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Monday, Aug 15, 2022
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A Healthy Hospital Backlog

Orange County is in the middle of a building boom—for hospitals and related medical clinics.

All around Orange County, healthcare systems are preparing new facilities whose costs are running into the billions of dollars. Part of the investment is to meet tough seismic codes scheduled to take effect in 2030, while another factor is the perception that local residents had to travel elsewhere to get world-class care.

“People are leaving Orange County to get care, which says we are not adequately providing the services that our citizens deserve,” said Dr. Steve Goldstein, vice chancellor for health affairs at the University of California, Irvine, a role that includes managing the $1 billion UCI Health system.

“People should be able to get the best possible care without having to leave.”

UCI Health itself is spending $1.4 billion for new construction on a hospital, clinic and the Susan & Henry Samueli College of Health.

The new buildings are providing plenty of work for numerous architectural and engineering firms on this week’s Business Journal annual lists (see pages 23 and 27).

What follows are plans for the region’s largest healthcare providers:

City of Hope: Feng Shui Advisers

Duarte-based City of Hope is planning a $1 billion, state-of-the-art 11-acre cancer campus that will include an outpatient center, a clinical research center and Orange County’s only specialty hospital focused exclusively on treating and curing cancer.

The first building scheduled is the 190,000-square-foot Lennar Foundation Cancer Center, which is set to open next year.

The City of Hope asked the architects, Los Angeles-based ZGF Architects LLP, to work with a feng shui consultant, who advised them to not have a front door where visitors could see down a hallway through the entire building.

“That would take the energy out” of the building, the consultant informed James Woolum, who along with Janet Pangman are ZGF’s key architects for the City of Hope.

The consultant also recommended the center part of the building needed pillars to look strong with metal—not silver—to imply strength. The architectural firm eventually used natural bronze.  

The architects also wanted to emphasize the area’s plants, the natural light available because of numerous windows and the views of nearby mountains. The firm is also helping design the adjacent hospital so that it flows with the cancer center.

“It was important that we thought about the cancer center and hospital together because they have a lot of overlap,” Pangman said.

Kaiser Permanente: Reassessing Needs

Kaiser Permanente likes to say it’s been ahead of the curve, constructing new hospitals in Irvine and Anaheim in recent years.

“Over the last 20 years, Kaiser Permanente has invested $1.5 billion between its Irvine and Anaheim facilities,” said Sunil Shah, vice president of facilities for Kaiser Permanente. “We were way ahead of our competition in investing in Orange County.”

The giant healthcare system has plans for major remodels and technology upgrades at its OC facilities. However, because of COVID and the rise of telehealth, it’s reassessing its needs, putting on hold facilities such as a 43,000-square-foot facility in Aliso Viejo and a new building with between 50,000-to-100,000 square feet near the Westminister Mall along the 405 freeway.

“A lot of things are under the microscope,” said Tony Smale, lead planner for Kaiser Permanente Orange County. “We’re in the crossroads of healthcare because of COVID.”

Providence: Seismic Regulations Key

Providence St. Joseph Hospital is developing the Helen Caloggero Women’s and Family Center on its Orange campus with the help of PMB, a San Diego-based healthcare real estate investor.  

PMB in August started demolition on the current facility, which will be replaced with a four-story, 137,000-square-foot medical office building that will house a wide range of services, including a mother and baby assessment center, maternal diabetes, and OB-GYN clinical offices.

Providence, which generates about $4.8 billion in annual revenue in Orange County through its network of hospitals, is currently studying a plan that may include more than $1 billion in improvements over the next eight years because of seismic regulations scheduled to take effect in 2030. This will likely result in major improvements at facilities like Providence Mission Hospital in Mission Viejo.

“If you’re a hospital and cannot afford to do the seismic change, you’re not going to be here after 2030,” Kevin Manemann, chief executive of Providence Southern California, recently told the Business Journal.

CHOC: Future Planning

CHOC has been renovating a building in Orange, turning a 12,000-square-foot area into its primary care services, which was previously located on the hospital main campus.

The space houses 26 exam rooms equipped with telehealth capabilities, and three work areas for providers and staff. The second floor of the building also underwent an approximately 8,000-square-foot full gut tenant enhancement to build out a new outpatient rehab facility.

CHOC said it’s working on plans to address future growth over the next decade. Sources tell the Business Journal that the children’s hospital is expected to soon launch a major fundraising campaign to fund forthcoming projects.

