An East Coast Medical LEED-er

The recently certified Jersey Shore University Medical Center's $300 million expansion is the first to earn LEED Gold in the garden state and is the largest on the East Coast.

By Kristen Eichenmuller

As energy efficiency and sustainability continues at the forefront of construction, many types of projects are achieving LEED certification, but the Jersey Shore University Medical Center in Neptune, N.J., set an example for the healthcare industry. With not many LEED hospitals in the U.S., Jersey Shore was one of the first three LEED Gold hospitals in the nation, receiving it's certification August 2010. "It's definitely a growing trend that hospitals are moving toward in their major expansions and renovation projects looking to LEED certification as a tool," Michael W. Pavelsky, AIA, LEED AP BD+C, sustainability director for The Sheward Partnership LLC, the overall sustainability and LEED consultant, said.

The major changes and additions are the first step in the hospital's five-year "Transforming Care" program. Masterplanning for the campus, which reflects the hospitals' needs until 2010, began in 2003, and the complete buildout will take place over the next 50 years. The hospital broke ground spring 2006 and opened fall 2009, taking three years for design and construction, while some small renovations in the labs expanded into 2010 and 2011.

Previously, the hospital was growing at an astounding rate, with inpatient areas growing 4 to 6 percent and outpatient areas growing 10 to 12 percent annually. And in the early 2000s, they outgrew the campus. "While the hospital made investments, it's been 20 years since any additional bed capacity had been built and about 30 to 40 years since any significant infrastructure improvements," Steve Littleson, president of the Jersey Shore University Medical Center, explained. "One reason we thought LEED certification was important was that it was a very visible, specific way to tell the community that we invested $300 million into the environment. I think it's going to grow and become more commonplace over time," he continued.

Transforming and improving patient care was the first priority. The campus' reorientation improved the hospital's main goals of access and future growth. The three distinct zones. The in-patient zone includes the new four-story Northwest Pavilion with an additional 108 private beds. The diagnostic and treatment zone, centered in the new three-story Diagnostic and Treatment Building, includes six new surgical suites, catheterization labs and the pharmacy and imaging services. Outpatient services are grouped in one zone, rather than being spread out throughout the hospital. A North-South Concourse connects the new expansion to the existing hospital. WHR Architects provided the unique architecture and interior design on the project and was selected by JSUMC after a competitive RFP process. Tushar Gupta, lead designer on the project, found inspiration from the shore, designing the three buildings organized around a node, in which the curvilinear form represents the sail.

$200 million for the JSUMC project was borrowed through a tax-exempt bond issue, while the other $100 million came from cash — $20 million was raised from a capital campaign through the community. As a result of construction taking place during the height of the 2006 to 2008 construction boom, escalating costs created a $60 million jump in price. Littleson noted that it was difficult to know what to cut, since so much of the project was designed together.

John Donnely, Jr. was the senior project manager for L.F. Driscoll Co. LLC, builder of JSUMC. With his experience in health care construction, and 51 percent of the company's work in healthcare, Donnely managed the subcontractors, project cost, schedule, logistics and more during the 36-month building process. The construction of the hospital on an old landfill brought challenges, as Donnely cited removal of the ID-27 and disposal as difficult. The seismic constraints, in which the structural steel and HVAC systems had to be designed and coordinated to handle the seismic zone, were also challenging, and at one point, coordinating 230 men to be productive also was a task, according to the builder.

While the final project reached LEED certification, the hospital's construction was already underway when the decision was made. "Our project documents already had some LEED requirements built into them, a credit to the architect, so the materials were already specified as such. The challenge was we had already started construction when JSUMC decided to go LEED," Donnely said. Since the project started at certified, it achieved Gold status through some investigation and documentation.

Littleson couldn't emphasize enough the importance of getting a good consultant that understands what it takes to be LEED certified, and "most importantly, what you don't need to do, which can waste a lot of money," he said. The Sheward Partnership LLC worked directly for Meridian Health and also simultaneously reported to the project management group Granary Associates — now Stantec. While the consulting firm covers most markets in addition to healthcare organizations, currently working on four or five other major hospitals seeking LEED certification, Pavelsky mentioned that hospitals are some of the more complex, larger projects they get involved with.

In terms of the facility's environmental performance, it is about 32 percent more efficient than the standard set by the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE 90.1). "That is huge in terms of the environmental performance and in terms of the financial returns they will reap from designing an energy-efficient facility," Pavelsky said.

Both Littleson and Pavelsky agreed on the main green featuers, including the HVAC system that brings in 100 percent outside air (not recirculating inside air) and the reduction in water consumption through faucet design. While the LEED consultant added that the glass doors between the patient rooms and the corridors let natural light transmit into the core of the building, which is rarely seen in the healthcare environment, the hospital's president emphasized the two gas-fired co-geneartion units that convert onsite waste into steam heat, ultimately reducing energy consumption. The hospital received a $1 million Smart Start grant from the state of New Jersey for the co-generation plant, which has taken about a year to constantly run smoothly.

Other green features include minimizing disturbances to local ecosystems by preserving open spaces, creating a new 966-car parking garage on site (50 percent of parking is covered), using over 30 percent of building materials that contain high levels of recylced content and generating waste through a recycling program. The Northwest Pavilion reduces it's water consumption by 3,600 gallons per day (30 percent) as a result of the chemicalfree water treatment system that conserves water and electricity.

The use of native and drought-tolerant plants reinforced the project's commitment to sustainability. Among the various landscape designs for JSUMC's Transforming Care Project, the plan included the rehabilitation of existing planting throughout the campus. "Projects of this nature are always challenging because, not only are you designing for an extremely wide range of users, but the design must also support the day-to-day functions of the hospital," Julie Boucek of Melillo + Bauer Associates commented. The landscape architect has been involved with Jersey Shore for over 30 years, including past design work for other Meridian Health System campuses and the design of an interior courtyard at JSUMC.

The night before the ribbon cutting ceremony, 100 managers spent the night throughout the three floors with 36 beds, providing the opportunity to experience the hospital from a patien'ts point of view. "As we got closer to the opening, we realized that it fairly looks like a high-end hotel with a lot of cool technology in it," Littleson replied. They held a scavenger hunt to learn how to use the new technology, such as the nurse call systems integrated into the phone system, the TV with Internet, the beds and more.

In 2010, JSUMC's admission was up by 5 percent, and they ended the year with a 2 percent profit margin. "You never know when you make an investment of this size if it will sink the ship or make it more boyant," Littleson commented.

Kristen Eichenmuller is the editor of American Infrastructure. She can be contacted at keichenmuller@penpubinc.com.