Contractors Work to Restore Aging Hospitals

Health care providers upgrade their aging infrastructure.

By Deb Wood

Although hospitals are suffering from loss of income and bonding capabilities as a result of the recession, health-care systems throughout the region are making significant investments in modern facilities and equipment to serve growing populations.

“There was a big boom in [health-care projects] in Oregon three years ago, with a lot of $100 million projects going on,” says Phil Kennedy, marketing coordinator with Andersen Construction in Portland. “A lot of that had to do with the baby-boomer effect on the area, and hospitals realize they need to up the number of patient rooms, support areas and parking. It has slowed quite a bit, but we have a few hospital projects in our backlog.”

Shriners Hospitals for Children — Portland

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Andersen Construction is building a $65 million, 73,000-sq-ft expansion and renovation to the Shriners Hospitals for Children - Portland on the Oregon Health and Sciences University campus. The project entails constructing a building above an existing parking garage and tying that new concrete and steel structure into the existing hospital.

“We have a substantial waiting list of patients trying to get in here,” says Keith Rogers, director of facilities for Shriners in Portland. “One of our bottlenecks is we only have two operating rooms. The addition will put in a third operating room, with the potential for a fourth to be built out at a later date.”

The hospital will decrease the number of inpatient beds from 40 to 29, mostly in private rooms, and focus more on outpatient services. Shriners rents the land from OHSU for $1 per year for 99 years.

“We are building right up to the constraints of the lease line,” Rogers says.

Shriners considered tearing the garage down and starting over but found the cost prohibitive, so it went up and over with a truss system that straddles the existing parking deck.

Andersen Construction recently completed a $40 million upgrade Providence Hood River. (Photo courtesy of Andersen Construction)

“They touch on a back wall but that’s it,” Rogers says. The base of the addition will be about 15 ft above the top of the garage, which remains in use during the construction project.

The addition is rising on a hillside between the existing facility and a public road. A 25-ft-deep, 25-ft-wide slope sits between the garage and the road. Andersen built a retaining wall and access road to reach the site, using a 100,000-lb drill rig.

A spread-footer foundation supports the existing parking deck.

“We had to drill through those existing footings and pin those down, to keep them from sliding out down the hill,” says Chris Douglass, senior superintendent for Andersen at Shriners. “We put two vertical elements into each of the existing garage footings on the downhill side. Once we had those in place, we cut down and put in a shoring wall to hold the structure in place.”

That allowed construction to begin at the new building. It is independent, outside of the garage, but some of it anchors the existing garage. Crews drilled approximately 48 24-in. to 36-in. piers to depths of 30 ft to 34 ft, which support the new structure on the north and east sides of the addition.

A shotcrete crew working for Skanska USA Building worked on the foundation walls for Virginia Mason Medical Center in Seattle. (Photo courtesy of Skanska USA Building)

On the west side, Andersen drilled micropiles supported by soil nail anchors and covered by shotcrete in a 3-ft void between the garage and a second hill. Then it filled the void with concrete to create a wall with vertical and lateral loading to carry the new building.

Concrete walls one floor above the existing garage support seven 90-ft and longer trusses. Once they are in place, Andersen will pour concrete on the second and third floors. The three-story, plus penthouse, building will be stick frame and structural steel.

When complete in 2011, the expansion will tie into the current hospital at floors two, three and four. Rectangular metal panels will clad the addition and give the building the illusion of multiple facets. SRG Partnership of Portland designed the building.

Virginia Mason Medical Center

In Seattle, Skanska USA Building began working in February 2008 on a $144-million, 340,000-sq-ft, 18-story bed tower adjacent to the existing Virginia Mason Medical Center. Completion is scheduled for 2010.

“It’s an 18-story building with nine floors in it,” says Chris Toher, senior vice president of Skanska. “It has 21-ft-tall floor-tofloors and interstitial connector levels.”

The new facility and existing hospital will match up on each floor, with the option of connecting at any level. In addition, NBBJ of Seattle designed it for future flexibility, with each floor capable of converting to other uses.

The concrete-frame building has a mat and spread-footing foundation. The elevator core is located next to the existing hospital.

Mortenson Construction, Bellevue, in the midst of a $500 million cancer center project for Providence Hospital in Everett. (Image courtesy of ZGF)

“The core is offset and off to the side to connect to the existing hospital, which presents an interesting challenge for the lateral seismic,” Toher says. “The perimeter walls are concrete shear walls all the way up, and we’re putting punch windows in those shear walls.”

Masonry, Swisspearl fiber cement panels and curtain wall will clad the structure.

The building reached grade at level seven in March. Mechanical spaces and future space for either operating rooms or procedures are below grade. The emergency department is at grade.

Skanska is using building information modeling and an integrated delivery approach.

