Pulse check

Market grows as more hospital expansions break ground

By Mark Friedman

In the South Central region and across the country, hospitals are in the middle of a construction boom.

"A lot of the hospitals were built after World War II … and are simply at the end of their useful life," said Rick Wade, senior vice president at the American Hospital Association. "They're incompatible with the way hospitals deliver care now."

Wade said the older hospitals aren't configured to handle the newer technology so a number of hospitals are renovating their buildings.

In other cases, hospitals are scrapping the old facility and building a new hospital. The hospital then will use the older structure for something other than patient care.

It now doesn't pay to have a small hospital or even a specialty hospital, said Jeff Collins, director of the Center for Business and Economic Research in the Sam M. Walton College of Business at the University of Arkansas.

"What we're seeing, because of demographic changes, is a real consolidation of health care services," Collins said. "It has a lot to do with efficiencies. So what you're seeing is the investment in large hospitals."

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Spending on hospital construction has jumped 21 percent from $5.2 billion for the first three months of 2005 compared to $6.3 billion for the same period in 2006, said Ken Simonson, chief economist of The Associated General Contractors of America.

Simonson said private hospital construction spending was up 23 percent and state and local hospital spending was up 12 percent in the first quarter of 2006, compared with the first quarter of 2005.

"The market for hospital construction has been strong for a couple of years now," Simonson said. "And it seems to be continuing. Given the bucks that employers and consumers and government are pouring into health care spending of all types, I would expect that several categories of health care related construction would remain strong at least through this year."

Mercy Health of Northwest Arkansas Campus, Rogers, Ark. The seven-floor, 350,000-sq.-ft. St. Mary's Mercy Health of Northwest Arkansas in Rogers, Ark., should be open in the beginning of 2008.

The $89 million project by JE Dunn Construction Co. of Kansas City, Mo., is one of the largest construction projects currently underway in Arkansas.

The job started in January 2005 and the hospital will be the focus of a 74.2-acre medical campus. A $20 million medical office building will be built at a later date.

The total price tag of the project is $145 million, which includes the cost to build the infrastructure, add the utilities and furnish the 200-bed hospital. The hospital will have all private rooms and emergency services. The hospital also will include care for cardiology, orthopedics, neurology and outpatient services.

Before construction began, JE Dunn leveled a hillside at the site.

"There was a little more than 350,000 cu. yds. of dirt moved," said Vance McMillan, senior project manager for JE Dunn.

He said one of the biggest challenges was finding enough construction workers because of numerous construction projects going on in northwest Arkansas.

"I had to draw upon a lot of regional subs," McMillan said. Perkins & Will of Atlanta is the architect.

Jackson-Madison County General Hospital, Jackson, Tenn. The main attraction of the $100 million project at Jackson-Madison County General Hospital in Jackson, Tenn., is a 10-story, 270-bed patient tower.

The $82.1 million, 365,000-sq.-ft. tower should be finished by October 2007, said Vince Bender project manager for Centex Construction in Dallas.

The job started in June 2005 and will feature a basement with concrete walls. The first three floors are concrete and floors four through 10 will be structural steel.

Bender said building the hybrid structure was a challenge.

"Bringing in two different trades, you've got to let one get out of the way totally before the other can begin," Bender said.

The building has a saw tooth pattern on its west side and a radius on the front face of the building. The building also ties into two existing bed towers on the first floor.

HKS Inc. of Dallas is the architect.

The first floor will also include the conference center, patient admitting and gift shop. Centex is also building a 30,000-sq.-ft. energy and laundry facility at the site and a $5.5 million 20,000-sq.-ft. expansion to the emergency department that will add 30 trauma rooms.

Baton Rouge General Medical Center Bluebonnet Expansion, Baton Rouge, La. When the $47.3 million Baton Rouge General Hospital Bluebonnet expansion is completed in March 2008, the number of patient beds will increase from 105 to 193.

Contractor Milton J. Womack Inc. of Baton Rouge, La., began building a four-story, 181,000-sq.-ft. wing at the hospital in December 2004.

