The five largest hospital projects underway in 2015 are:

1. Tisch Hospital expansion in New York; $2 billion
2. New hospital tower at the Hospital of the University of Pennsylvania in Philadelphia; $1.5 billion
3. Loma Linda University Medical Center replacement in Loma Linda, Calif.; $1.2 billion
4. Veterans’ Affairs Fitzsimons campus replacement in Aurora, Colo.; $1.1 billion (despite reports the actual cost is closer to $1.7 billion)
5. Lucile Packard Children’s Hospital at Stanford expansion in Palo Alto, Calif.; $1.1 billion

Health Care History & Outlook

In addition to naming the top projects in 2015, Revista also calculated the additional number of people — 15.3 million — who now have health insurance since the implementation of the Affordable Care Act and translated that number into square feet of medical space.

The firm found that in 2013, there was 4.8 square feet of medical office space for every insured person. Today, that number has dwindled to 4.58 square feet for every insured person.

Revista’s findings come after Dodge Data & Analytics’ recent 2016 Construction Outlook report, which found health care construction remained flat this year and predicted a slight 1 percent rise in 2016. Dodge said the industry has been hesitant to make significant capital investments into major construction projects due partly to the "uncertainty that continues to plague the health care market" after the passage of the Affordable Care Act.

However, Dodge — similar to Revista — predicted the industry will soon move past that environment of uncertainty and face the need to serve an expanding elderly population and replace older facilities. Once the industry reaches that point, "health care construction is likely to see stronger increases given the speed with which changes are happening in both the population and the health care industry itself," according to the Dodge report. In addition to the top five projects listed here, Healthcare Finance News listed the top 50 projects from Revista’s data, to see the full list click here.
 

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According to an inaugural report from healthcare real estate data service Revista that was released May 20 during a launch event in Boston, there are 66 health care construction projects in the Northeast alone, and Revista is planning on releasing more market data in the coming months.

“The level of healthcare real estate construction activity seen in the Northeast bodes well for the rest of the country,” Mike Hargrave, one of Revista’s founding principals, said at the Boston event. “Although we don’t have national data yet, we would not be surprised to see similar levels of activity in other parts of the nation.”

Highlights of the report include the following:
• There are a large number of medical facilities in the Northeast, including 473 general acute care hospitals, 4,491 medical office buildings (MOBs) and 2,105 other health care buildings.
• Most medical facilities in the region are affiliated with a health system. Forty-four percent of MOBs are affiliated with a hospital, 36 percent of MOBs are affiliated with a health system and 68 percent of hospitals are affiliated with a health system.
• Construction of health care facilities in the Northeast is going strong. This includes 43 MOB/outpatient facility projects totaling more than 4.35 million square feet with a total value of almost $2.9 billion, and 23 hospital/inpatient projects totaling more than 4.5 million square feet with a total value of more than $5 billion.

By the Numbers: Hospitals Being Built or in Late Planning Stages
• Connecticut – four projects, 1.34 million total square feet, $1.081 billion approximate value

• Massachusetts – seven projects, 641,543 square feet, $555 million

• Maine – two projects, 401,000 total square feet, $287 million

• New York – 10 projects, 2.17 million total square feet, $3.09 billion


By the Numbers: Medical Office Buildings Under Construction or in Late Planning Stages
• Connecticut – nine projects, 708,139 total square feet, $464 million approximate value
 • Massachusetts – 11 projects, 756,263 total square feet, $595 million

• Maine – five projects, 398,700 total square feet, $50 million

• New Hampshire – two projects, 190,974 total square feet, $124 million

• New York – 16 projects, 2.3 million square feet, $1.65 billion


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“The celebration today is a testament to the excellent job of the project team in delivering a top-notch facility ahead of schedule,” said Stephen Powell, consultant for project manager CBRE Healthcare at the ceremony. “For a project in northeast Ohio to be able to say we made it through this past winter two weeks ahead of schedule, and still beat cost targets, is a testament to the process and team we have in place.”

