PHOENIX COLLEGE HANNELLY CENTER
Developer: Maricopa Community College District/Phoenix College
The $16.5M project includes an addition to and remodel of the Hannelly Student Center and remodel of the Learning Center Building to form a new student union. Expected completion is 4Q 2012. Subcontractors include Ten Eyck Landscape Architects, Energy Systems Design and Dibble Engineering.
Mixed Use Medical Buildings
Banner Health Systems’ 60-acre Gateway campus in Gilbert is buzzing with activity. The 120,000 SF MD Anderson Cancer Center is rising from the construction dust, a new mixed use medical office building was just completed, and an older office complex is being renovated and expanded.
The same healthcare giant just announced plans to build the Banner Health Center, housing doctors offices plus a variety of medical and lab services, on 11 acres in the Wells Retail Center in Maricopa.
And in one of the most unusual mixed use medical pairings, Arizona’s most prolific retail developer, Westcor (owned by Macerich), is teaming up with venerable healthcare provider John C. Lincoln to plot out 84 acres in northwest Phoenix for a community hospital/medical office/retail center/auto mall.
Healthcare-anchored, mixed use developments seem to be the current real estate trend. There are dozens around the state. Some are hospital centered, and others, such as the proposed Maricopa project and the 50-acre Arizona Health & Technology Park in Mesa, are designed to combine medically focused businesses and other community services.
The Mesa project’s plans include space for a dental clinic to serve the nearby Arizona School of Dentistry, other specialty outpatient service facilities, offices, and biotech research and development facilities.
Hamilton Espinosa, national healthcare specialist for DPR Construction, says clustering a variety of medical uses and complementary services is a national trend, not just a local one.
New hospitals are seldom designed as stand-alones. Campuses are master planned to grow as the surrounding community does, with room for expansion of inpatient beds, outpatient services and other ancillary services from specialized clinics to doctors’ offices to pharmacies and even restaurants and hotels.
It’s a natural progression, Espinosa says. Evolving medical technology has transformed many treatments that previously required a hospital stay into outpatient procedures. Add to the mix the need to rein in healthcare costs and — in Arizona, at least — a bounty of land.
Purchasing and master planning a big chunk of property, but building components as population and changing medical needs progress, makes sense in a cost-conscious and rapidly changing environment, Espinosa says.
He compares the mega-campus evolution to Arizona Department of Transportation (ADOT) planning of the state’s freeway needs.
“Healthcare providers have to be much more judicious in capital spending. There is more apprehension,” Espinosa says. “Like ADOT, they build what they can afford now and add later when they can afford it and as the census dictates (demand).”
But far from being something new, master planning a campus that blends medical and other business services is old hat to Plaza Companies, says Sharon Harper, president of the Arizona-based real estate company.
Plaza pioneered the first mixed use, medically-anchored community in Peoria in 1982, Harper says. Plaza del Rio’s 185-acre campus was originally designed to meet all the needs of an active senior living complex and grew over time to also meet the needs of the thousands of employees who work in the ever-expanding community, Harper says.
It includes senior residences, skilled nursing facilities, dozens of doctors and dentists offices, several specialty hospitals, clinics and other outpatient medical centers, condos, apartments, shops, restaurants, schools, offices, science and research facilities. But there’s not a traditional inpatient hospital in the mix.
Next on the drawing board, according to Harper, are single-family homes.
Plaza del Rio is a hugely successful one-of-a-kind model of a medically-anchored, mixed use development, but Harper says big hospital-anchored campuses and small neighborhood-focused complexes are essential to the future of healthcare delivery.
Jason Meszaros, vice president for Irgens Healthcare Development Partners, which just completed Mercy Medical Commons, a medical office project adjacent to the Mercy Gilbert Medical Center campus, agrees that there is no one-size-fits-all solution. Arizona is relatively saturated with hospital beds, Meszaros says.
“The trend is we are done building hospitals for a while,” he adds.
The Desire For Mixed Use Medical Buildings
The focus for the foreseeable future will be filling out space on existing campuses with other services that make a hospital more competitive as a destination for patients, as well as for doctors and surgeons who want on-campus offices to cut daily commute times from inpatient to outpatient visits, he says.
“A hospital becomes an anchor for all types of real estate needs,” Meszaros says. “You most likely have hospitality needs, places for a family to stay. And you have lots of people who work there and in offices, and that drives retail. You need some place to eat lunch.”
But a bounty of available land on hospital campuses is only one motivation for mixing up healthcare real estate and other uses.
The changing needs and desires of aging baby boomers and new healthcare reform measures are also factors driving how and where medical services are provided now and into the future, says John Driscoll, president of Alter+Care, the healthcare division of the Alter Group. The company is developing the Arizona Health & Technology Park in Mesa.
“Boomers have been market changers over the years,” Driscoll says. “And the first boomers will be retiring this year.”
Lifestyle demands and the bubble of people moving to Medicare during the next two
decades will require medical services that are more “competitive, attractive and affordable,” he says. And another 30 million insured people, many on Medicaid-like systems, means cost-effective real estate solutions will be key.
