It wasn’t a typical groundbreaking ceremony at the Elizabeth Seton Children’s campus in Westchester, NY, last month. For starters, Cardinal Timothy Dolan, the top Catholic official in the region, came out to bless the ground that will become home to nearly 100 long-term residents about two years from now. More importantly, the construction project is like no other in the US: It is creating a much-needed home for medically complex young adults who are aging out of the organization’s prestigious children’s center. Such children are today living longer than ever expected in past years. But in 2019, the organization saw 30% of children it discharged due to age die a little more than a year after the move. That was a clarion call for CEO Pat Tursi, who recalled crying in the chapel with staff as they mourned the loss of children who’d become like family. Now, Tursi sees her fledging young adult center — a demonstration project funded in part by New York state and the Centers for Medicare & Medicaid Services — as a potential model for providers all over the country facing similar realities. “We needed to be the pioneers, and we needed to be the innovators because that is what we do and nobody else wanted to do it,” Tursi tells McKnight’s Senior Editor Kimberly Marselas in this episode. “How can you just sort of take away all of the wonderful foundation that we've built upon and the love and and have it just, you know, disappear at age 21.” Under the new model, older residents will be able to stay with Elizabeth Seton Children’s until age 35. Buoyed by private donations, the organization is building a physical campus that supports residents with upgraded features and the technical specifications needed to serve young adults with physical needs, such as ventilator and trach care, and severe intellectual and other disabilities. Mobility for residents within the center — their home — and the ability for most residents to go on outings with the support of a robust staff have been key considerations. Listen to this special episode to learn from Tursi about what she envisions for today’s residents, tomorrow’s young adults with intense medical needs — and what lessons traditional skilled nursing providers can take from Elizabeth Seton Children’s journey.