Borgess, Borgess, quite a success, how does your garden grow?

November 9, 2009

Source: Joe Boomgaard
Department: MiBiz
Phone: (616) 726-6909
Email: jboomgaard@mibiz.com

KALAMAZOO - Residents in the Kalamazoo area will soon have an updated option for skilled nursing care, one designed with modern healthcare practices in mind.

Borgess Gardens is the first new Kalamazoo-area nursing home in 20 years and has been on the drawing board for the medical system for several years, said Tony McDonnell executive director of the Borgess Foundation.

A $5.5 million gift from Bill and Julia Van Domelen jumpstarted the $17 million campaign, which will cover the cost of the nursing home and two adjacent cottage facilities, as well as renovations to the hospital's emergency and trauma center.

Once the foundation reached the $9.5 million dollar mark, McDonnell said the partners felt confident enough to start construction. The facility is located at the health system's Nazareth Campus, and the Sisters of St. Joseph of Nazareth congregation donated the land.

Borgess Gardens has 121 skilled nursing beds, the exact number of beds at the outdated facility Borgess is replacing.

"This facility really reflects the kind of care we can give and enhances (our capabilities)," McDonnell told MiBiz. "Folks will have the opportunity to live out the daily activities of their life in a homelike setting."

Mary Ely, senior marketing specialist at Borgess, said the new facility would ascribe to the Eden Alternative model and offer both long-term care and short-term rehab.

Eckert Wordell designed the facility. Miller-Davis Co. served as the construction manager.

Borgess is also in the middle of a project to combine its ER and trauma center into one room to make it more flexible for staff to treat patients.

McDonnell said the hospital saw a "huge increase in demand" for such services after launching its "no wait" guarantee. The existing unit was built to handle about 44,000 annual visits, but current usage is about 60,000 patients.

The ER project will start in November, and the hospital will continue providing emergency care during the construction.

AVB Construction is the construction manager for that project, which was designed by the Trinity Health Group.

Edenic setting

Typically, nursing homes have more of an institutional feel, but the Eden model requires a different approach.

According to Rick Wordell, co-founder and senior principal of Eckert Wordell, the design for the larger building focused on a neighborhood concept. Each of the four neighborhoods has its own identity with individual color schemes and their own open-air gardens, Wordell said. The majority of the rooms are private, and residents share common space, like a great room, in each neighborhood.

"Each resident feels connected to their house," Wordell told MiBiz. "It's a culture. The design implication is individual rather than institutional."

Incorporated into the concept are many earth tones and natural lighting.

The two detached cottages, each with a 10-bed capacity, take a slightly different approach, but maintain the individual design characteristics.

"They'll be a bit more intimate than a larger facility and designed for residents who will be in the facility for a longer period of time," McDonnell said.

The main site and the cottages have many garden features, like raised planting beds and trellises. Wordell said the company also tried to build on the Borgess' existing buildings in the design of the new facility.

"When you look at the front of Borgess Medical Center, it has an old, historical front that has some residential-style gables. The fa ade is a sloped roof. We used the same type of form on the Borgess Gardens project, referencing the architecture of the old building in the new building."

Construction started in July 2008, and the crews did as much as they could before last winter hit.

"It would have been a challenge to erect and enclose all three buildings before a mild winter, but the weather blasted us with unseasonably early, bitter temperatures and record-setting snow falls," Karen K. Gruss, project manager for Miller-Davis, told MiBiz.

Miller-Davis built a temporary enclosure over a 70-foot-by-100-foot area to contain temporary heat, which allowed contractors to pour thickened concrete slabs. The subcontractors kept the frost out of the ground with insulated blankets and by hand-shoveling snow, Gruss stated.

While LEED certification isn't being sought for this project, Gruss said the site design included careful attention to land conservancy, including controlling soil erosion and waterway sedimentation.

"Miller-Davis Company promotes sustainable practices and waste management on all projects," Gruss said. "In this case, we incorporated environmentally conscious practices by utilizing recycling dumpsters for concrete, wood, drywall, cardboard, and metal. Not only did this reduce landfill impact, but it also enabled us to pass cost savings on to Borgess Nursing Home."

Healthcare business feels the pinch

McDonnell said many healthcare providers and hospital systems are faced with the question of "pouring more dollars into the physical plant when in the long run we knew we needed a new facility." Luckily for Borgess, the philanthropic donation helped move the project forward. McDonnell said donations were strong, but the amount of giving was affected by the economy.

Other healthcare projects have slowed across the country, a fact felt by both Miller-Davis and Eckert Wordell.

"While expectations of growth in healthcare construction remain for the long-term, that sector recently seems to be experiencing the same challenges as other sectors," Rex Bell, president of Miller-Davis, told MiBiz. "Spending for healthcare construction has declined but not to the extent of some other types of construction. We expect this to gradually improve with the slow improvement of the economy."

Wordell said his company, based in Kalamazoo, typically does about 75 percent of its business in healthcare facilities across the nation. Eckert Wordell designs many specialty centers, including for ophthalmology and orthopedics practices and ambulatory surgery centers.

Wordell said work has slowed lately, but he's hopeful healthcare spending will begin to pick up in the near future.

"A lot of healthcare decisions have been sort of waiting in the wings for this healthcare reform," Wordell said. "This hit about the same time as the economy and the presidential change. Everything, put together, slowed it for us."

Given lender wariness, hospitals can't borrow money because their bond ratings aren't as high, and they aren't being quick to spend given the uncertainty of what healthcare reform will mean for the structure of reimbursements.

"They have projects that they're thinking about, but it's safer to put them in the drawer," he said. "We don't like to complain, but we've definitely noticed a slowdown in work."

Still, Wordell is confident that Southwest Michigan is doing better than many parts of the state. His company recently finished up nursing homes in Calhoun County and in Hastings, but has several projects in other parts of North America, including Massachusetts, Florida and Alberta, Canada.

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