“There is no question in the future that healthcare providers will have to be more efficient,” Driscoll says.
Rather than a single model for healthcare real estate in the foreseeable future, there are several scenarios likely to emerge simultaneously based on a community’s needs and assets, he continues.
The giant, hospital-anchored campuses make sense for regional medical services, but the future focus will emphasize bringing healthcare closer and making it more convenient to those who use it on a regular basis.
Driscoll envisions smaller neighborhood-based destinations with a range of services such as medically-based fitness centers, post-surgery rehabilitation facilities, sports performance centers — “health villages with different kinds of services for people who are sick and to keep people well.”
“We’re seeing more co-mingling of medical and wellness services,” he says.
Future development also will be real estate-driven and may include adapting empty big boxes retailers to house medical services, he adds. Picture the shell of a former Borders Books or Ultimate Electronics housing a host of medical providers, such as acute care clinics, labs and medical imaging services.
Randy McGrane, managing director for Ensemble Real Estate, has already imagined that as the future of outpatient healthcare delivery. He adds that off-campus medical services are a bigger trend than the expansive hospital-centered developments.
The ratio of inpatient to outpatient medical services is about 60/40 now, McGrane says, but he predicts the numbers will reverse within 10 years.
Communities want medical services in their own neighborhoods, and retail centers are suffering from curtailed discretionary spending during the recession, he says. So, the empty retail anchor spaces are obvious and cost-effective solutions for both real estate segments.
In smaller neighborhood strip centers abandoned by a supermarket anchor, adding a clinic or urgent care facility could change the whole dynamic of the center. It could spawn new medical and/or retail services such as pharmacies or health-food shops, and the same type of services — dry cleaners, casual eateries and coffee shops, for example — that cluster around a supermarket to make a neighborhood commercial center a one-stop convenience for employees and customers, McGrane says.
And adding medical outpatient facilities to a big box-laden power center can re-energize flagging retail, bringing in new foot traffic and boosting business for all tenants, he says.
So who are the visionaries on top of the trends in changing healthcare delivery systems? Savvy industry giants already are planning multi-faceted networks that add satellite services in diverse locations, as well as boosting hospital campuses with a variety of services to remain competitive, according to the local industry experts.
The major players plotting out Arizona’s healthcare delivery systems of the future are the top hospital names, such as Scottsdale Healthcare, Banner Health, Catholic Healthcare West, John C. Lincoln and Abrazo Health Care, according to industry experts.
And the on-the-ball real estate developers, designers and construction companies have healthcare divisions in place ready to make it happen.
“There is growth in healthcare and in more sophisticated delivery of healthcare services,” Harper of Plaza Companies says. “It’s an exciting industry.
As part of AZRE magazine’s Centennial Series, find out who made the list of the most influential people in Arizona Commercial Real Estate.
Most Influential People In Arizona Commercial Real Estate
Roy P. Drachman Sr. (1906 – 2002)
Roy Drachman Realty Company, Real Estate Development
Known as “Mr. Tucson,” Roy Drachman’s love for the city helped put Tucson on the map. A real estate tycoon who landed the Hughes Missile Systems Company site, Drachman also petitioned to build better streets, waterways and schools in his beloved city. He is responsible for bringing Major League Baseball teams to Arizona for spring training (the Cleveland Indians began training in Tucson in 1947). Throughout his career, Drachman donated generously to the University of Arizona, mostly for its cancer research. He funded a scholarship at the UA College of Architecture for upperclassmen who show proficiency in design. UA named its Institute for Land and Regional Development Studies after him. (Photo: Drachman family)
Grady Gammage, Jr.
