Renovating an aging hospital year after year carries with it the burden of determining what to fix and when-all while being financially responsible. As these facilities age and technology advances, inevitably the question arises: Should we continue renovating this old building or simply tear it down and rebuild? However, the answer is not so simple, especially in today's economic climate. With diminishing assets and looming healthcare reform, hospitals more and more are choosing a conservative approach. According to an
HFM/ASHE 2010 Construction Survey, only 16% of planned construction is new while only about 11% is replacements. But, without adequate evaluation, sometimes rehab can prove to be the more expensive option.
So, when making the critical decision to continue updating an aging facility or rebuilding altogether, one must proceed with knowledgeable expertise and caution. How does a facility make the best decision while stretching dollars as far as possible? While there is no proverbial crystal ball, there are actions to take that can accurately predict future growth, prioritize needs, and test the existing facility to determine with proximity exactly what the facility needs. There are three questions that must be asked and once they are answered, the decision to build or renovate usually becomes obvious.
Such was the case with Marietta Memorial Hospital in Marietta, Ohio. The administration and board of this 199-bed hospital had struggled for many years over whether to replace their hospital or to continue expanding and renovating. When my partner Bob Gesing and I arrived at the nearly 80-year-old building, we immediately understood their dilemma. Three sides of the site were severely sloped while the fourth side contained two main water lines buried underground which served the entire city. We could not determine which alternative would cost less nor could we say that expansion and renovation was even feasible. A thorough analysis was needed, a process we divide into the following three questions.