“It is so great to see the building take shape on our campus after all the months we spent planning it,” said Grace Wakulchik, chief operating officer at Akron Children’s Hospital. “Everything about the building is so well thought out and it is all about providing the best care to our patients and their families.”

One of the largest pediatric hospitals in the country, the Akron Children’s Hospital manages more than 700,000 patient visits annually. Upon completion, the $200 million, seven-story addition will house the hospital’s new emergency department, as well as an outpatient surgery center. A 100-bed neonatal intensive care unit and new labor units will also be added to provide additional care for those with high-risk pregnancies. Crews will connect the new addition to the existing facility February 2015, and the structure will welcome its first patients later that spring.

HSK Architects and Hasenstab Architects worked jointly to design the new facility, which is being constructed by the Boldt Company and Welty Building Company. The project team also includes civil engineer Environmental Design Group, MEP engineers CCRD and BWK, and structural engineer Thorson Baker. Mitchell and Dynamix Engineering will provide medical equipment and technology respectively.

To deliver the facility in an efficient manner, the design and construction team used an integrated project delivery method that involved the entire team from onset of the project. This method also allowed the building’s future users to provide input during the design process. Hospital staff and patient families were even invited to weigh in on potential furnishings for the new facility to select the most comfortable and functional options.

Two hundred past and current patients were also integrated into the addition’s design through the hospital’s Graffiti Project. This project honored patients, who were nominated by the hospital community, by spray-painting their names on the facility’s concrete slabs. As construction progresses, the names will be covered by the building’s exterior but will remain with the structure.

"As Akron Children’s grows to meet the current and future needs of children and their families, it was important to us to keep our patients at the heart of it all," said Gretchen Jones, director of principal giving for the Akron Children’s Hospital Foundation. "Our patients’ names will forever be a part of our new building and they will continue to inspire us as we serve them and other families."

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During a speech at the groundbreaking ceremony, Principal Chief Michell Hicks said that the project provided, “a unique opportunity to create a facility which will serve as a health care and community anchor for the Eastern Band of Cherokee Indians.” Hicks added that the project, “recognizes the need to address the health care challenges of our tribe, and to create a positive wellness environment.”

Also attending the groundbreaking were the nation’s Vice Chief Larry Blythe, Carmaleta Monteith, governing board chair, Terri Henry, chairman of tribal council, David Wolfe, chairman of the tribal health board, and Casey Cooper, CEO of the hospital. In his address, Cooper commented that the investment in health care is an example of the tribe’s long-held values.
“We stand here today because we are dedicated to the health care of this tribe for the next seven generations,” Cooper said. “This morning’s ceremony is yet another illustration of our tribal leadership’s commitment to the future of our tribe.”
CIH will focus on areas such as disease control, primary care, and other services already in high demand. Included in the campus will be inpatient and outpatient services, a laboratory, pharmacy, emergency room and a physical therapy area. Dental and vision clinics will also be located on site, though mores specialized surgical services and deliveries will be available at other nearby facilities.

The new complex will double the size and capacity of the existing tribal hospital, which was completed in the early 1980s, and will allow the Eastern Band to offer additional medical services in-house. The project will also bring departments that are currently forced to work out of onsite trailers back into the main facility, which will feature warm, comfortable and inviting interiors, as well as décor made by local artists.

Design Strategies of Greenville, S.C., completed the design for the new Cherokee Indian Hospital. A series of community meetings were held to gather input on the overall plan.

“The local community including tribal elders, artists, students and enrolled members, as well as physicians and medical professionals, have all played a big role in shaping this new facility,” Hicks said in a statement

The groundbreaking was long awaited, as the project has already spent three years in the planning stage. Construction and engineering firm Robins & Morton of Birmingham, Ala., will lead construction using an Integrated Project Delivery (IPD) approach.

The $75 million facility will be both owned and operated by the Cherokee tribe, which assumed control of community health care in 2002.

