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June 21, 2013 -
Today's tip from Building Operating Management: Challenges face healthcare facilities located off hospital campus.
Once you move off the known world of the hospital campus, everything from code compliance to management strategies becomes a learning opportunity.
Over the last five years, four sleep centers have been added to the Crozer-Keyston Health System. There's a 60,000-square-foot building built almost four years ago where Crozer-Keystone holds the master lease. Immediately adjacent is another 60,000-square-foot building — the master lease of which is also held by the organization — that is being built out to house a cancer center.
"We're in the process of building a linear accelerator and a medical oncology suite in an office building that we don't own," says Brian Crimmins, vice president, facilities planning and development, Crozer-Keystone Health System in Pennsylvania. "These are things the typical office building is never involved with."
The linear accelerator, for example, sits just outside the main building envelope. It requires a vault with 5-foot thick concrete walls. The facility will require specialized HVAC and emergency power, significantly beyond that required by a typical office building.
As well, even though you can take a service out of a hospital, you can't take the regulations and level of review out of the facility housing the service. Not only will there be a cancer center in the new building, but also a gastrointestinal lab. Though it is only 4,000 square feet, the lab triggers Pennsylvania Department of Health regulatory review, which was an unexpected turn due to recent changes in what classifies as ambulatory versus business occupancy. In any situation where even one patient is incapable of self-preservation (basically whenever an anesthetic agent is being used), the facility is classified ambulatory and a whole different level of review, which was totally foreign to the developer, comes to bear. Alterations to the base building had to be made because of different fire ratings required, and fire system and emergency power testing frequencies and procedures are stepped up.
"It adds some complexities to the construction process when we're off the campus," Crimmins says. "With the hospital, you know what you're dealing with. But you get out into these communities, and it's a whole new ballgame for everyone."