Gammage & Burnham, Attorneys At Law, Real Estate Lawyer
For the past 20 years, Grady Gammage, Jr. has practiced law at Gammage & Burnham, taking on real estate projects such as redevelopment, high-rise buildings and planned communities. Gammage was a board member of the Central Arizona Project for two, six-year terms, beginning in 1996. Gammage’s urban mixed projects in Tempe won him three architectural awards. He is also affiliated with Arizona State University as an adjunct professor at the College of Law, the College of Architecture and Urban Design, as well as a Senior Fellow at the Morrison Institute. (Photo: Gammage & Burnham)
Jennings Haug & Cunningham, Real Estate Lawyer
William Haug has dedicated much of his career to developing and establishing construction and surety law in Arizona. His leadership in the practice was recognized with his induction in the inaugural Maricopa County Bar Association Hall of Fame for his role in developing the practice of construction law. Haug developed his practice in complex dispute resolution in construction, fidelity and surety law. For more than 35 years, Haug has been an arbitrator and mediator. He joined the firm in 1981, became one of the original construction lawyers in Arizona, and paved the way for the practice to develop as construction across the state grew with its population. (Photo: Jennings Haug & Cunningham)
Sam Kitchell (1923 – 2006)
Kitchell Construction, General Contractor
Originally named Kitchell Phillips Contractors, Sam Kitchell started the company in 1950 with then partner James B. Phillips. Its construction of Safeway stores and local schools helped Kitchell evolve into one of the top 10 largest private companies in Arizona and one of the top 75 construction companies in the country. One of Kitchell’s main focuses included healthcare projects, which led to the construction of Good Samaritan Hospital in Phoenix, the Mayo Clinic of Scottsdale, Phoenix Children’s Hospital and Scripps Memorial Hospital in California, to name a few. (Photo: Kitchell Construction)
J. Daryl Lippincott (1924 – 2008)
CB Richard Ellis (CBRE), Real Estate Broker
Daryl Lippincott directed the CBRE Phoenix office from its opening in 1952. With retail stores such as Goldwater’s, Diamond’s, Leonard’s Luggage and Switzers, Lippincott helped build Arizona’s first shopping mall — Park Central. In 1957, Lippincott helped the Phoenix office expand to other services, including mortgage loans, property management and was later announced as the head of CBRE’s Southwest Division. Lippincott shaped both CBRE and the commercial real estate industry with his retail and commercial projects. (Photo: CBRE)
John F. Long (1920 – 2008)
John F. Long Properties, Homebuilder
John F. Long symbolizes the Phoenix transition from desert to urban city. His 1954 Maryvale project, named after his wife, established a base for all future affordable housing in the Valley. With an emphasis on quality, Long also built the Solar One housing development, getting a head start on sustainable practices. Long’s projects were built with everything in mind; hospitals, golf courses and shopping centers, giving homeowners whatever they needed within close reach. As one of Arizona’s most influential builders, Long is in the Arizona Business Hall of Fame and was awarded the first WESTMARC Lifetime Achievement Award, which has since been named after him. (Photo: John F. Long Properties)
Westcor, Retail Development and Management
During his more than 40 years as CEO of Westcor, Rusty Lyon led the way in retail development and continues to contribute to the public’s shopping needs. Retailers have turned Westcor into the largest owner of commercial real estate properties, with projects such as Scottsdale Fashion Square, Chandler Fashion Center, San Tan Village, Flagstaff Mall & The Marketplace, Prescott Gateway Mall, Biltmore Fashion Park and The Boulders Resort. (Photo: Macerich)
M. M. Sundt (1863 – 1942)
Sundt Construction Co., General Contractor
Sundt Construction was founded in 1890 by Mauritz Martinsen Sundt, a Norwegian ship carpenter who immigrated to the U.S. as a teenager. The company’s early projects were homes and farm structures in northern New Mexico. In 1929, Sundt built a Methodist Church in Tucson. The project was directed by John Sundt, one of Mauritz’s 12 children. John liked Tucson, and decided to stay. Sundt‘s clients today are industrial, commercial and government projects, both nationally and internationally. In 1936 the company was awarded a contract for six projects, one of which was the expansion of the University of Arizona’s Tucson campus. In 1956, Sundt began construction on one of its biggest military projects, Davis-Monthan Air Force Base in Tucson. (Photo: Sundt Construction)
Frank Lloyd Wright (1867 – 1959)
Architect, Interior Designer
Frank Lloyd Wright spent most of his life designing homes, buildings and museums that changed the world of architecture. Wright designed more than 1,000 projects and more than 500 were actually built. Thirteen are in Arizona and are some of his most famous designs. Wright’s summer home, Taliesin West in Scottsdale, is also home to the Frank Lloyd Wright Foundation’s international headquarters, where an archive of all his sketches and projects is housed. ASU students have a constant reminder of Wright’s architectural genius with the Grady Gammage Memorial Auditorium, named after Dr. Grady Gammage, ASU’s president from 1933 to 1959. (Photo: Frank Lloyd Wright Foundation)
Newsmakers in Arizona Real Estate
Newsmakers in the commercial real estate industry are featured each issue. Here are the movers and shakers for May – June 2011:
Shelly Cramer joined GPE Commercial Advisors as associate vice president in sales and leasing, with an emphasis in dental and veterinary properties. Her past professional experience includes positions at CB Richard Ellis and Julien J. Studley.
Trisha Ramsey joined GPE Commercial Advisors as an associate in sales and leasing. Ramsey secured her broker’s license in 2010 after acquiring more than a decade of experience in B-to-B sales and procurement for the semiconductor and furniture industries.
Sundt Construction promoted Wayne Einbinder to vice president to spearhead the company’s new special projects division. The recently launched division will focus on large-scale projects ($100M or more) with external joint-venture partnerships. Einbinder will be responsible for the management, identification, pursuit and acquisition of special projects.
Mike Merk joined Grubb & Ellis as senior vice president, Office Group. Merk joins Grubb & Ellis from BAX Global Inc., where since 2002 he was director of real estate, responsible for the company’s 4.1 MSF North American office and industrial portfolio.
Justin Miller joined the Alter Group as vice president in the firm’s Scottsdale office. Miller’s focus will be on the planning, marketing and development of several Phoenix-area business parks.
Brian Woods was promoted to vice president-Retail Properties at Colliers International. Woods joined Colliers in 2003, and specializes in leasing regional power centers and represents national retail tenants throughout Arizona. Developers and landlords represented include Vestar Development, Nexus Development and Vertical Holdings.