Providence Everett Medical Center

Mortenson Construction of Bellevue began work in August 2008 on a $325 million, 12-story, 713,000-sq-ft, 360-room nursing tower at Providence Everett Medical Center’s Colby Campus in Everett, Wash., which serves the North Puget Sound area.

 “It’s a significant investment and the largest in terms of dollars the Providence system has ever done,” says Scott Anderson, vice president of construction project management for Providence Everett. “It costs more than $500 million [total]. It’s a huge investment in health care.”

Portions of the current campus were built in 1928 and the rest in the 1960s and 1970s, and patient rooms do not meet today’s standards.

“It’s a replacement of most of our acutecare facilities,” Anderson says. “The project is a replacement of an aging facility and a lot about capacity. Fairly frequently, the emergency department is on diversion because we are at capacity. Plus the area continues to grow at 2.5% per year, so our situation is getting worse.”

Zimmer Gunsul Frasca Architects of Seattle designed the treatment and diagnostic areas for operational efficiency and flexibility, says Dan Simpson, a principal with the firm.

The North Valley Hospital project in Tonasket, WA, replaces the Acute Care and Emergency Departments on a first floor addition of 18,862 sq ft. An unfinished basement of 18,487 square feet provides for future surgery. (Image courtesy of KDF Architecture)

“It is reflected on the exterior as brick, masonry and areas of transparency, revealing the public areas within,” Simpson says. “The unitized curtain wall on the tower was designed with constructability in mind, but it also gave us the opportunity to think about the upper part of the building appearing lighter. The glass has a unifying quality. The metal panels are white, and we hope it will pick up the qualities of the sky and distant mountains.”

The curtain wall and bay windows in the nursing stations bring natural light into the structure and offer views of the scenery. Frosted-glass doors on the patient rooms facilitate illumination in the center of the building.

The new structure is located in a residential neighborhood, so Mortenson has had to comply with strict noise ordinances. Work cannot start until 7 a.m. on weekdays and 8 a.m. on Saturdays.

“All of the trucks are staged offsite until 7 o’clock,” says Michael Harder, construction executive with Mortenson.

The basement contains a kitchen, central supply and loading docks. A new 79-room emergency department occupies the first floor. Imaging is on the second floor, 28 surgery suites are on the third and fourth levels and six floors of beds are positioned in a U-shape above the podium and surround a landscaped courtyard.

The structural-steel building sits on a spread-footing and caisson foundation. Magnusson Klemencic Associates of Seattle provided structural engineering services.

“It utilizes buckling restraint braces for the seismic lateral [loads],” Harder says.

The project is scheduled for completion in September 2011.

Providence Hood River Memorial Hospital

At another Providence facility, Andersen Construction recently wrapped up construction of a $40 million expansion at Providence Hood River Memorial Hospital, River, Ore. It includes building a 36,000-sqft, three-story building and 9,000-sq-ft central utilities plant that attached to the hospital through an underground tunnel. Work continues on a 39,000-sq-ft renovation of existing departments.

“This is a facility they will grow into, so we were planning for the next 20 years of growth,” says Scott D. Combs project manager for Clark/Kjos Architects of Portland.

Work began in April 2007, with relocation of utilities and communication lines. The structural-steel building sits on spread footings and continuous slab on grade. It is built into a hillside, with concrete retaining walls on two sides, says Chuck Blomquist, project manager for Andersen.

“We encountered an underground spring and had to mitigate water flowing underneath the new addition part of the building and move the water around our central utility plant,” Blomquist says. “We used a series of piping systems, perforated plastic pipe, 8 in. to 10 in. in diameter, laid underground to collect the water and route it around the building and into the city’s stormwater system.”

The addition includes new labor and delivery rooms with family zones, same-day service treatment rooms, medical oncology rooms and an imaging department. Insulated metal panels and a storefront glass curtain wall system grace the exterior. The main entry features a basalt rock wall.

“Architecturally we wanted to tie [the hospital] to the Columbia Gorge, which has a lot of basalt rock formation,” Combs says.

Other projects

At Kaiser Permanente Sunnyside, Andersen is building a $13.6 million parking deck, and at Good Samaritan Hospital in Corvallis, Ore., the company is constructing a $25 million, 64,000-sq-ft west tower. The company also has a $9 million medical office building under way near Providence Happy Valley, Ore.

Kennedy, Andersen’s marketing coordinator, says he expects the firm to start three more office buildings by year end.

Harrison Medical Center Bremerton, Wash. has applied to the state of Washington for a certificate of need to add 92 acute-care beds at its Silverdale campus, while reducing by 42 the number of beds at its Bremerton campus. The total project cost, according to the state, is $204.9 million.

A decision was expected in April. Harrison did not return repeated requests for more information.

Providence Sacred Heart Medical Center and Children’s Hospital in Spokane has applied to the state to add 152 acute-care beds and 21 neonatal intensive care beds during a $84-million expansion. The state plans to make a decision in June.