In recent years, there has been a significant increase in the construction of outpatient healthcare facilities. Informed patients seek quality, choice, and convenience, and they are finding that outpatient specialty clinics can provide high quality care at low prices than hospital care – often right in their own neighborhoods.
According to LF Driscoll Healthcare (LFDH) project manager Kristopher Pomilla, the trend started in early 2019, just prior to the COVID pandemic.
“Our clients have been talking with us about new medical technology, customer outreach and support in urban and suburban areas, and that existing hospitals simply don’t have the footprint to expand their facilities,” he says. “We’re seeing a growing trend in converting underutilized office buildings into healthcare facilities as a cost-effective, environmentally friendly way to meet that demand.”
FINDING THE RIGHT BUILDING
The type of building best suited for conversion depends on the intended use, says Pomilla. Multistory buildings can be converted to facilities housing a variety of medical practices and supporting labs. Finally, empty box stores and mall anchors like Sears or Lord & Taylor can be repurposed to become ambulatory care centers offering medical offices and outpatient services such as surgical centers, cancer treatment facilities, and dialysis clinics. This conversion approach also lowers the embodied carbon footprint of the building.
Ideal buildings for medical repurposing should have plenty of free parking or be accessible by public transit. Prior to acquiring a building for conversion, Pomilla recommends that clients obtain soil boring testing and a geotechnical report. In addition, it is important to document existing conditions of the exterior windows and façade. Many commercial leases are triple net, which means insurance, taxes, and building maintenance are the responsibility of the tenant, and failure to document existing conditions that need remediation can increase the cost of the project.
Converting a typical office building or storefront into a healthcare facility also requires specialized knowledge and meticulous planning. The finished building must meet key requirements for healthcare facilities using Department of Health (DOH) protocols or Facility Guidelines Institute (FGI) criteria which include specialized HVAC, electrical, and plumbing systems. Typically, the building is gutted to white box stage and outfitted with all new MEP.
According to LFDH project executive Scott Frank, one of the significant protocols is the review and detailed inspection of every wall before it is closed. “We ensure that the interstitial space in the wall cavity has been properly sanitized and that there is never any hidden dust or debris that could potentially compromise a patient’s health in the future.”
CONVERSION IN ACTION: SUMMIT HEALTH IN GARDEN CITY
In February 2023, LFDH completed the $18 million transformation of an existing 28,000sf, three-story office building into a state-of-the-art medical facility for Summit Health, serving patients in Garden City, Long Island. The building is now home to cardiology, dermatology, ENT, orthopedic, podiatry, and primary care practices and a pain management clinic. A lower-level radiology suite includes five X-ray rooms, a CT scanner, and an MRI machine.
The year-long project was a full gut job, with removal of all MEP services back to points of entry. All new electrical service gear was installed to take on the additional load from the radiology equipment and the new elevator.
New boilers and water heaters were installed along with ejector pits and fire protection systems. The design also called for the removal of an old staircase and installation of a new stairwell.
The demand for healthcare is expected to grow at a compound annual rate of 5.4% between 2020 and 2025, driven by factors such as population growth, an aging population, and the prevalence of chronic conditions, according to the World Health Organization
LFDH came onboard at the program stage, which was critical to the success of the project. The team identified long-lead elements and purchased them early, resulting in significant cost savings and improved delivery times. They also assisted the owner and design team with local regulatory approvals and permits. Finally, the team developed an early demolition and building assessment package in order to develop a full understanding of the existing building conditions.
Getting involved early also helped the team identify and solve potential challenges—especially when it came to the soil. “The lower level of the building is below grade, and we have very sandy soil on Long Island. “As soon as we excavated, sand filled the hole,” says Pomilla. To solve the problem, the team vibrated lagging boards into the ground to hold back the soil and support the existing foundation while they dug.
Some of the soil was also contaminated. “Anytime we dug for plumbing, electrical, and the lighting protection system, we had a certified remediation crew safely standing by to remove the soil,” says Frank.
When all was said and done, however, LF Driscoll Healthcare’s team of trained healthcare construction professionals has helped a major healthcare network expand its services to a whole new community while making the benefits of building repositioning a reality.
“These kinds of projects demonstrate how construction can play an essential role in future patient outcomes” says Pomilla.