Like the proverbial cat covering crap on a marble floor...

Last week, Bosley dropped big news on a small group of us.  A long-awaited project for a replacement hospital, medical office building (MOB), and specialty clinic in Montana was finally approved to move forward.  And we're already behind.

St. Ermahgerd Hospital and Clinics of Bieffee, Montana was built during the Hill-Burton era of the 1940s and 1950s, are were many of our clients' existing facilities.  As one might expect, these facilities are now outdated: too small, too big, too expensive to retrofit to work with the new requirements for HVAC and filtration requirements, too impossible to fix.  It seems so odd that a building that's "only" 50 years old cannot be salvaged for medical care, but that's how much the field has changed since these facilities were built.  Hospitals must have separate ductwork to put a high volume of filtered and conditioned air into the building and to take it out of the building back to the air handling units that filter and condition the air.  A third set of ducts must take air from certain areas and vent it directly outside, do not pass go, do not collect $200 from Medicare or insurance companies.  Ducts take up a lot of space above a ceiling, and if the 1955 hospital you're in is only 12'-0" from the floor to the roof, well then...that's not gonna work. And we haven't even begun to discuss the difficulties of installing updated electrical, data/IT, and medical equipment.

So a lot of these facilities end up building some or all new buildings for actual patient care, and they either put all their administrative functions into the old building, or they sell the old building to someone to use as office and meeting space.  Some of our clients trade the old hospital with the city and county authorities in exchange for a site on which to build anew.  Wheatlands Hospital in Wheatlands, KS, did just this.  (Longtime readers of WAD know that Wheatlands was the project I was finishing up just as I started this blog back in 2007.)  St. Ermahgerd will be selling their old building, I think, and know they're buying a new property on the edge of town.  They were on the edge of town when they built their original building in 1940 and then added on most of the present-day facility in 1950.  They're now landlocked in town and need to be able to expand.  So, off they go to the new edge of town, where they'll be landlocked again in another 50-80 years.

Today begins a busy next several months for our project team.  St. Ermahgerd needs to break ground on their two clinics this fall, and they want to break ground on the replacement hospital next summer. And by the way, we haven't done a lick of actual design work yet, because they didn't have their funding in place.  We gave them a program and a facility size along with a hypothetical exterior design back in February, and they've been simmering and dealing with financing since then.  And now, it's go-time with extreme prejudice.  

This project will be like Wheatlands, but bigger and faster. But this isn't our first rodeo--it sure isn't mine.  We're ready for a bumpy ride, but we'll be doing it in style.  It's just how Design Associates rolls.