UCI Health: Campus Additions

While UCI Health already operates a hospital campus in Orange, it wants medical facilities closer to its Irvine campus, thus helping its clients and medical students avoid the numerous traffic jams on the 55 freeway.

Hence, it’s spending more than $1.2 billion on the UCI Medical Center-Irvine, a 200-acre site located at the corner of Jamboree Road and Birch Street, near the Irvine and Newport Beach city line.

The project will include a 165,000-square-foot Center for Advanced Care for children’s health and neurosciences, an Ambulatory Care Center for outpatient care and a couple of large garages.

The biggest building will be a 575,000-square-foot hospital that will include 144 beds and eight operating rooms. The hospital alone will cost almost $1 billion.

“Hospital construction is very specialized and very expensive,” said Brian Pratt, the architect and associate vice chancellor of design and construction services at the University of California, Irvine.

Besides meeting seismic requirements, the hospital must provide specialized facilities. Also, each of its hospital bedrooms will be able to meet the high standards of an intensive care unit so a patient can stay in the same bed in same room through whole course of care.

“If you start out in the ICU, but you start to improve, you’re not getting moved around. They just convert the room,” Pratt said.

It will have views for patients and guests at its café of nearby San Joaquin Marsh that leads into upper Newport Beach Bay.

“The idea is we’re trying to benefit from the marsh and the natural environment,” Pratt said. “We think this site is the real differentiator from a wellness point of view.”

The funding is already in place, although it is looking for donors to put their names on the buildings.

The openings will range from 2023 to late 2025. It’s relatively quick in the world of construction because UCI has its own jurisdiction, so it doesn’t need to ask permission from the city of Irvine.

“We can move fast. We don’t have to submit to a city. We are the building department,” Pratt said.

UCI is also spending about $185 million on building the nearby Susan & Henry Samueli College of Health Sciences.

Pratt oversees a staff of 20, saying “We are running very lean, but we intend to hire another 20 in the coming year.”

Hoag: Going Big in Irvine

Hoag Memorial Hospital Presbyterian, which has about 2 million square feet of owned and leased space in Orange County, plans to add another 500,000 square feet in the coming years including:

• A primary care and family practice facility totaling 24,000 square feet at the corner of Irvine’s Jamboree and Campus Drive, adjacent to the new UCI Health-Irvine facility going up.

• Renovation of the 35,000-square-foot Cancer Center at Newport Beach campus.

• A 45,000-square-foot facility for administrative support along Red Hill Avenue in Costa Mesa.

These projects are in addition to opening “health centers” in cities like Tustin and Foothill Ranch, as well as a new baby center in Irvine where about 100 babies a month are being delivered.

“Over the last couple of years, we’ve been concentrating on the distribution of services into the communities,” said Sanford Smith, senior vice president of real estate and facilities at Hoag.

“We’re going to try some really interesting things to deliver outpatient care.”

In June, Hoag made one of the largest real estate transactions in Orange County this year when it purchased its Irvine hospital facility and adjacent land parcels for $226 million.

Big projects on that campus are expected to include new hospitals and medical facilities, with the first major additions scheduled to open in 2025. All told, more than 400,000 square feet of additions are under consideration, according to city filings.

“The Irvine hospital is in response to growing needs of the community,” Smith said, noting that the community is aging and will need more health services.

The seismic rules are creating a lot of discussion in the healthcare industry, he said.

“Everybody is trying to figure out the right path forward,” he said. “Hoag is having a lot of internal discussions. It has a huge potential impact on the Orange County health care community.”

MemorialCare: Women-Focused

MemorialCare, which has two hospitals in Orange County, is focusing on building smaller facilities, such as a three-story Women’s Health Pavilion at its Saddleback Hospital in Laguna Hills.

The new 40,000-square-foot facility will hold the Breast Center and several other programs such as pelvic health, fertility specialists and a large gynecology program.

“It will make it easy for women to go to different specialists within one location,” Dr. Gary Levine, medical director of MemorialCare Breast Centers, told the Business Journal. “It’s pretty unique in South Orange County. There’s nothing like this.”

MemorialCare has been concentrating on improving its more than 200 doctor offices, which are typically under 10,000 square feet, throughout Orange County.

“Some of it is new construction, some of it is refurbishing and taking over new locations,” said Dr. Adam Solomon, chief medical officer of the MemorialCare Medical Foundation, which oversees its physicians.

MemorialCare is concentrating on improving patient experiences in offices, such as deleting the wait time prior to an appointment and reducing an average visit from one hour to 40 minutes. That has freed waiting rooms to be repurposed.  

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