Eight real estate professionals from the CB Richard Ellis Phoenix office are ranked among the company’s top 225 producers in North America. Tom Adelson, Brad Anderson, Tyler Anderson, Sean Cunningham, Jim Fijan, Rob Marsh, Jim Trobaugh and Bryan Taute are among the list of exceptional performers in 2010.
John Glassmoyer and Neil Glassmoyer joined Colliers International’s Scottsdale office as senior vice presidents specializing in investment sales. John has more than 30 years experience in sales, leasing and development of industrial, office and retail properties. Neil has more than 20 years experience as an institutional investment consultant.
Mark Seale joined the office division at Cassidy Turley BRE Commercial. Seale joins the company with more than 26 years of commercial real estate experience. Seale previously worked at Lee & Associates, where he was part of the firm’s Top Producing team in 2008, 2009 and 2010.
Dan Pierce was named senior vice president at Kitchell. He joined Kitchell 30 years ago and has been involved with the construction of numerous hospitals and healthcare facilities throughout the Southwest.
Arizona’s Finest Lawyers honored five members of the firm of Jennings, Haug & Cunningham. Those honored include Bill Haug, Curtis Jennings, D. Kim Lough, Chad Schexnayder and Mark Barker. The five have more than a century of combined experience in various areas of commercial real estate law.
Berens, Kozub & Kloberdanz PLC has changed its name to Berens, Kozub, Kloberdanz & Blonstein PLC, adding 3-year member Marc Blonstein to the firm’s name. Berens, Kozub, Kloberdanz & Blonstein PLC is a boutique commercial and residential real estate and business law firm. It has been in business in the Valley since 2001.
Land Advisors Organization in Scottsdale added Ryan Semro, Bret Rinehart and Ben Heglie to its firm as land specialists. Semro, Rinehart and Heglie’s previous roles include stints with Grubb & Ellis, Hogan & Associates, and most recently as principals with Lee & Associates.
Rider Levett Bucknall promoted John Jozwick (general counsel) to senior vice president and Scott Macpherson (principal) to vice president. Jozwick also was elected to the Rider Levett Bucknall North American Board of Directors.
Bryan Taute was promoted to senior vice president and Greg Mayer and Scott German were promoted to vice president at CB Richard Ellis. Taute is involved in all aspects of the commercial office market, including landlord and tenant representation, investment and user building sales, land sales and ground-up development. Mayer specializes in the representation of institutional and private owners of commercial office buildings in Metro Phoenix. German represents corporate clients in site selection and lease negotiations in Metro Phoenix and the Southwest.
Joe Snell, president and CEO of Tucson Regional Economic Opportunities (TREO) was named co-chair of the Economic Development Committee of the Arizona-Mexico Commission.
Daniel Dobric joined Grubb & Ellis’ Office Group as senior vice president. He will team with Michael Myrick, vice president, Office Group, who joined the company in July. Dobric joins Grubb & Ellis with 29 years of commercial real estate experience. He previously spent five years with BRE Commercial as a senior vice president.
Valerie Kelly joined Kitchell as director of Client Services for the Healthcare Division. A 20-year veteran of the local construction and development community, Kelly most recently was with McCarthy Building Companies, where she led business development efforts for the Southwest region.
Colliers International promoted Cindy Cooke to executive vice president-multifamily investments. Cooke has 30 years experience specializing in multi-family investments and leads an investment team that consists of 12 Colliers professionals throughout the Western U.S.
Chris Gerow, senior vice president at NAI Horizon’s Phoenix office, was honored by NAI Global with its Council Appreciation Award.
GESTAMP SOLAR STEEL
General contractor: Mortenson Construction
The first phase of the $6M project is 75,000 SF of high bay manufacturing space, with a 12,000 SF office. The first phase is master planned to allow expansion of future 75,000 SF bays to an estimated growth close to 500,000 SF for the production of steel for a range of solar power plants destined for the Southwest. Subcontractors include W.W. Smith Construction and Blount Contracting. Construction to begin 2Q 2011.
Mothers may love their little ones’ baby fat, but they tend to cringe at the thought of the fat their babies give them. That’s why women are waving goodbye to pregnancy plump and saying hello to taut tummies and va-va-voom curves — with Mommy Makeovers, one of the more popular plastic surgery trends to hit Scottsdale.
According to Dr. Robert Cohen, who owns the Scottsdale Center for Plastic Surgery, Mommy Makeover is a series of plastic surgeries that address areas of the body related to pregnancy, almost always including the breasts and torso. These surgeries include breast augmentation, breast lift, tummy tuck, liposuction and thigh lift.
The combination of surgeries a patient receives depends on the woman’s individual needs, Cohen says.
After losing 100 pounds in one year following the birth of her two sons, one recent patient, who asked not to be named, opted to undergo breast implants, a breast lift, a tummy tuck, and liposuction in the stomach, hips and thighs.
“I knew that I did not desire to have any more children,” she says. “I wanted to physically be able to enjoy my life — to go to the water park with my kids.
