Healthy City: Inside New York City's Hospital Building Boom

2016-2020 Forecast: Continued Growth and Diversification

The Building Congress asked hospitals to forecast construction spending for the years 2016 through 2020. Based on the survey responses, the Building Congress estimates New York City hospitals will outlay more than $10 billion on construction during this time, with $8.2 billion of this spending slated for 2016 through 2018, including nearly $3 billion in 2016, and increasing to slightly more than $3.3 billion in 2017. Spending declines in 2018-2020, in part because hospitals have not completed their capital planning processes.

This massive amount of spending will help add roughly two million gross square feet of hospital space over the 2016-2020 period, when development of primary and outpatient care capacity on and off the main hospital campus will continue to be an industry-wide priority.

Montefiore Medical Center — Hutchinson Metro Center Building

For example, Mount Sinai Health System is investing over $200 million to improve its Institute for Advanced Medicine, which provides a range of primary and supportive outpatient services. Several institutions are making investments to improve outpatient and primary care, both on the main campus and at new acquisitions and satellite locations. The affiliation of NewYork-Presbyterian and New York Methodist Hospital is expending over $400 million to construct or improve several outpatient primary care facilities throughout Brooklyn, including the ground-up Center for Community Health in Park Slope, which is intended to move a number of basic primary health services out of more typical hospital settings.

NYU Langone and Northwell Health are also making major commitments to expand outpatient services. NYU Langone is spending $200 million to construct a 160,000-square-foot emergency room and outpatient diagnostic facility in Cobble Hill, Brooklyn. Northwell Health is investing over $300 million during the next five years on facilities that include outpatient service clinics at various locations on Staten Island, far beyond its traditional Nassau County campus.

Jim Crispino, Principal at Francis Cauffman Architects noted, "Large institutions will be using new locations to offer front-line medical services directly in local communities as part of a broad effort to expand their presence beyond their traditional catchment areas. Hospitals, particularly the largest ones, are becoming truly regional resources with multiple locations, giving them a reach well beyond what they have had in the past."

The survey also revealed that the largest individual investments are being made by large institutions to improve existing facilities on their main campuses.

For example, NYU Langone and NewYork-Presbyterian are working to complete major projects in Manhattan to replace or upgrade core hospital facilities on their main campuses.

NewYork-Presbyterian is erecting a 750,000-square-foot building, housing an advanced maternity ward as well as a range of outpatient services.

NYU Langone is completing two transformative projects on its main campus, adding more than one million square feet of new space, including an 830,000-square-foot inpatient facility, creating modern single-occupancy rooms and other visitor facilities.

Memorial Sloan Kettering – Josie Robertson Surgery Center

Vicki Match Suna, Vice Dean and Senior Vice President for Real Estate Development and Facilities at NYU Langone, said that upgrading core patient services and amenities is a mission-critical project. "Our new single-bedded tower on our main campus is just one of the many ways we are addressing the evolving needs of our patients. Consumers select their healthcare providers based on the care they receive and the level of services offered. NYU Langone is making significant investments across our expanding project portfolio to provide a seamless, best-in-class experience in both inpatient and outpatient environments."

NYC Health + Hospitals is seeking to invest $200 to $300 million annually from fiscal years 2016 through 2019 at ten of its facilities throughout the City.

The largest expenditures will be at four of its main hospital buildings — Coler, Bellevue, Metropolitan, and Coney Island Hospitals — to harden facilities damaged by Superstorm Sandy, as well as to update and modernize key buildings. Work includes adding a more than 300,000-square-foot Emergency and Post-Acute Care facility in Coney Island, anticipated for completion by 2021. The Coney Island facility represents a major investment by NYC Health + Hospitals to provide longer-term healthcare for patients and stems from the same economic and regulatory forces leading hospitals to invest in outpatient care to prevent hospital readmissions.

While independent hospitals appear to be making smaller investments, the Hospital for Special Surgery is forecasting five years of continuous investment at five separate sites on Manhattan's Upper East Side that average more than $25 million per year to improve inpatient services and visitor amenities.