Construction of a Healthcare Facility

architect drawing of hospice

Doctor's Life Magazine followed Compass Construction as they built the New Care Center for Hernando Pasco Hospice in Brooksville, Florida.

The New Care Center for Hernando Pasco Hospice is a 25,000sf, 24 bed hospice care center equipped with medical gas, nurse call and a chilled water HVAC system.

The project begins-

by Doug Oliver, Project Manager for Compass Construction

From September 2008 Doctor's Life Magazine

We were awarded this project as the low bidder in a competitively bid process. Once the contract agreement was entered into with the owner, planning and procurement of materials began in anticipation of a start construction date. Drawings had been submitted to the local building department and were in the final round of review. One of the clearest indications that building is not always a simple process was the need for final approval from the South Florida Water Management District. This is a rather lengthy review and permitting process by the State, and even when started early on it can quite often exceed the time estimated by the project team. Resolution of this matter was a team effort, and in approximately 60 days permits were ready and construction was ready to start.

Prior to the start of any work a preconstruction meeting was held between all parties associated with the project. This included the owner, architect, engineer, contractor and lender. This is a critical part of the construction process during which the responsibilities and expectations of all parties are outlined. Numerous topics are covered including the submittal process, the owner’s level of input beyond that handled by the architect, coordination of owner’s responsibilities such as phone, data and other building systems, the monthly payment process, construction schedule as well as general construction issues. At this meeting a regularly scheduled Owner/Architect/Contractor (OAC) meeting is established in order to monitor and manage the project throughout construction. On this project it was decided to initially hold these meetings once a month with the understanding that the frequency of the meetings might change as work progressed.

Once the front end work was covered we mobilized our site crews, cleared the native land and began the process of preparing the building pad. From this point the two main paths of construction are sitework and building construction. While they are separate from each other in many ways and usually shown as separate activities on the construction schedule, the interaction between the two are quite closely related. In our instance the building pad was prepared as early as possible which released the work of the actual building trades including the concrete, plumbing and electrical crews. During this same time the overall site was being prepared for site drainage and utility piping. Once the heavy sitework began, access in and out of the project became limited and coordination between the site crews and building crews became a major part of the superintendent’s daily activities. When left to their own devices, each trade will proceed in a manner that suits them best and quite likely will impact or prevent other trades from working efficiently.

The project is now moving forward and we are completing the structural elements of the building (exterior walls, trusses, roof, etc.) which will allow the interior framing and mechanical rough-in portion of the project to move forward. As is evidenced here, construction is not always a smooth process but with the coordinated efforts of all parties obstacles can be identified early and dealt with and an expeditious manner.

Exterior photo of Hernando Hospice under construction

“The Interior Takes Shape”

From November 2008 Doctor's Life Magazine

Progress has continued in Brooksville, Florida at the New Care Center for Hernando Pasco Hospice, a 25,000sf, 24 bed hospice care center equipped with medical gas, nurse call and a chilled water HVAC system.

Since our last issue, the structure has been erected and the project has begun to take shape and resemble what the end product will be. This is an exciting time during the construction process where people can begin to see the tangible results of all the hard work and effort that has gone on behind the scenes. From this point forward the level of detail in our daily activities is greatly increased and the attention to this detail is ever more important. Interior walls have been erected and the owner now has the ability to walk through and physically experience what the end product will become.

Hernando Hospice interior

This is also the time where realizations of what has or has not been related through the contract plans become more evident and the time where many owners rethink certain aspects of the project. While it is not too late to make changes in the project, the team needs to be aware of how these changes can impact the overall flow of the project schedule.

As an owner and end user it is important to understand that prior to this point in construction you should work closely with your architect, interior designer and contractor to get a good perspective of how all of your finishes will look in conjunction with each other. It is often difficult to gain a clear picture or how things will ultimately come together, which is all the more reason to work closely with your team. From a contractor’s point of view changes at this point in the project have a very significant impact on the completion date since most of the materials have been ordered, put into production and in many cases delivered to the jobsite. Not only can this affect the cost of portions of the work that are being changed, but more important is how changes affect the schedule and flow of work. Changes quite often relate to extended time and general conditions cost to the contractor which include the cost of supervision, management, construction utilities and general site operating costs.

