This year’s annual Environments for Aging conference will be held in Orlando, FL. We will be presenting our analysis of how innovation and design standards converged in a major three year initiative to build 1,533 new nursing home beds in Nova Scotia. We examine the surprising outcomes and their determinants in form, space and culture when a strict design standard is used. In particular, we explore how innovation was handled – such as adaptations to space requirements and cost reductions – and ultimately propose a method for embracing innovation within a design standard.