In most ways AdventHealth Palm Coast Parkway, as the crescent-shaped 100-bed hospital rising in the heart of the city will be called, is a construction site like any other, just bigger: there is no larger construction site in the city or the county. Almost every inch of the 10-acre site swarms with heavy equipment, piping, rebar, slabs of all shapes, a giant red crane, and any one of the 112 hard-hatted men and women appearing and disappearing behind the naked tilt-up concrete panels of what will be a 158,000-square foot structure four stories high when it opens in the spring of 2023.
In another way it’s the living metaphor of the permanent mission ahead: a hospital is nothing if not a reconstruction zone for human bodies, with physicians and their specialized teams soon to be spunlaced rather than hard-hatted in the very same spaces, repairing, excavating, soldering, cauterizing and curing, using equipment that operates on the same principles as the heaviest construction-zone equipment, but on a more atomized, more organic scale.
Since “Erection Day,” as a felt-tipped notice jotted on one of the whiteboards in the general contractor’s conference room referred to what the Amish would call a barn-raising–the days when the 60-foot panels started going up, transfiguring the site into an apparition–drivers along both sides of Palm Coast Parkway have been seeing a Coliseum-like structure take shape before their eyes, and possibly wondering what it must be like in there. AdventHealth’s marketing team, seeing that long dry spell of splashy stories between groundbreaking and ribbon-cutting, must’ve figured this was a good time to give people a peek inside. So reporters were invited today to take a tour–escorted and prefaced with a safety briefing in keeping with OSHA regulations. As the assistent superintendent put it, “We have some semi hazardous work in progress.”
When AdventHealth first announced plans for the hospital in January 2021, it was to be a $100 million project–$1 million a bed–with a scheduled opening of late 2022. Five months later the plans added a two-story medical office building to go up simultaneously, rather than the previous phased-in approach. When AdventHealth officials gathered to choreograph and tape what was to be a virtual groundbreaking last September–as Covid was still on a rampage–the cost of the project had risen to $145 million. Today, that cost is $164 million, according to David Gordon, AdventHealth’s program director of major projects, who was among the officials leading the tour.
“There have been challenges, but we’re working through them,” Casey Mabe, Robins & Morton’s superintendent, said this morning. “Nothing that’s going to impact the opening of the project or anything else like that. We’re managing it properly.”
Contractors across the country have seen construction costs spiral from a combination of high demand–construction has been brisk–and strained supplies, because of supply-chain issues. AdventHealth itself is currently developing 12 construction projects in Central Florida alone, David Breen, AdventHealth’s external communications manager, said, including the construction of an in-patient tower in Winter Garden and a new emergency room at another facility.
AdventHealth Palm Coast Parkway–a name likely to cause confusion for first responders and 911 dispatchers in a hurry, given its kinship to AdventHealth Palm Coast–will initially open with 80 beds, not 100, and will have its own emergency department, imaging, five operating room suites, two endoscopy suits, with support services and the 30,000 square foot medical office building, with outpatient rehab services, orthopedic services and so on. On opening day there’ll be about 400 jobs, with an average wage of $67,000 a year, assuming Weimar-type inflation doesn’t affect that too much. At the groundbreaking last year, AdventHealth officials said there would eventually be up to 700 jobs on that campus alone. Combined with the more than 900 jobs at the existing AventHealth Palm Coast, the company, already by far the largest private-sector employer in Flagler County, could eventually surpass the Flagler County school district as the largest employer, period. The district has 1,800 employees.
It’s not just nursing that’s driving the new jobs, Gordon said. “We’ll have entry level will have semi professional clinical non clinical opportunities,” he said.
The guts of the construction site themselves are not remarkable in the main, until you start taking note of certain unexpected details: for all the ongoing construction, it is somehow remarkably clean, as the interior bare concrete floor were being regularly swept and shined. All the tilt-up concrete panels, 9 inches thick at ground level, 12 inches thick above it, were poured and cured for weeks at a time on site, as they will be again once the medical office building is built. (See how such walls are built and insulated here and here.) The hospital’s structure will withstand up to 150 mph winds and will be among the safest buildings in the county. Mabe said. If just 112 workers were on site today, construction employment will more than double over the next few weeks and months as activity multiplies with the pouring of the last floor and the roofing, than the interior construction accelerates.
It is all astoundingly efficient, as Mabe, the superintendent, illustrates, taking out his mini iPad-like device and riffling through any and all building designs and plans he needs at any given time, in any given spot. Previously, everything was hand-drawn, and every drawing had to be kept in a trailer or trundled through the site, using up time and lending itself to misplacements or error. No more. It’s now all in the palm of the superintendent’s and others’ hands. Every model is computerized to the slightest detail and schematized along a timeline: here’s what it looks like now, here’s what it looks like when done. Every element is coordinated, from sanitary piping to electrical wiring to any other behind-the-walls anatomy.
In a short time, all areas of the building will be tagged with QR codes that, the moment they’re scanned, it’ll pull up “what the room is, the ceiling height, what utilities are in there, what changes have been made, pretty much anything about it if there’s been like a request for additional information about the room, anyone can come out here with that application,” Mabe said. “The old way of doing it, you have to go back to the office, ask the project manager, hey, I need this drawing. It’s amazing.” Then he describes the capabilities of 3D cameras.
That’s why the contractor could set up offices well off the property, in the Roma Court center, a long walk from the building under construction. But technology has made those distances irrelevant, all of it helping to make construction more efficient and speed up construction. Bad weather can still interfere. Three days of rain-outs per month are built into the construction schedule.
When built, the hospital and patients’ rooms–all private, single-occupancy–will not be distinctly different from those at AdventHealth Palm Coast. As construction stood today on the third floor, a vast smooth-concrete plaza rimmed by those outside walls but as yet not subdivided into rooms in the least, the telltale signs of each room were delineated by their sleeved pipes in the floor–where the shower will be, where the lavatory will be, room after room curving around the structure, and the placement of the future nurses’ station near the middle.
The floors below have started to be subdivided, looking more like thickets of skeletal scaffolding and steel or aluminum framing. It still doesn’t look like a hospital, except in the ether. But it’s a matter of months. Before long the hospital’s permanent role as reconstruction zone will replace hardhats with masks, hammers with scalpels, rebar with silk. After the boasts and projections and ribbon-cutting pride and banal speeches will follow hope and sorrow, pain, comfort, grief, relief, despair and joy and all the other heavy equipment of existential bottom lines. Only then could it be called a hospital.