“After losing weight naturally, (my family and friends) were very supportive of the surgery. It was almost like my reward for going through the difficulty and the self-discipline of dieting and exercising.”
While these surgeries are not new, Mommy Makeovers allow a woman to undergo several procedures in one day, instead of through multiple visits.
Cohen says the advantages of having multiple surgeries in one day include convenience and lower costs, since the patient only needs to undergo anesthesia once and there are no duplicated operation fees. There is also less risk in going under anesthesia a single time, as well as the benefit of seeing the end result instantly instead of incrementally.
“When patients get their surgeries in one day, there is a greater chance that they will have instant gratification,” Cohen says.
Of course, there are also risk factors involved with having multiple plastic surgeries in a single day. According to Cohen, the longer a patient is in surgery, the chance of risks increases. Some of the risks associated with these procedures, though uncommon, include infection, bleeding into inner body pockets, tightened tissue around implants and blood clots.
Cohen says, Mommy Makeovers typically cost between $12,000 and $25,000, although prices range dramatically due to the variety of surgeries offered, and from doctor to doctor.
In Cohen’s office, the costs of surgery can be eased through financial services and plans. The office works with CareCredit, a medical and dental financing company, to find workable payment plans for patients who can reasonably afford the surgeries they desire.
The age of Mommy Makeover patients ranges from early 20s to mid-60s, according to Cohen. However, the most common age group is women in their late 20s to mid-40s.
Ideal candidates for this surgery are those who do not plan on having any more children, as tummy tucks can be affected after additional pregnancies and previous scar tissue, Cohen says.
So far, the surgery package has been a hit in Cohen’s office.
“Patients will come in very self-conscious, won’t get into bathing suits and won’t go to the pool,” Cohen says. “Afterwards, we get pictures of them on vacation in Hawaii, taking surf lessons, trying on clothes they could never fit into before; we hear stories of how relationships have improved. It’s not a life-or-death surgery, but it’s a quality-of-life surgery.”
For more information about Mommy Makeovers, visit www.scottsdalecenterforplasticsurgery.com.
Scottsdale Center for Plastic Surgery
5410 N. Scottsdale Road
Paradise Valley, AZ, 85253
Eat The Right Foods, Prevent Food Sensitivities And Food Intolerances
Food plays a vital role in the proper nourishment of the body. However, it can be difficult to know what effect food has on the body until one eats the wrong thing and experiences uncomfortable symptoms.
Believe it or not, symptoms such as stomach pains, headaches, irritability and fatigue can be treated not with medicine, but by eating the right foods for your body.
Using food in place of medicine is far from a new concept. The ancient Greek physician and father of modern medicine, Hippocrates, once said, “Leave your drugs in the chemist’s pot if you can heal the patient with food.”
Unfortunately, this form of thinking has been lost as we make more advancements with medicines and solutions that treat the symptoms, but don’t fix the problem.
Arizona board certified naturopathic medical doctor, Suneil Jain of Rejuvena Health and Aesthetics in Scottsdale, says food sensitivities are far more common today than many people might think. Although often equated with food allergies, food sensitivities also include food intolerances that, unlike allergies, are toxic reactions to foods that do not involve the immune system and can be more difficult to diagnose. This occurs when something in a food irritates a person’s digestive system, causing him to improperly digest or break down the food. Intolerance to gluten and pasteurized dairy are two of the most common food sensitivities.
According to Jain, the average American eats about 92 grams of sugar a day. However, the human body needs only about eight grams for energy, an amount that should be satisfied mostly through natural sugars derived from fresh fruits, vegetables and grains. Knowing these facts and the foods your body can tolerate can help reduce reaction symptoms.
Jain’s Food as Medicine Program teaches patients the right foods to eat and the ones to avoid. Each personalized diet plan is based upon a blood analysis to determine underlying food sensitivities.
The Food Sensitivity test involves running samples of one’s blood against a diverse panel of foods to determine intolerances. This might compare to a food allergy test, however, food sensitivities differ from allergies in that:
• Reactions are delayed and not immediate or life threatening.
• A small amount of food may not provoke noticeable reaction, but a large amount will.
• Symptoms can appear immediately or in up to three days.
• A person may be reactive to more than 25 foods and food chemicals.
• Even so-called “healthy” foods such as chicken, salmon, spinach, blueberries, apples or garlic can cause problems.
Knowing the foods your body can tolerate can result in fewer headaches, less bloating and more energy. It can also help you lose weight.
As the saying goes, “One man’s food is another man’s poison.” Different people can have very dissimilar reactions to exactly the same food. Symptoms can come and go and change throughout life. They may not be very harmful, but eventually they will affect an individual’s well-being.
Food intolerances and the symptoms associated with food intolerance can be prevented by taking the following simple steps:
Learn which foods in which amounts cause you to have symptoms, and limit your intake to amounts you can handle.
When you dine out, ask your server about how your meal will be prepared. Some meals may contain foods you cannot tolerate, which may not be evident from the description on the menu.
Learn to read food labels and check the ingredients for problem foods. Don’t forget to check condiments and seasonings. They may contain MSG or another additive that can lead to symptoms.
