Terrace View Long-Term Care Facility

Owner: Erie County Medical Center

Project Value: $90.5 million

Completed: December 2012

Architect: Cannon Design

Beds: 390

In 2008, reform was mandated to implement changes improving New York’s health care system for the 21st century based on the Berger Commission. As part of this commission, Erie County Medical Center’s (ECMC) 80-year old county nursing home in Alden, New York needed to be consolidated onto the ECMC campus. Plans for the Terrace View Long-Term Care Facility and parking garage were approved. The name is based on the design feature of multiple terraces that provide residents with views of the neighborhood. Benefits of the move included having hospital resources next door for residents, increased access for employment of Buffalo and suburban residents and reduced operating costs by eliminating resident transportation costs between Alden and Buffalo.

Our team members oversaw the new, modern, long-term care facility and a supporting precast parking ramp project under a construction manager at-risk contract. Cannon Design was hired by ECMC as the architect of record for both projects.

In December 2010, preconstruction team members began by evolving the design and confirming if budgets were aligning with ECMC’s goals. As part of the preconstruction efforts, a Master Activity Schedule was completed detailing milestones for both the long-term care facility, as well as the parking ramp. This also specified important milestones which all project team members were required to accomplish at each level of design. In January 2011, our team members worked with ECMC and Cannon Design to complete the first estimate at the design document level. After confirming it was over budget, the next few months included two rounds of value engineering presentations and reviews from February through March 2011. Our team members then worked to competitively bid the project to the contracting community through late winter of 2011.

To ensure all the trades were scheduled as effectively as possible, our team developed the phasing plan with the various trades utilizing a BIM model. The various trades added their components in an appropriate order as follows:

• Plumbing contractor began with the model, as their installation requiring pitch needed the most options. At this stage they added sanitary and storm piping.
• Next, sheet metal contractor added components.
• Third, plumbing contractor added domestic water and medical gasses.
• Next, mechanical contractor added piping.
• Sprinkler contractor integrated their system.
• Electrical contractor added components for electrical, lighting and cable tray.

After this input of data, each individual contractor signed off on the final model. This process identified many architectural challenges prior to construction and, once corrected, avoided costly change orders and schedule delays in the field. Then, contractors were able to begin preparing to work in the field and complete any feasible fabrication processes.

Construction began on the long-term care facility in June 2011, and our team members quickly came upon unforeseen conditions with contaminated soils found during excavation work. The need to move over 14,000 tons of hazardous soil off-site created an immediate 6-week delay. Foundations and steel structure began in October 2011, and the structure necessitated getting shrink-wrapped in plastic so work could continue through the harsh winters. Heaters were brought in to ensure temperatures were maintained allowing concrete foundations and concrete slabs-on-deck to begin in December 2011.

In the end, the long-term care facility is a five-story, 296,549 sq. ft. building with a total of 390-beds designed with multiple wings off a main core. The facility is organized into 12-bed households and follows a person-centered care model. Each household includes a living room and fireplace, kitchen and dining rooms. Resident’s rooms include a wide bay window and adjoining bathroom. All households include showers and whirlpool tubs available to residents. Additionally, each floor includes an outdoor terrace and an indoor terrace lounge to offer residents fresh air spaces. Adjacent courtyards and gardens offer visual and recreational enjoyment for residents, families and staff.

It contains three floors with 96 skilled nursing beds, a floor with a 66-bed short-term rehabilitation area, a 20-bed ventilator unit, a 16-bed behavioral intervention unit, a 10-bed bariatric unit, and dedicated specialty beds for Alzheimer’s and dementia care. Concurrent to this work was the construction on the adjacent staff parking garage, which began in October 2011 and was completed in May 2012. The parking garage is a five-story, 374-car precast structure to support the long-term care facility.

The original anticipated certificate of occupancy date for the long-term care facility was October 2012 with move-in for December 12, 2012. However, with the delays due to contaminated soils and changing the scope of the parking garage to add another level, the completion was adjusted. A certificate of occupancy was issued for the long-term care facility in December 2012, with resident move-in on February 8, 2013. The budget for the projects was established at $85.3 million. After the additional scope of work was added to the project, the final project came in at $90.5 million.