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Indoor healing or therapeutic gardens are now blooming in hospitals, outpatient clinics, substance abuse facilities and hospice settings across the country. Where health care providers once relied on potted plants and landscaped entryways, many are now dedicating interiors to lush, living oases, and seeing some serious benefits.

Roger Ulrich, now an environmental psychologist at Texas A&M University, was one of the first to examine how integrating nature into health care settings could positively impact patients. Ulrich specifically studied patients recovering from gall bladder surgery. The only distinct difference in their treatment and recovery was the view from their hospital room. Ulrich found that patients who enjoyed a view of nature typically required less pain medication, experienced fewer complications and healed a full day faster than their counterparts who faced brick walls.

In 2008, researchers at Kansas State University published similar findings. They found that patients recovering from appendectomies in rooms containing plants and flowers required significantly fewer postoperative analgesics, and had more positive physiological responses when compared to patients in the flora-free control group.

Shane Pliska, president of the interior landscape design firm Planterra, enthusiastically supports these findings. Pliska and the Planterra team have completed multiple garden installations in health care facilities across the country, and believe their work has an important impact on physical and psychological health.

“We need plants,” Pliska said. “People are stressed in medical facilities, whether it’s because of their own illness or a loved one’s [illness]. When they have nature in sight, when there are plants in those spaces, it makes people feel more comfortable. It relates to the human element of what we’re doing.”

In 2012, Scientific American magazine also noted the increased use of healing gardens in hospitals and clinics, referencing design standards developed by Susan Rodiek, also of Texas A&M. According to Rodiek, lush, layered and diverse garden installations with a minimum of concrete interruptions are most conducive to healing and engagement. The gardens should also stimulate multiple senses, be easily accessible and feature realistic sculptures as opposed to abstract images.

These living green spaces can be integrated into nearly any hospital or clinical setting. Many facilities concentrate healing gardens in atriums or entryways; however seating areas, collaborative spaces and corridors can also serve as ideal venues for containerized installations. According to Pliska, Planterra designers have even converted defunct interior fountains into lush gardens.

Living installations are also a safe option for sterile environments. Planterra and other interior garden designers often use a sub-irrigation system and sterilized growing media as opposed to traditional soil. This prevents water from being exposed to air. Meanwhile, the plants add to the overall air quality of the space by creating new oxygen rather than simply filtering it.

For example, at Planterra’s Henry Ford Hospital installation in West Bloomfield, Mich., two plant-filled atriums act as the facility’s lungs. Together they include roughly 2,500 live, oxygen-generating plants, which can be easily viewed from numerous patient rooms. The atriums also serve as important gathering spaces for large or small groups, offering more intimate conversation and reflection spaces.

Henry Ford Hospital President and CEO Gerard Van Grinsven also considers the garden an important extension of the hospital’s mission. “Even in the offseason time, our community can come here and be connected to nature, and really take advantage of its healing effects,” he said.

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The facility began as the Utah Regional Cancer Center and was then renamed in honor of Huntsman in 1999. Its mission is “to understand cancer from its beginnings, to use that knowledge in the creation and improvement of new treatments, to relieve the suffering of cancer patients and to provide education about cancer risk, prevention and care.”

The six-story addition to the existing facility will be named the Primary Children’s and Families’ Cancer Research Center. Rather than focusing on treatment, the new addition will be dedicated to studying the relationship between cancer and genetics. It is the fourth such expansion made possible through the continuing support of the Huntsman family. An outpatient clinic and infusion lab was completed in 1999, followed in 2004 by a 50-bed hospital, which was later expanded in 2011.