Rejuvena Health and Aesthetics specializes in wellness and anti-aging. For more information about food sensitivities and food intolerances, visit www.werejuvenate.com or call (480) 551-9000.
Building a Pediatric Hospital
At a pediatric hospital, the healing process should begin as soon as Mom or Dad drives up the driveway to look for a parking space. That’s where it all begins for the young patient and his or her family. And that’s where the differences begin when it comes to building a pediatric hospital, as compared to a “traditional” facility.
After completing three pediatric hospitals in Arizona within the past two years, Kitchell has refined strategies and tactics regarding these special hospitals, which have become ever more complex as technology advances and medical care evolves to treat increasingly acute patients.
Over the past two years, Kitchell has been CMAR (Construction Management At Risk) for Banner Desert Medical Center’s Cardon Children’s Hospital in Mesa, the recently opened Diamond Children’s Center at University Medical Center in Tucson and Phoenix Children’s Hospital.
Fortunately for hospital architects, engineers and builders, there is solid research to draw upon to guide the development of the most effective, functional children’s medical campuses.
Transformation by Design, produced by the National Association of Children’s Hospitals and Related Institutions (NACHRI), reviewed 320 evidence-based design studies published in academic literature. This report concludes “the physical environment of healthcare settings affects the clinical, physiological, psychosocial and safety outcomes among child patients and their families.”
The No. 1 goal as builders is to produce a stress-reducing, healing environment, while reducing the chances of infections and medical errors. There are several issues to consider when constructing pediatric hospitals:
Bringing all stakeholders, including young patients who are “frequent fliers” at the hospitals, as well as owners, architects, engineers and contractors, into the pre-design phase has proven highly beneficial to construction outcomes. The theme, Through the Eyes of a Child, drove the entire Cardon Children’s Hospital project. And Diamond Children’s Medical Center hosts two ongoing advisory councils comprised of children and teens. Initiatives like these ensure children’s perspectives are always front and center.
Theming to engage and entertain is certainly the most obvious defining characteristic of a pediatric hospital, but how to achieve the right tone, taking age-appropriateness into consideration, is far from obvious. Creating a sense of comfort and fun for a toddler is very different than creating a sense of coziness and relaxation for a teenager, both of whom will be sharing space. Some hospitals cultivate a playground/amusement park feel, while others try to maintain a more staid, yet welcoming youth-driven atmosphere. Cutting-edge technology is being utilized to bring “edutainment” and social media options directly into patient rooms.
A quiet environment may reduce recovery time. Rubber flooring with high STC acoustical ratings has replaced vinyl sheeting predominantly used in the past.
Multiple textures, varied artwork and soothing finishes reinforce the healing process. Highly durable, vibrantly colored terrazzo flooring is currently very popular. Natural elements, such as whimsical water features, are a dynamic way to bring the outside in (and engage the senses of hearing, smell and touch, as well as sight) to what has traditionally been a cold and sterile place.
Studies show natural lighting helps babies heal faster. The industry is coming up with creative ways to integrate natural lighting with state-of-the-art LED interior lighting that enables healthcare staff to perform their jobs effectively, but is also pleasing to the patients — a huge leap forward from the harsh cathode lighting of the past.
Pods vs. Private Rooms
What is better for the youngest patient and family, a private room or a pod arrangement? This is actively being discussed right now. The benefits of private rooms seem obvious, but healthcare experts value the interactive nature of community-oriented pod set-ups, which are conducive to family-to-family interaction. After all, no one can relate to a family’s ordeal better than another family simultaneously going through the same challenges. Current designs have trended toward private rooms, but family areas, clinical programs and hospital-directed family support groups have promoted the “community” healing benefit for the young patients.
At pediatric hospitals, more space is needed to accommodate more than one family member. For example, ample space is available for fold-out beds and private guest showers in patient rooms. In general, there are more “soft” spaces for siblings and other family members. The most critical issues to consider when constructing or expanding a pediatric hospital? All involved need to minimize negative impacts to the recovering patients. “The patient comes first,” says Mike Wolfe, a Kitchell project director. “If you or a loved one had the misfortune to be in a hospital that was undergoing construction, would you want a construction crew to be jack-hammering concrete in the middle of the night? Working in and around children’s hospitals requires extra sensitivity and flexibility to work around patients’ needs.”
Some Unique-to-Pediatric-Hospital Construction Features
- Expanded kitchens to fulfill children’s menu preferences (pizza, stir-fry, etc.)
- Treatment rooms on each floor so patient bedrooms are “pain-free” safe havens
- Wireless Internet access for each patient and their families
- Interactive play/family spaces on each floor
- Teen activity rooms
- Lactation rooms
- Auditorium/stages for children to see performances, concerts, graduations
or have parties
- Meditation rooms
- Healing gardens
- Toy stores
What if your business was overcharged for its electricity, natural gas, or perhaps new computers or furniture? Most of us would take a look at our bills, determine where the mistakes occurred and then take the needed steps to resolve the discrepancies. But what if your business is being overcharged for its property taxes by thousands of dollars each year? Is there a course of action to fix this potentially costly problem? The answer is yes.
