Health Care Construction Checkup

Pulse Remains Strong despite Ailing Economy

The prognosis for health care building in the Southwest remains good, while other construction sectors are being wheeled into intensive care. The three projects profiled here provide a massive $1 billion shot in the arm for the construction industry.

By David M. Brown

During the nation’s economic downturn, health care remains one of the pillars for the economy and construction industry.

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Three of the current Southwest projects are the Hualapai Mountain Medical Center in Kingman, Ariz.; the Phoenix Children’s Hospital expansion; and phase four of the VA Medical Center in Las Vegas.

Hualapai Mountain Medical Center

Near historic Route 66 in Kingman, Ariz., the $70 million Hualapai Mountain Medical Center provides a needed general acute care hospital for the growing city.

Looking toward landmark Hualapai Mountain, the approximately 200,000-sq-ft tower includes 70 beds and is shelled for 36 additional beds.

The hospital also has a 24/7 emergency room with 22 beds; heart services; inpatient and outpatient services; an ICU unit; full imaging services; and laboratory areas.

Built on a 31-acre greenfield site, the four-story building is cast-in-place concrete and precast concrete on the ground floor, with energy-efficient components such as double-pane windows.

The hospital plans a second bed tower on the remainder of the site. A medical office building attached to the first tower also is planned, says Duane Scholer, the hospital’s president.

The 16-month project is on budget and on schedule for an October opening, says Jay Hornung, vice president for Charlotte, N.C.-based MedCath, the facility’s owner.

Lott Bros. Construction Co. of Austin, Texas, is the general contractor.

Sitework began in May 1. The Lott team had to begin in a remote part of the city with little to no infrastructure. As a result, all utilities and services, including roads, had to be brought from as far as 2 mi away to serve the new facility.

“Because this project is within a newly zoned commercial district and part of a larger master subdivision project, there were significant issues that needed coordination to ensure all parties would have the required utilities and services that will eventually be needed,” Hornung says.

The facility was designed to harmonize with nearby Hualapai Mountain, which will be visible not only from the patient rooms but also from the nurses’ station through the waiting area’s floor-to-ceiling glass windows. The façade incorporates natural colors such as terra cotta, beige and sand hues.

Diagnostic and treatment areas are grouped to provide efficient flow for patient and materials transport. All outpatient services can be accessed directly from the lobby/waiting area, and major departments are located to minimize staff’s walking distance.

“Once considered institutionalized and intimidating, heath facilities are slowly evolving into medical environments with designs that have impacts on patient care,” says project designer Angela Lee, AIA, LEED AP, vice president of Dallas-based HKS Architects.

Phoenix Children’s Hospital Expansion

Built in 1963 as Doctors Hospital, the first physician-owned hospital, the Phoenix Children’s Hospital is expanding to become one of the country’s largest pediatric hospitals.

The $588 million addition to Phoenix Children’s Hospital will include a 12-level hospital tower, three parking garages and a central plant. (Photo courtesy Kitchell)

The $588 million project includes six major components on a 30-acre site: a stand-alone 30,000-sq-ft loading dock/central plant connected by a tunnel to a 12-level 765,000-sq-ft hospital tower, 180,000 sq ft of renovation and three parking garages totaling 1,750 spaces.

Serving as construction manager at risk, Phoenix-based Kitchell began the multiphase project at the Thomas Road and State Route 51 campus in February 2008.

Due for delivery in 2011, the tower is structural steel with concrete slab on metal deck. The parking garages - the first was completed in January and the last two garages will phase in with the tower component - are post-tension and precast concrete.

“The new hospital will create spaces designed to promote valuable interaction with others in an environment consistent with the everyday setting of life,” says Jeffrey Stouffer, AIA, principal-in-charge with HKS, which also designed this project.

While not targeting LEED certification, the project incorporates sustainable components and is designed to meet the government’s self-certifying “Green Guidelines for Health Care Construction.”

Crews will complete more than four miles of underground piping for the project, says Russ Korcuska, project director for Kitchell.