There have been a few realizations that have led to minor changes during our finish stage of the project, but fortunately most of these have been addressed in a timely manner and the overall impact to the project has been minimal. The drywall and finishes are progressing for our project and we are preparing to begin installation of hard tile and wood trim over the next month. This is a very rewarding phase of construction as we can begin to share in the excitement and anticipation of the staff and board members of this new facility, and we look forward to turning over a successful project on time and within budget.

“The Home Stretch”

From January 2009 Doctor's Life Magazine

Construction is nearing an end in Brooksville, Florida at the New Care Center for Hernando Pasco Hospice, a 25,000sf, 24 bed hospice care center equipped with medical gas, nurse call and a chilled water HVAC system.

The drywall has been hung and finished, interior wood trim, cabinets and tile are well underway and sitework is in its final stages. This is the point in the project where timing is even more critical and coordination and overlap of the various building trades requires the constant attention of the building superintendant. The idea of changes to the building at this point are difficult at best and most likely will lead to delays in the project turnover date. The scheduling activities become more concise and when someone slips a day it has ramifications to many other trades. For this reason the onsite coordination meetings become more focused and commitments must be made on a daily basis in order to keep everyone’s daily scheduling in line.

Exterior Hernando Pasco Hospice Dec 2008

As an owner your involvement in the project will be increased during this phase of the project especially if you have contracted certain elements of the project aside from your agreement with your General Contractor. This is quite common in a typical medical facility with regards to systems such as nurse call, security systems, telephone and data networks and certain finishes. Depending on the project and ownership group you may choose to take on various other aspects of the project as well. In the instance of this project with the owner being such a prevalent and important part of the local community there are many relationships which have been forged over the years that have allowed them to take on quite a few other aspects of the project including landscaping and irrigation, kitchen equipment and various interior finishes. However, this is certainly not a necessity and if you so choose, all of the responsibilities for the entire project can fall under the umbrella of your General Contractor. These decisions usually are based on your experience with certain building systems, your availability with regards to coordination and quite often your existing relationships with various service oriented companies.

The project team including the General Contractor, Architect and owner are meeting twice a month on a formal basis and the communication between the site superintendant and owner’s representative is on a daily basis. This communication is paramount to the successful completion of the project, and allows for all parties to stay in touch with the requirements and expectations of others. As with any project there always seems to be something that doesn’t go according to plan, but with good communication and regular meetings these setbacks can be properly addressed and overcome without impact to the project completion.

“Project Complete”

From March 2009 Doctor's Life Magazine

Construction is now complete in Brooksville, Florida at the New Care Center for Hernando Pasco Hospice. A ribbon cutting ceremony for the new 25,000sf facility was held March 10th to share the center with the local community and the turnout was tremendous.

hospice courtyard

As the project reached the finishing stages, everyone pulled together to obtain all inspections and necessary approvals for the owner to open their new facility. Given the specialty elements of a healthcare facility there are quite a few additional steps beyond what is required for a typical office or retail building. With the new care center, we had an emergency generator and medical gas system which had to be commissioned prior to final approval as well as working with the owner to obtain their state level licensing from the Agency for Health Care Administration (AHCA). The owner’s involvement in the project was greatly increased during these final steps of the construction process. The open communications between their trained healthcare professionals and our construction professionals allowed us to identify all of the potential pitfalls prior to each inspection.

Hospice lobbyhospice bedroom

Lobby and patient room of New Care Center for Hernando Pasco Hospice in Brooksville, Florida.

It was also during this time that the finishing touches were put on the building including touch-up painting, final cleaning and the final punch list. As the contractor, it is important that we endeavor to complete these final tasks in a timely manner and turn over the building to the owner for their use and continued maintenance. These tasks have occurred for our project and the owner is now fully occupying their facility in preparation for their Grand Opening. Inevitably, as with any project there is likely to be some issues that come to light during this initial occupancy and we must recognize as your contractor any work that must occur after the owner’s occupancy must be carefully coordinated with the staff to limit any impacts to their daily operations. We are currently addressing a few HVAC controls issues as well as making a few minor modifications to room functions at the request of the owner. All of these activities are scheduled to wrap up in the next week.

The completion of a project allows everyone involved to step back and recognize the fruits of their efforts. We labor through the process and deal with the problems as they arise, but once the finish line is reached we share in the accomplishments of what we’ve built. Healthcare construction is particularly rewarding given that each our lives will at some time be touched by caregivers and it’s comforting to know that we have shared in the process somewhere along the line.

To learn more about Compass Construction, visit www.compassconstruction.com/new/index.html

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