The project also calls for renovating 42,000 sq. ft. inside the existing hospital and building a helicopter pad. The contractor will also build two 24-ft. by 27-ft. treatment rooms for radiation oncology that features 4-ft.-thick concrete walls.

The new wing is structural steel and the exterior has a brick and precast concrete façade, said Milton J. Womack project manager Ann Ellis. The floors are made with poured-in-place concrete.

"The biggest challenge is to add onto the hospital while keeping it operational," Ellis said. "We meet with the owner every week and we coordinate. So it takes a lot of effort on everybody's part just to keep things running smoothly."

To build the wing, workers removed the exterior brick of the four-story hospital to make the structural steel tie-ins at each floor.

"We probably have more than 100 structural steel connections into the existing building," Ellis said.

The architect is WHL Architecture LLC of Baton Rouge, La.

Methodist Medical Center of Oak Ridge, Tenn. In fall 2004, Methodist Medical Center of Oak Ridge, Tenn., began its first significant building project in 20 years.

The $28 million job is expected to be completed in March 2007 and will feature 84,000 sq. ft. of new space, said Bucky Watson, project manager for Rentenbach Constructors Inc. of Knoxville, Tenn. The project will include the renovation of 84,000 sq. ft. of the hospital.

Dry wall was used for the renovations and brick exterior and architectural precast concrete is used for the new sections.

The architect is The Estopinal Group of Jeffersonville, Ind.

The renovations are taking place on the first three floors of the five-story hospital, Watson said.

The centerpiece of the project is the construction of a new emergency room that will double the size of the current emergency department and includes a fast-track area for non-emergency cases and two X-ray rooms that uses digital technology to create immediate images.

There will also be a conference room that will hold 150 people.

Watson said the main challenge of the project has been keeping the daily operations going and preventing the hospital from being contaminated with dust and dirt.

He said construction crews used temporary walls and machines to clean the air to prevent the hospital from being infected.

"We did a tremendous amount of work in the off hours, which was less disturbing to patients and the public," Watson said.

Biloxi Regional Medical Center, Biloxi, Miss. The day after Hurricane Katrina hit the Gulf Coast last August, M.J. Harris Inc. of Birmingham, Ala., rushed to Biloxi Regional Medical Center to get it operational.

"Power was down," said Ralph Crumpton, senior project manager for M.J. Harris. "The emergency generator was submerged in water and it didn't work any more."

M.J. Harris had power restored to the 153 bed hospital within two days.

But the hospital's operating rooms had been flooded and hospital officials worried about mold, Crumpton said.

"So we had to shut down the OR and get it back on line pretty quick," he said.

The 350-member construction crew worked 24 hours a day to strip out the wet sheet rock, replace and refinish it on all six floors of the hospital.

The storm repair project cost $18.8 million. The roof had to be rebuilt and all the windows in the hospital had to be replaced. Crumpton said the project is nearing completion and only minor caulking around the windows is being done.

Crumpton said it wasn't difficult finding materials after the storm because M.J. Harris was stocked up on materials.

"We prepare pretty well," he said. "We're ready to move when (a disaster) happens."

Christus Schumpert Sutton Children's Medical Center, Shreveport, La. The $13 million Christus Schumpert Sutton Children's Hospital in Shreveport, La., is being built within the walls of the existing Christus Schumpert St. Mary Place hospital.

"We just demolished inside the northwest corner of the hospital, just tore down the walls and started from scratch," said Sally Croom, a spokeswoman for Christus Schumpert Health System, which owns the project. "So the outside is still there, but the inside has all changed."

Hand Construction LLC of Shreveport, La., began construction of the 65,000-sq.-ft., five-story children's hospital in April 2005 and should complete the project in August.

The project will feature a 16-bed Pediatric Intensive Care Unit with accommodations for a parent, a 22-bed Pediatric Inpatient Unit and a 40-bed Neonatal Intensive Care Unit. The new hospital will also have a family hospitality wing with hotel-style sleeping rooms, a pediatric emergency department and a 10,000-sq.-ft. outpatient clinic.

The children's hospital will have its own entrance made of glass and brick.

Christus Schumpert will spend $7 million furnishing the hospital. The architect is Somdal Associates of Shreveport, La.