The center is located on the University of Utah campus and currently holds one of the most comprehensive genetic databases on the globe. According to a profile provided by the institute, its researchers have discovered multiple genes that, when mutated, lead to a greater risk of melanoma, breast cancer and other types of cancer. Mary Beckerle, CEO and director of the Huntsman Cancer Institute, added that the institute’s scientists have discovered inherited susceptibility genes for multiple cancer types including ovarian, head and neck, and colon cancers.
Leukemia, sarcoma and brain cancers will be the primary focus of this new, state-of-the-art facility, in which patients being treated are matched with a full team of researchers and specialists. New laboratories will also be established to dive deeper into both genetic childhood cancers and those that could be passed down through families.

“This additional research space is absolutely essential to HCI’s mission to relieve the suffering of cancer patients through understanding cancer and bringing that understanding to bear in the development of new and better treatments,” said Beckerle, in a statement. "With our state-of-the-art technologies and largest genetic and population database in the entire world, we believe that, with this new facility, we’re going to be able to move to learn more about genetic risks for children’s cancer than has ever occurred in the past."

In total, Huntsman said his family has dedicated roughly $400 million to their eponymous cancer center and has raised nearly $1 billion for overall research. Though the Huntsman family will provide roughly half of the necessary expansion funds, the Church of Jesus Christ of Latter-day Saints, the Utah Legislature and other local groups will contribute the remainder.

"Hopefully we’ll make this disease disappear one way or the other, and we’re throwing everything at it we can in terms of dollars and in terms of wonderful scientific minds," Huntsman said.
In a statement by spokesman Cody Craynor announcing the expansion, the Church of Latter-day Saints said it was “pleased to support this important effort and anticipate it will bless many lives throughout the community and surrounding areas.”
The design process for the new facility is now underway and preliminary plans include a biotechnology center and tumor-imaging suite. Construction is projected to begin sometime in 2014.

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The new structure will contain a 24-hour emergency room, 14 operating rooms, an imaging unit with X-ray, CT scanner, MRI functionality and 30 inpatient beds. Though the facility will more than double in size, the number of beds will actually go down from 34, meaning most of the gains will be in services and procedures, not the amount of inpatients.

Hospital officials believe the move will create a small growth in jobs, creating 10 to 15 new positions. The move from Park Place and Eight avenues to 12th Avenue will also decrease the distance between the facility and Baylor All Saints Hospital. The facility will offer a wide array of services, covering surgical procedures including spine, urology, orthopedic and plastic surgery. Should they need it, hospital officials could look into Patient Financing from United Medical Credit to help with treatment costs involved in procedures like plastic surgery. There will also be room for general practice, and specialists in pain management and ear, nose and throat health.

Roger Rhodes, CEO of Baylor Surgical Hospital, explained his excitement in a statement, saying, “The project marks the beginning of a new chapter for our hospital system. Health care is rapidly changing and our goal as an industry leader is to remain on the cutting edge of service for our patients, doctors and community.”

Jones Lang LaSalle, based in Chicago, will serve as construction manager on the project and negotiated the land purchase on behalf of the hospital. Page Southland Page was selected as the architect on the project.

Baylor spokeswoman Susan Hall told the Star-Telegram the old facility would likely maintain its functionality as an ambulatory surgery center and be sold or leased to another medical group.

The project represents a small piece of a $6 billion building spike in the Dallas area with more than $1.2 billion of that activity coming from the Baylor Health Care System. Parkland Memorial Hospital’s replacement provides a strong rival, coming in at $1.27 billion, while numerous other hospitals are being built at smaller, yet significant, price tags ranging in the high hundreds of millions.

The trend has grown at an amazing rate, as the Dallas Morning News reported that the area experienced the largest growth in health care back in 2006, when the total expenditure was estimated at only $2.2 billion.

Though the growth may be good for the economy, some health care experts caution that the boom in construction might be too aggressive, with too many hospitals battling over a limited number of patients. Others believe the baby boomer generation will provide a massive increase in patients over the next two decades and prevent this upswing in the construction industry from becoming a bubble. Whether it comes to the number of patients or the number of projects, it seems that everything is still bigger in Texas.

