I have a 3 stall center aisle barn that has a T aisle. The top of the T is the 3 stalls that have dutch doors that lead to a dry lot. One of the stalls has a 12X48’ medical paddock. On the right hand of the stem of the T is the tack room that has a bathroom and a washer/dryer. The left of the T is the feed and hay room, along with stairs that lead to 1/3 or the overhead space as the hayloft. The other 2/3’s of the space is a barn apartment. 2 bedrooms, 1 full bath, den and kitchenette. Frig, microwave, toaster oven, sink and table to seat 4.
The space between the tack and feed rooms is my tack up area and wash stall. I have a roll up garage doors on the N, E and W ends of the barn that I can open and close to control the amount of ventilation in the barn. So far the only time I’ve had the 3 closed was during the polar vortex. The dutch doors on the S were open. I was able to do barn chores in a turtle neck, scarf, and down vest in temps that were in the teens due to the lack of wind.
I would talk to your vet about the medical paddock. From what I read, long and skinny was better than wide. You are able to increase the length of the paddock as they get better, but with it skinny they can’t canter in a circle around a wide ( but not wide enough paddock). They might trot/canter to the end and stop and make the turn and trot/canter back, but they can’t trot/canter an endless circle. a 12’ width is one that can accommodate a round pen panel that can be moved to enlarge the paddock by 8’ increments.