted it for 108 years and we see no advantage or disadvantage to it,” Infante says. “We just never have done it.”

Both homes are funded through laws in each state that provides a 2% assessed from fire insurance premiums paid to foreign-owned insurance companies in the states. And both seek private donations. In New York, those residents who can afford it, are charged a daily fee.

There's no indication yet that more retirement homes for firefighters will be built in other states. However, if this becomes one of the trends in elder care, there's now a benchmark on the Hudson.