Design-build project creates jewel of a hospital

The new Orange Regional Medical Center is a showcase for the benefits of design-build construction.

Talk about trial by fire or — more precisely — by tropical storm. The paint was barely dry on the new Orange Regional Medical Center (ORMC), Middletown, N.Y., when the remnants of Tropical Storm Irene gave the new health care facility a thorough working over in late August.

The hospital stood its ground and survived without a scratch, serving as a testimony to the quality of the hospital's design and construction. Located about 65 miles from Manhattan, the new 621,000-square-foot, 383-bed greenfield hospital is the first built from the ground up in New York in the past 25 years.

As a replacement for the aging Horton Medical Center (built in 1929), Middletown, and Arden Hill Hospital (built in 1967), Goshen, it was essential that ORMC offer 21st-century health care services.

Hospital officials credit leading health facility design-build firm HBE Corp., St. Louis, with delivering a top-quality project on time and for well below what other competing firms had proposed, due in large part to HBE's ability to integrate architectural, engineering and construction services.

The result: a state-of-the-art acute care facility that came in for 20 percent less than the amount projected by ORMC.

Among the hospital's features are private rooms, an advanced birthing center, a cardiac rehabilitation center, a bone and joint center, a pediatric unit, wireless health care information technology and more.

"It's really a jewel in the Hudson Valley," says Rob Lee, director of public relations and marketing, ORMC.

The facility was created despite tight financial limitations. "The best the independent architect, engineer and construction manager could propose was just over $1 million per bed. We couldn't afford that," says Wayne Becker, vice president, special projects, ORMC.

With more than 1,100 separate health care facility projects under its belt, HBE guaranteed performing all phases of the project for about $720,000 per bed, Becker says.

"HBE saved the hospital $100 million it didn't have," says Scott Batulis, CEO and president, ORMC.

"You have one firm, a single point of accountability, a single contract. There was one lump sum guaranteed pricing. We had fewer professional fees," Lee says about the multiple advantages of the relationship with the designer.

Consolidating all phases of the architecture, engineering and construction with one company takes the guesswork out of the cost, which typically starts to mount as soon as the initial planning begins when each phase of the project is fulfilled by a separate company, according to Fred Kummer, CEO and president, HBE.

"We develop all of the preliminary work at our own risk," Kummer says. "We work with clients to understand their limitations in terms of the expenditures that they're capable of making. We provide the architectural services and engineering and then ultimately the construction. Until we have developed a comprehensive plan and fixed cost, the client has zero at risk."

The project offered some special challenges, Kummer says. The hospital was built on a 61-acre site atop a hill about 70 feet from the entry level to the high point, requiring removal of tons of earth to make the site suitable for construction, he explains.

While Kummer takes great pride in all the projects his company has completed, ORMC is special to him. He was born at Horton Medical Center, one of the hospitals ORMC is replacing, 83 years ago.

"To go back and build them another hospital is an interesting run of events," he notes. "And a wonderful honor."