Fueled by the adoption of the Affordable Care Act, the healthcare industry is undergoing a shift from inpatient to an outpatient based model of care. The emergence of “retail healthcare” facilities across the country is evidence of this shift in patient care delivery. This shift, along with growing competition in the market place, has created a burden on healthcare facility managers to often adapt available retail space into health care ready facilities. The push to be the first to market within a location as well as the premium on budget constraints often cause the existing mechanical and electrical infrastructure to go overlooked during initial budgeting, purchasing or lease negotiations, however the infrastructure has the potential to make or break the project budget. When evaluating an existing retail space for conversion to an outpatient clinic, the following items can have a significant impact on project costs (either construction or the lease agreement) and should be evaluated at the early stages of a projects inception:
Local/State Healthcare Design and Construction Regulations
For regions utilizing the FGI Guidelines for Design and Construction of Healthcare Facilities, existing retail facility infrastructure may not be adequate to meet the requirements of the guidelines and will often require a nearly complete replacement of the existing mechanical and electrical systems to meet the regulatory requirements.
Electrical Service Capacity
The electrical service requirements of clinics are often greater than typical service capacities of retail shell space. When radiology or imaging services are included in the space program, the electrical service typically will require an upgrade or replacement. An initial electrical service size should be calculated by the design team based on the space program and coordinated with the electric utility to understand the impact to the project.
Heating, Ventilation and Air Conditioning System
HVAC systems for retail space often consist of single or multiple packaged rooftop units. The existing systems must be evaluated for available heating/cooling capacity, proper filtration, and the ability to provide adequate temperature control zoning for multiple healthcare functions within the clinic. Upgrades to the HVAC equipment can have an impact on electrical and gas service requirements as well as the roof structure.
Available Space for Piped Medical Gasses
While not always a requirement for clinics, if piped medical gasses are required by the space program, adequate space for medical gas equipment must be accounted for within the clinic or on site which can affect leasable space requirements for the clinic.
Proper evaluation of the existing infrastructure in the early stages a retail healthcare clinic project will allow the Owner to make prudent decisions regarding the construction budget and lease agreement.
If you need assistance reviewing mechanical and electrical infrastructure for a potential retail clinic project, Barton Associates can help you. Please contact Michael Jacobs, PE at (717) 845-7654 or firstname.lastname@example.org.