In the city of Charleston, a construction team from the Birmingham-based company Robins & Morton and subcontractors are hard at work assembling what will become the 625, 000-square-foot Medical University of South Carolina (MUSC) Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion.
The $385 million hospital is set to open in 2019 and will house technologies and specialized services for women with high-risk pregnancies and medically fragile newborns. Once complete, the facility will be a new addition to Charleston’s downtown medical district, which already includes Roper Hospital and the Ralph H. Johnson VA Medical Center.
“A hospital is a complex building, ” says Robin Savage, Robins & Morton’s president and COO. The privately held, Birmingham-based construction company is the construction manager-at-risk on the project in partnership with two other firms.
“A hospital probably has more systems in it than any other type of building, ” says Savage. “It has emergency systems, back-up water systems and the HVAC. The mechanical systems are very complex because of the air requirements. So we train our people in the intricacies of all of those systems. It’s a huge coordination of efforts on a building like that.”
While Robins & Morton has both a government and a commercial division, healthcare is the company’s largest sector, he says. The company has raised, renovated and expanded hospitals, outpatient clinics and medical office buildings across the United States.
“We have seven offices around the country, ” says Savage, “and the majority of their work is healthcare work.”
One of Robins & Morton’s most recent high-profile medical construction projects is the 305, 000-square-foot, $430 million Miami Cancer Institute at Baptist Health South Florida, which opened in January.
Robins & Morton’s healthcare work is scoring high marks in the industry these days. Last year, Modern Healthcare Magazine ranked Robins & Morton at number two among general contractors in the nation based on companies’ self-reported 2015 dollar volume, square footage for completed projects, total work involving health care projects and other factors. Moreover, Associated Builders & Contractors awarded Robins & Morton with 2016 National Excellence in Construction Eagle prizes for three of its healthcare projects, which included the Cherokee Indian Hospital, in Cherokee, North Carolina.
Established in 1946, Robins & Morton’s introduction to the healthcare market began in the 1970s with a couple of bid contracts, Savage says.
“But when we really entered the market in a big way was in the early 1980s, ” he says. “We were awarded three major health care projects. We were then tasked with, ‘How do we build up for this effort?’ So we began hiring and training people on how to build hospitals.”
Some of Robins & Morton’s healthcare projects over the years in Alabama alone have included UAB Medical West in Bessemer, University of South Alabama Mitchell Cancer Institute in Mobile, the HealthSouth Rehabilitation Hospital of Dothan, Brookwood Women’s Medical Center in Birmingham and Clearview Cancer Institute in Huntsville.
Savage says the company trains its workers on healthcare construction topics ranging from understanding hospital and clinic systems and infection control to how to collaborate with medical personnel. Having staff with specialized knowledge gives the company a competitive edge.
“When you go in to sell a hospital project, you better have a superintendent, a project manager and some support people who you can stand up in front of them [prospective clients] and let them talk and tell them how they’re going to take care of them, what their knowledge is of a health care project, talk specifically about their project and the peculiarities of the job. And you better have people who have done that before and are well trained in it. We have a lot of people in the company who carry those credentials.”
In Charleston, Robins & Morton is the construction manager-at-risk on the MUSC children’s hospital and women’s pavilion project, along with a South Carolina firm Brownstone Construction and Cummings Construction Management based in Los Angeles. The architects on the project are from the firm Perkins + Will.
The building will have a 10-story bed tower, a five-story diagnostic treatment building, 262 patient beds, a labor and delivery unit, neonatal and pediatric intensive care units and a pediatric emergency room. The building’s exterior will include a seventh-floor, 10, 000-square-foot outdoor play area.
Building onto or near existing medical facilities, however, requires a delicate dance of planning and coordination to protect nearby patients during construction, says Robins & Morton Senior Project Manager Steven Wiley.
“We’re located in the heart of the medical district, and there are three separate hospitals that we’re working adjacent to, ” says Wiley, “We’ve had to coordinate with them to make sure our construction, the traffic, our dust or anything else is taken care of and that it doesn’t affect patients.”
Wiley says that even before construction began, the company began tracking air quality, noise and vibrations to develop protocols for adjusting their construction work, if neighboring hospitals complained about noise or dust.
Moreover, to foster effective lines of communication among all the hospitals, the construction teams meet weekly with hospital facilities managers, infection control officers and others to provide updates and review construction schedules for the coming weeks.
Another big challenge for construction crews has to do with MUSC’s location. Charleston is a coastal city in South Carolina’s low country region and is therefore prone to flooding, hurricanes and even earthquake tremors, Wiley says. To address those concerns, the crews are constructing a building exterior that can withstand high winds and putting in a deep concrete pile foundation to strengthen the hospital against seismic activity.
The expected construction costs for the building will reach $255 million, Wiley says. To help save money while meeting the needs of the client, he says Robins & Morton implemented several strategies, including pre-purchasing some of their building materials. “We made early commitments to steel and glass to avoid [price] escalations, ” he says.
Savage says the biggest growth areas for healthcare construction these days have been in states like Florida, Texas and North and South Carolina. Therefore, the majority of Robins & Morton’s healthcare projects are, these days, outside of Alabama, where he says there has been less money for healthcare capital improvements. He says actions by Congress on the Affordable Care Act could further impact healthcare construction.
“There are a lot of healthcare CEOs who are nervous about that bill, because of what it may do to reimbursements of health care costs and their business and how it affects insurance, ” Savage says.
Overall, though, Savage says he is optimistic about the future of healthcare construction, owing to several factors. One factor involves rapid advances in medical technology. He points to recent projects that involved upgrades to hospital operating rooms and spaces to house the latest imaging equipment.
Also, the nation’s baby boomer population is aging, so they will require more medical treatments and places to receive those treatments. In addition, healthcare delivery is changing and driving healthcare construction, he says.
“There is currently a bit of a boom in outpatient clinics, because many health systems are building outpatient clinics to be feeders for the hospitals, ” he says. “So you have the ramp up of construction just as the need arises from that.”
Savage says Robins & Morton has set an aggressive sales goal of $1.25 billion this year and is on track to meet and even exceed the mark.
“As a company, ” says Savage, “I think we have a very solid basis for growth over the next two to three years.”
Gail Short is a freelance contributor to Business Alabama. She is based in Birmingham.
Text by GAIL ALLYN SHORT