Each year, typically in February, the county assessor releases “postcard” valuations for each property in the county. In some cases, these valuations exceed the properties’ market value. The problem that we see in Arizona is that many people do not take notice of their property taxes until the county treasurer’s office mails its annual tax bill. But in Arizona, you cannot protest your taxes — only the postcard valuation. Therefore, the time to review your property taxes is when your values are mailed in February, not when you receive your tax bills in October.
What does this mean for local business owners?
Without protesting a postcard valuation, a business owner’s taxes may be substantially higher. In many cases, they need not be. If a business owner paid $4M for an office building last year, on average, the owner will owe approximately $100,000 in real property taxes. However, if the county assessor values the property at $7M based on its computerized mass appraisal, and the business owner does not protest, the owner’s taxes may exceed $175,000.
Why would my property be overvalued?
Over the past several years we have seen significant changes in commercial values, with prices quickly rising in 2005 and 2006, and falling over the past couple of years. Today, however, there are signs of hope. According to William Spart, senior vice president of Wells Fargo Bank, “some submarkets and property types, including apartments, are showing signs of firming up.”
These drastic changes in the market over the past several years have made it difficult for county assessors to determine property value. It is not feasible for the assessors to separately analyze the unique characteristics of each and every parcel. Therefore, the assessor must rely on a blanket formulary approach that attempts to classify buildings and land into various categories to produce a valuation.
The positive is that many people, including Pete Bolton, executive vice president and managing director of Grubb & Ellis, says he believe that we are at the bottom of the market. According to Bolton, the “market has definitely stabilized and we are seeing five to seven main groups, including the FDIC, national banks, CMBS special servicers and others slowly releasing property to the market with market values bouncing along the bottom.”
What if I recently acquired my property?
In Arizona, real property is assessed on an annual basis by the assessor’s office of the county, where the property is physically located. Property tax values are released around February prior to the tax year. While existing owners of real property are required to file all administrative protests within 60 days of release of the postcard values, Arizona has special rules for new owners.
Under Arizona law, new owners have the ability to either take over the old owners’ appeal or if an appeal was not filed, they can typically appeal their valuation to the County Superior Court until Dec. 15 of the valuation year. If the prior owner did not appeal the current year taxes (prior year’s postcard values), you may be able to appeal these taxes as well.
For more information about property taxes, visit wwptax.com.
INTERDISCIPLINARY SCIENCE AND TECHNOLOGY BUILDING 4
Developer: Arizona State University
The $160M ISTB4 is a 7-story building that will include collaboration rooms, meeting rooms and offices for faculty and administrators. There will also be lab space, which will contain 166 modules. Completion is expected by 2Q 2012.
Ben Shunk, senior project manager for Adolfson & Peterson Construction, was first attracted to Valley Partnership when he learned about its Community Project Committee.
Six years later, he remains active in all aspects of the organization, and is finding career success in its networking opportunities.
“(Valley Partnership) has helped me in my career because it’s a local organization where people who are trying to make a difference in the commercial industry as a whole can meet,” Shunk says. “This includes architects, developers, contractors, engineers, subcontractors, city personnel, attorneys — basically everyone who touches the private and public real estate industry.”
Shunk hasn’t lost his passion for community service, though, and served as chairman of the Community Project Committee in 2010.
The project Shunk spearheaded was with Phoenix Day, one of three day care facilities in South Phoenix. The team spent the first Saturday in November renovating the facility’s courtyard playground.
Shunk says he believes that was his single best experience with Valley Partnership.
“Even though it was a tough year for the economy, we had a great group of committee members, and it turned out to be an amazing project even in the tough economy,” he says.
Shunk adds that he is proud to be a part of Valley Partnership because he believes the organization serves a vital purpose in real estate, calling it “the voice of industry professionals.”
“If there are issues that the industry is passionate about, (members) can have a voice and an impact,” he says. “If it wasn’t for an organization like Valley Partnership, I don’t think those opinions would be heard.”
Shunk says he has high hopes for the real estate industry after a difficult few years, adding that “2010 was a little rough for everyone. We’re seeing a lot of momentum for 2011.”
For more information about Ben Shunk and Adolfson & Peterson Construction, visit www.a-p.com.
Wrinkles, sun splotches, uneven skin tones — these are just a few things altering skin conditions today and haunting us as we grow older. While there are hundreds, even thousands of treatments, not many boast the same process and effects as the Pearl Laser and Pearl Fractional treatments offered at the North Valley Plastic Surgery Center (NVPSC).
Stacey Bailey-Gitt, a laser technician and anesthesiologist at NVPSC, describes the treatment as an easier way to remove aging signs and skin damage.
“These treatments target skin resurfacing,” Bailey-Gitt says. “It isn’t a skin tightening procedure like other common surgeries and treatments.”
With Pearl Laser Treatment, younger looking skin is just around the corner and is available in two types. The first targets the epidermis and upper layers of the skin. The second targets the deeper skin layers and has a longer recovery time of five to seven days, according to Bailey-Gitt.
