When LifePoint Hospitals acquired Clark Regional Medical Center (CRMC) in May 2010, a commitment of the deal was to build a replacement hospital to better serve the healthcare needs of Winchester, Kentucky, and its surrounding area.
Two years later, a $70 million, 79-bed facility answers that need. The new CRMC features a one-level design concept that works off of a central spine from which each department stems, private admission and exam rooms, a new Center for Women and Babies, and a 100% geothermal heating and cooling system.
While notable features of the hospital may be plentiful, the story behind its construction includes a team that relied upon the trust its members had for one another to push ahead—even when the project’s tight schedule went up against record-breaking weather conditions, greatly reducing the window built between substantial completion and occupancy milestones.
The team
CRMC CEO Kathy Love says it was imperative that an aggressive timeline for the project be put into place to bring a conclusion as quickly as possible to begin serving the community. In the end, three Kentucky-based firms were selected to work toward that goal: Stengel Hill Architecture, Wehr Constructors Inc., and CMTA Consulting Engineers.
Beyond the tight schedule, Love says there were a number of desired needs that had to be met by the team, as well.
“In any project in today’s economic environment, you have to come up with ways to get your objectives met with not unlimited funds, and so we were looking for a very efficient and effective design that incorporated our need for growth and the latest technology into what is a private, serene environment,” she says.
Having worked together on previous projects, the familiarity team members had with one another was credited by Love as saving months of time from the outset.
“We had a running start from that perspective and these were people who knew our owner’s standards that are very specific, and we also had immediate trust in them right out of the gate to come up with some innovative ways to get this done quickly,” Love says.
Project delivery
Scott B. Smith, executive senior vice president at Wehr, says a unique component to how LifePoint runs its projects is bringing the contractor/construction manager on at the design/development stage. In the CRMC project, Wehr worked under a construction manager at-risk contract, consulting on the project months before ever turning a shovel of dirt.
“It allows us as the contractor to know upfront almost at the conception, decision-making point of what the owner wants, as well as what the design team wants,” he says, adding that the early involvement better prepared Wehr for components to prepare for, such as that geothermal system.
And it helped push through the schedule, as well, with Wehr helping develop documents in a sequence that allowed construction to start even before a majority of the design was completed.
“We were able to do things in conjunction with design intent to allow us to build the building as efficiently and as sequentially as possible,” Smith says.
Love also credits Wehr for forging through weather conditions well beyond the expected. “We had this commitment from our contractors that was second to none, and I mean through the wettest winter of Kentucky history—we had frozen ground we were trying to drill and blast; the site work was a miserable experience. They worked every weather hour—day or night, weekday or weekend—to get this done on time,” she says.
Another commitment on the project delivery came in the promised use of local subcontractors. Smith says Wehr guaranteed a minimum of 15% to 20% of the project labor would be brought from within a 50 mile radius of the facility, and ended up yielding 30%.
Going underground
Another unique component to the CRMC project was LifePoint’s desire for energy efficiency, which was answered with the decision to pursue a geothermal system for heating and cooling needs.
“LifePoint obviously had a forward-looking outlook on this to be able to see the future of healthcare design and buy-in to something with CMTA to design this facility 100% geothermal. It’s going to be an extremely energy-efficient hospital. It’s a maintenance-friendly design, and I think it’s going to be great for them,” says Kevin Sandrella, PE, LEED AP, electrical engineer with CMTA.
While geothermal is in use at healthcare facilities across the country, CRMC represents the first 100% geothermal hospital in Kentucky. The team credits the state with having an ideal geography for such a system thanks to the amount of underlying rock found there.
“The thermal transfer of rock versus other soil types is pretty similar, but the really important aspect of rock is it’s easy to drill,” Sandrella says. “It makes the drilling cheaper and makes the whole system very cost-effective. We also run into water a lot of times in Kentucky, and that really helps with the heat transfer for the wells.”
Chris Malicki, AIA, LEED AP BD+C, principal for the CRMC project at Stengel Hill, says the system was intentionally designed for ease of use. “Each individual heat pump unit is served by one type of filter size—they’re all basically utilizing the same parts, so it’s just a kit of parts that’s repeated over and over again,” he says.
The system also offers flexibility with temperature control for individual rooms, and when one unit goes down, it’s limited to that area and an entire wing doesn’t need to be shut down to service that one unit, he adds.
In the end, Love says the system, providing monthly energy savings combined with tax credits and incentives, will see a 10-month payback. “That is significant for the investment that we made that will pay off years and years and years into the future,” she says.
Also imperative to the efficiency of the building was the envelop itself, with a spray-applied polyurethane insulation applied inside the walls, expanding to as much as 5 inches of thickness in the exterior wall cavity that was then sealed tight.
“If you don’t have a very efficient thermal envelope, basically you can put the best mechanical system in the world in and it’s not going to do any good,” Malicki says. Also sealing the building is a roof installation that included an insulated concrete system, as well as UV glass to limit heat gain throughout the facility.
For more information on Clark Regional Medical Center, please visit www.clarkregional.org.
Coming soon to Healthcare Building Ideas: The Clark Regional Medical Center team shares more insight on what to consider when it comes to using a geothermal heating and cooling system in healthcare. Watch for it at www.healthcarebuildingideas.com.
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