There are certain intricacies particular to the design and construction of buildings when the end-use is designated for medical-related businesses. Medical industry construction services are sophisticated and require a specialized skill-set to assure expeditious and quality construction delivery. Specifics regarding medical construction to keep in mind:

Bay depths of medical office buildings are typically shallower than general office buildings. Designing a building with bays that are too deep can cause leasing/sales problems. Although the rental rate may be acceptable in the market, a tenant (or buyer) may be forced to take more space than needed because the rooms are too deep; thus making the total rent or purchase price unacceptable to the prospective client.

Medical chart storing (high-density file cabinets) is typical. In order to avoid reinforcing the floors under these files, increasing the floor design live load to 80 or 100 lbs. per S.F. adds future flexibility. Also, equipment sensitive to vibration could exist in the space, so it’s important to provide stiff floors (calculated deflections of less than 1/360th of the span is the norm). Some diagnostic equipment generates heat while other equipment needs a constant ambient temperature, even on nights and weekends. These requirements put unusual demands on the HVAC system. Each suite must be divided into many control zones.

Usually toilet rooms are located in tenant spaces, so it’s not necessary to provide large, multi-purpose toilets. Two single-occupancy toilet rooms per floor are usually adequate. A circulating hot water loop should be provided on every floor to supply instant hot water at all sinks and lavatories. Also, usually, laboratory specimen box closets must be located on every floor, simply to assure security for multiple lab boxes. Mailrooms are typically larger, as well, to accommodate oversize x-ray film and drug samples.

Depending on the medical services provided, many suites require special construction, including radiation protection, electromagnetic frequency shielding, 24/7 constant temperature, conditioned power supply and other requirements.

Because of high patient traffic, more and larger elevators are required; at least one elevator must be large enough to hold a stretcher or gurney. There are regulatory authorities pertinent to the medical/healthcare and diagnostic industries that generate current and appropriate guidelines as requirements change.

Construction costs are typically higher for medical vs. commercial building use, as well. Historical estimates for Interior Build-Outs range from ‘bare-bones’ at $70.-$75./SF; to ‘medium finishers’ at $85. /SF; to ‘high-end’ at $120. /SF.

Tenant improvements will usually equal or exceed the cost of the shell and core as a result of a combination of extensive plumbing, sophisticated HVAC, institutional quality hardware, medical cabinetry, and sound attenuating construction. High density commercial carpet, plastic laminate cabinets, vinyl wall covering, steel or aluminum door frames are routinely provided. Higher traffic flow, high level of cleanliness, possible need for bio-waste removal, emergency power requirements, and additional lighting level requirements are also impactful considerations. Shell construction for Medical Office Buildings (MOB’s) isn’t necessarily different than shell construction for commercial buildings, though there are parking requirement differences. MOB’s require five to six parking spaces for each 1,000 S.F. of gross building area (one space for every 166 to 200 S.F. of building area). Historical estimates for MBO Shell construction range from ‘Building Only’ (up to 25,000 SF) @ $88.-$93./SF; to ‘Building Only’ (25,000 to 75,000 SF) @ $83.-$87./SF. Sitework for small sites could be approximately $200K/Acre with 4+ Acre sitework coming-in at $125,000/Acre.

Surgery Centers (Ambulatory Interior) going in to an existing shell can be from $250.-$280./SF. Stand-alone Centers with sitework can be from $350.-$375./SF. Assisted Living Facilities (ALF’s) – though their construction specifics are certainly not typical to commercial or medical office buildings – also offer-up a unique set of design and construction elements. ALF’s historical costs, including complete Build-Out with sitework (75,000 – 100,000 SF) range from ‘medium finishes’ at $165. /SF to ‘high-end’ at $195. +/SF.

Though additional design and construction considerations may exist, these are some of the difference between a “typical” office building and a MOB or other medical/healthcare-type facilities. Anderson-Moore Construction Corp. has a division that specializes in preconstruction, vertical construction and tenant build-out for medical and healthcare related facilities. They can coordinate the necessary consulting services from the site-plan approval phase through building completion.