At the North Valley Plastic Surgery Center, each Pearl treatment is set up uniquely for the patient. The technician sculpts the treatment based on a patient’s pain tolerance, the portion of face being treated and the desired result. As a non-invasive surgery, these skin treatments are ideal for multiple kinds of cases.
“I like to categorize things,” Bailey-Gitt says. “We have our prevention cases who want to prevent aging, our corrective cases who want to correct aging that has already occurred, and maintenance cases that maintain previous facial treatments and surgeries.”
Many clients have sought facial treatments in preparation for summer, hoping to both rid the skin of aging signs and prevent further skin damage from the sun.
Recovery time spans from three to seven days and requires skin ointment, as well as the application of SPF to achieve the best results. During the recovery process, the skin rids itself of the unwanted wrinkles, spots and blotches, leaving the skin healthier, younger and brighter.
Compared to most skin surgery treatments, Pearl Laser Treatment and Pearl Fractional Laser treatments have a much shorter recovery time and are a great deal less invasive, making the procedure much more appealing to interested clients.
For more information about Pearl Laser Treatment and Pearl Fractional Laser treatments, visit www.nvpsaz.com.
North Valley Plastic Surgery Center
20950 N Tatum Blvd Suite 150,
Phoenix, Arizona, 85050
Don’t look for medical marijuana dispensaries to pop up next door to your neighborhood drug store anytime soon.
Cities are wrestling with a host of issues to determine where the new businesses can set up shop, even as the Arizona Department of Health Services tries to figure out who can operate them and who can use them.
After publishing preliminary guidelines, followed by a period of public comment, ADHS issued start-up regulations on March 28.
The state agency divided Arizona into 126 community health analysis areas, or CHAAs, based on population density. The agency will issue a maximum of 124 dispensary licenses, with no more than one license within a CHAA, says Will Humble, ADHS director.
State regulators will start taking applications on June 1 and will dole out licenses starting in August after vetting the sites and the potential business owners, Humble said.
If more than one acceptable application is submitted within a CHAA’s boundaries, a lottery will decide who gets the license, he added. The first dispensary in the state could debut by fall. Humble said he expects to issue 90 to 100 licenses within the first full year of start-up. After that, ADHS will revisit the rules to determine if some tweaking is necessary.
“By the end of a year, we’ll know where the qualified patients are,” he says.
Proposed dispensary sites must comply with the zoning requirements of the municipalities they fall into, so cities have been scrambling to get zoning in place and start vetting potential locations, otherwise, they risk the state issuing licenses in unsuitable areas, says Thomas Ritz, Glendale senior planner.
Glendale passed zoning guidelines on Feb. 22, and the rules are similar to those of most cities in regard to type of site, such as office or industrial. In addition, a dispensary must be 1,320 feet from schools, 500 feet from residences, and one mile from another dispensary, Ritz says.
Scottsdale will allow medical marijuana dispensaries on campuses, and within 2,000 feet of another dispensary. Tucson will allow them to do business in retail centers, as long as they are the required distance from schools and residences.
Tucson, among the first off the block to embrace the new businesses, completed its zoning rules in November, says Craig Gross, Tucson’s deputy director for planning and development. But Gross pointed out the complexities of working within the state’s guidelines.
Tucson has 10 CHAAs within its city limits, he added, but because CHAAs are based on population density irrespective of municipality boundaries, nearly all are partly in other cities, towns or even unincorporated county land.
“That makes it interesting,” Gross says.
Tucson has a handful of applications and a dozen or so serious inquiries in some stage of processing, Gross said, but he doesn’t know if there are sites also in process by other government agencies for the same CHAAs.
And in Scottsdale, which houses two CHAAs but has about the same number of applicants or pre-applicants in the pipeline as Tucson, most of its potential operators are opting for the Scottsdale Airpark area, says Kira Wauwie, project coordinator for the city’s dispensary rollout.
Meanwhile, Glendale is bracing for a deluge of dispensary operator wannabees.
“We had a neighborhood meeting, and we had about 35 people learning, listening — a healthy stream of people asking questions,” Ritz says. “We’ll see how many turn in applications.”
But first those hopeful applicants have to snag sites that conform to state and city regulations. And even in this high-vacancy real estate market, potential landlords are leery of housing dispensaries.
“I’m surprised that individuals are finding it tough to get into a building they like,” Gross says. “Property owners don’t necessarily want to rent to them.”
Arizona real estate brokers confirm that many building owners are reluctant to lease space for dispensaries, despite the numerous hoops the potential business owners need to jump through to get a license.
Gross says building owners are slow to the table because the process is so new, and he thinks more will opt in now that ADHS rules have been set in stone — or at least for a year.
For more information about medical marijuana dispensaries, visit the Arizona Department of Health Services’ website at azdhs.gov.
TUCSON FBI BUILDING
Developer: Quality Group of Companies
Tucson broke ground on its new FBI building the same day Phoenix broke ground on its new FBI headquarters. The General Services Administration signed a 20-year lease for the field office, which is expected to be completed by 1Q 2012.