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The project will be designed by Gresham Smith and Partners with Barton Malow Co. serving as the general contractor. The same team worked on St. Joseph’s Hospital—North, a similar project that was completed two years ago.

At the event, Representative Kathy Castor, whose district covers the majority of Tampa, expressed her belief that the project would greatly aid the local economy. “Think about it: $225 million invested here and the ripple effect that will have. First, construction jobs boosting small business throughout the community. Then, the medical professionals that will move here and their families that will grow up here. This hospital is going to be an anchor for economic development for the South Shore community and all of southern Hillsborough County.”

The hospital staff will consist of approximately 500 people. The construction of St. Joseph’s Hospital—North, led to a boost to the local economy as banks, professional services providers, and retail developments quickly sprung up to serve the employees and patients. Hospital president and CEO Isaac Mallah explained that his staff worked on the project for more than seven years before a single shovelful of dirt was moved, getting everything approved through local, state and federal governments. The project’s history extends even further, as hospital leaders purchased this plot of land in the mid 1980s.

This project will mostly mimic the process involved in creating its sister facility to the north, but the team is also using some of the feedback from that project to improve on the model. Paula McGuiness, chief operating officer at St. Joe’s North, told the Tampa Bay Business Journal the design team was eliminating some privacy shades included in that project from the South version, as patients didn’t use them as much as expected. She added that some lighting and plumbing fixtures would be altered as well to enhance productivity.

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Conducted at the Fall 2011 Healthcare Design Conference in Nashville, Tenn., the survey questioned more than 300 conference attendees. Mortenson sponsored the event’s cyber café and surveyed attendees as they logged in to use the computers. Participants included health care administrators and facilities managers, architects, builders and suppliers.

“The challenge in doing these types of surveys is getting a lot of responses, and I think we finally hit on methodology here,” said Steve Pekala, Mortenson’s manager of market intelligence. “This is a way that lets you get a lot of responses from the exact kind of people that you want to talk to.”

The survey found that despite the state of the economy, 75 percent of respondents expect their organization’s construction activity to increase over the next 12 to 24 months. Additionally, 70 percent of health care institution respondents said their organizations are pursuing LEED or other sustainability certifications on new projects.

Key highlights of the survey also included responses to evidence-based design (EBD) questions, where 87 percent of respondents said EBD’s popularity was growing within their organization, half saying it is an integral component of their institutions work. However, Pekala notes that owners had a bit more faith in EBD than the architects did.

“Maybe its just because the architects are a little closer to it and work with it more on a day-to-day basis and they see more of the limitation in it, but most owners felt like there was plenty of evidence out there to allow evidence-based design to be broadly utilized, but most of the architects didn’t see that,” said Pekala. “And then most of the architects said that the uniqueness of health care projects really limit where evidence-based design can be applied, but the owners didn’t see it that way.”

Architects and owners also differed when it comes to alternative delivery, with architects noticing a growing interest in alternative delivery interest but owners seeing things differently.

“This is an industry that is in kind of a tough spot. They are worried about healthcare legislation. They are worried that reimbursements from the government are going to go down. Medicaid, they think, is badly broken and urgently needs to be fixed. But then, at the same time, they are very optimistic about the future. They are very optimistic in their own ability. They are optimistic that they will be able to pick themselves up and face these problems head on,” said Pekala. “I thought that was kind of interesting; we got lot of negative answers to questions about the state of the industry, but then I got this huge optimism about the future.”

To download the survey results visit http://www.mortenson.com/resources.aspx and click on Healthcare Industry and Design Trends, Jan. 27, 2012.

Mortenson began conducting these types of surveys at trade shows within the past year and has completed surveys on mission critical/data centers, education, solar energy and wind energy. Studies on building in China and on stadium building will take place within the next couple of months.

The company is the second-largest owner of wind farms in the country and one of the top builders of utility-scale solar, says Pekala. Renewable energy comprises about one-third of Mortenson’s business and the rest is traditional commercial, including a lot of healthcare, higher education and mission critical facilities.

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