Contractors with a healthcare specialty have their choice of work in the Salt Lake Valley and beyond these days. But getting your hands on in-demand, easy-to-clean materials … that’s another matter.
Healthcare providers around the state are merging, expanding major care centers, and, in many cases, opening specialized satellite clinics in order to bring down medical costs as the state’s population booms. Major projects continue on the University of Utah campus, with work just beginning on the new Huntsman Mental Health Institute. But real estate on the east bench is in scarce supply, so Utah’s largest health networks have begun to decentralize, driving dozens of projects from community clinics in St. George and Logan to new satellite hospital for Primary Children’s.
“I don’t see [healthcare construction] slowing down. That’s my perspective,” said Jared Francom, Project Director for Okland Construction.
Activity in the healthcare sector has meant growth for multiple Utah-based firms, including architectural design firm Arch Nexus, which is currently working on its largest-ever project—a massive overhaul of St. Luke’s of Boise that is likely to reach seven figures by the time it is completed in the late 2020s.
While not all healthcare project for Arch Nexus are that large, according to Senior Healthcare Planner Scott Larkin, sizable projects at the University of Utah have kept the firm grounded in its home state. Arch Nexus is wrapping up a $135-million, 225,000-SF addition to the Kathryn F. Kirk Center for Comprehensive Cancer Care and Women’s Cancers. The expansion, which should be complete by the end of next year, includes additional operating spaces as well as a wellness center with offerings such as art and music therapy, acupuncture, and access to trails in the adjacent Wasatch Mountains.
Although the advent of COVID-19 required a shift toward materials that can stand up to increased cleaning, Arch Nexus has worked to ensure the expansion maintains the same look and feel as the larger Huntsman Cancer Institute, according to Lisa Whoolery Ramidan, a Senior Healthcare Planner at Arch Nexus. The goal, she said, was to create an atmosphere that is less clinical and more comfortable, as with design for hospitality.
“We’ve been thinking and dreaming about this addition forever, but it was on such a tough site that there were a lot of people who didn’t believe it would happen,” Ramidan said. “When we started, we thought it might start small, but then the footprint went high, with bridges connecting to the existing hospital. It’s a great project.”
As that project comes to a close, Arch Nexus is turning its attention to the Huntsman Mental Health Institute Utah Translational Research Facility, which the firm won in September. Although the details are still up in the air, Ramidan said early estimates put the research facility in the range of $105 million for 85,000 SF, with a target completion date of 2024.
Working on a facility dedicated to researching mental health, Ramidan said, presents an opportunity to do a bit of research of their own regarding how clinic design impacts mental health treatment.
“There’s just this big altruistic vision, and now we’re here to talk about how that translates into architecture. […] Mental health has flown way too far under the radar for far too long,” she said, so the project will potentially consider “everything from how different exam rooms affect patients, to if there’s a clinic in a rural area—how that space affects the patients. It’s a true research space.”
The new mental health facility will be located on the east side of the University in the research park area, Ramidan said. However, the University is running out of space around its main campus for further expansion—especially on the bench near the Huntsman Cancer Institute—and this has the University pursuing new locations for growth.
“In a way, it’s sad that on this site there’s no more room to grow,” Ramidan said, “but they do have affiliates they work with around the country, and I think that’s the way they will go more in the future—having communities all around the country rather than just having it all on the hill.”
University of Utah Health isn’t the only network branching out beyond Salt Lake. At Okland, Francom has projects in the works at both ends of the state, including a 120,000-SF renovation for Intermountain Healthcare in Logan, and the 130,000-SF Red Cliffs Hospital in Washington City near St. George.
“One of the things healthcare is doing right now is they’re decentralizing some of their facilities,” said Jeff Pinegar, a Principal at VCBO. “There’s a lot of work now with ambulatory surgery centers that are either attached to hospitals or stand alone. Imagining is all standalone. Bringing the services to the communities—that’s a trend that is happening right now.”
Pinegar and VCBO have been engaged in perhaps one of the most prominent examples of this trend—the construction of a satellite Primary Children’s hospital in Lehi. The five-story, 485,000-SF facility will include a full-service emergency department, a behavioral health component and facilities for charities such as the Ronald McDonald House and Sophie’s Place.
The need to integrate state-of-the-art technology in a child-friendly space required the design team to develop a whole new set of standards for the hospital, which is set for completion around 2023, Pinegar said. Potential sensory experiences for children were integrated throughout the facility—small cubicles where kids can sit and read a book, or wall panels that change color when touched. Patients will be able to change the color of their rooms, and special screens will identify caregivers to parents when hospital staff enters the room.
Many of the people on the design and construction team already have a connection to Primary Children’s in some capacity, Pinegar said, which has made working on the Lehi satellite an especially fulfilling, once-in-a-lifetime experience.
“It’s really like it’s your hospital,” he said. “It’s your facility, and you’re part of that, so it’s really a great experience.”
At the same time, VCBO has just started a major overhaul of a community hospital in Beaver, which will get $35 million in upgrades over the next 30 months. The remodeling will take place while the hospital remains in operation in the midst of a pandemic—presenting its own unique challenges.
“With COVID, there’s always the talk, ‘How can we make things more resilient?’” Pinegar said. “Who knows what the next thing will be, so we’re trying to make things as flexible as possible, making spaces that you can convert into triage if you need to, into bed spaces and things like that.”
Traditional healthcare design has been reviewed and revisited in many facets to better meet the pandemic, including mechanical systems and air flow as well as materials and even patient circulation.
“A lot of this will be subtle, where we don’t put seats as close together as we used to,” he said. “Or changing waiting rooms […] to where we are accessing every floor of that facility from a parking garage, so instead of coming into a main lobby and circulating to the floor you need, you go to the floor you need and then enter the facility.”
COVID precautions have strained supplies of popular, durable materials needed to stand up to more frequently cleaning. But then, nearly all materials are currently hard to come by.
“I’ll just say—it takes six months to get metal studs,” Ramidan said.
Larkin estimated that healthcare construction costs have increased 15–30% in the last two years, the largest increase he said he’s seen in his career. This at a time when hospitals are taking actions—decentralizing and relocating—to keep costs low. For some smaller and independent hospitals, this has delayed or canceled projects, Larkin said.
“When you’re planning for three years and saving money and finally ready to do an ER addition and the 30% price increase comes in,” he said, “they may have to shelve it.”
But overall, Francom said, the healthcare market seems unlikely to experience a contraction any time soon.
“There is more capital available than ever, […] and healthcare is a good place to put it,” he said. “I don’t know where this is going, but there’s a lot of people with a lot of money, and real estate has always been a good investment—and that’s true for healthcare.”
As a result, Francom said, healthcare projects and even whole systems are “going for a premium,” driving mergers, acquisitions, expansions and, on the whole, plenty of healthcare construction work for the foreseeable future.