The Kingswood Manor Health Care Center in Kansas City, Missouri was originally designed on the philosophy of a medical model of care. The physical environment was focused more on the medical care of the residents and staff efficiency and sacrificed, for the most part, the residents' social, psychological, cultural and spiritual needs. As a result, the environment reflected many "institutional" characteristics, typical of many long-term care facilities built in the 1960's and 1970's.

The pre-renovation floor plan of the Kingswood Manor Health Care Center. Long hallways with resident rooms on both sides, a large dining room, and a centrally-located institutional nurses' station characterized the institutional nature of the health center before renovation.