Kitchell and HKS had to ensure that the curved façade design of the tower met wind tests. As a result, high-grade steel, only available from Luxembourg, was ordered well in advance of an expected steel-price hike. To ensure maximum strength, the team also called for brace-frame construction.

A phased turnover approach has presented logistical issues because the basement-through-third levels turn over about six months before floors four to 11.

To ensure the closest collaboration, Kitchell and HKS have used building information modeling, and the team plans to develop a working model that can be used by the hospital in the future for maintenance of the facility.

A value-engineering meeting, including the architect, engineers, Kitchell and hospital officials, was held at the end of the schematic design. The group identified more than $100 million in savings to the project without reducing the overall building size and scope of services.

VA Medical Center, Phase Four

The VA Medical Center in Las Vegas is adding a 790,000-sq-ft main hospital to the 150-acre greenfield site bordering Clark County and North Las Vegas.

The $364.9 million fourth phase of the Las Vegas VA Medical Center will add 790,000 sq ft of space, including a seven-story hospital tower and a two-story mental health facility.( Image courtesy JMA)

Begun in October, the $364.9 million project - the largest construction contract ever awarded by the Veterans Administration - is on schedule for an October 2011 delivery to the VA’s Southern Nevada Healthcare System, says Jim Day, LEED AP, vice president of Las Vegas-based Clark Construction Group, the general contractor in a joint venture with Phoenix-based Hunt Construction Group.

Washington, D.C-based Parsons provided construction management services. Linda B. Murray, a Parsons vice president, coordinated efforts with the Veterans Administration to develop a detailed project implementation plan.

Architecturally, the project is a 50/50 joint venture between RTKL of Washington, D.C., the design architect, and JMA of Las Vegas, executive architect.

The phase four main hospital includes a 90-bed seven-story tower and a two-story 20-bed mental health facility. The structure will offer ambulatory care facilities, radiology/MRI and nuclear medicine, pharmacy, laboratories, diagnostic/treatment clinics and education/administration and warehouse space.

Onsite parking for 2,450 vehicles is also being built.

Materials include CMU block, poured-in-place concrete, architectural aluminum for windows and louvers, galvanized structural steel, metal panel systems and phenolic exterior wall panels.

The panels will identify five areas within the hospital that are easily navigable. “Each programmatic box received an entry pavilion of glass and is marked with its identifiable color - directly associated with the program area it serves,” says Thomas Schoeman, AIA, executive architect with JMA.

This final phase of the medical campus follows completed phases one and two and continues as phase three concludes. Scheduled for completion in September, phase three is a 120-bed, 106,000-gross-sq-foot nursing home. The $48 million design-build project is also led by Clark Construction.

The $41 million first phase, also a Clark Construction project, started in August 2006 and completed in April 2008. The scope included a site package, access road and 47,000-sq-ft central plant/energy center.

Delivered in the summer by Whiting-Turner, the second phase was a foundation package. A portion of the phase four foundation was completed as part of the scope of this contract as well.

The design/construction team is extensively using building information modeling to coordinate design and construction. After Hurricane Katrina, the government’s Physical Security Design Criteria was updated for federal buildings - changing the design process for the hospital.

“The requirements were strengthened to have the facility capable of continuous operations during times of war, national security emergencies and mitigating the effects of natural and manmade disasters,” Schoeman says.

As a result, the Clark/Hunt team is installing all major mechanical and electrical equipment for the energy center during phase four, making the building independently operational for four days on its own power.

Key Players

Hualapai Mountain Medical Center

Owner: MedCath
General Contractor: Lott Bros. Construction Co.
Architect: HKS Architects.

Phoenix Children’s Hospital Expansion

Owner: Phoenix Children’s Hospital
CM at Risk: Kitchell
Architect: HKS Architects

VA Medical Center, Phase Four

Owner: Veterans Administration Southern Nevada Healthcare System
General Contractor: Clark Construction Group/Hunt Construction Group joint venture
Architect: RTKL; JMA

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