preclude them from having to maintain numerous sites. A new building also would bring the opportunity to create an environment tailored to exact specifications, free from the constraints of existing infrastructure. The challenges included having to re-imagine their space as a single entity, finding a site that was in their target geographical area, and working through the municipality’s building design and approval process. The result was a beautiful and highly visible facility that has allowed this client to continue providing care for the patients they already had, while also becoming a more prominent player in the community and, thereby, drawing new patients from outlying areas.

Existing Facility Renovation and Reactivation

Another client, an award-winning orthopedic provider, had seen their patient numbers steadily increase to the point where they needed addi- tional space to keep up with caseload demand. This client found an opportu- nity nearby; a different specialty pro- vider had recently shut down operations throughout the state, leaving a local, vacant ASC in need of a new tenant. This available space would allow our client to expand their practice within their region without the disruption of an addition to their current facility. We sur- veyed the facility and provided a report detailing the scope of work needed to re-activate the space. Our client would be taking occupancy as a new tenant, so they needed to consider the following, all of which potentially differed from

the previous occupant: ■

the codes under which the ASC was originally designed versus the cur- rent code requirements that are trig- gered by the renovation and re-acti- vation of the facility;

the list of procedures to be per- formed at this facility, immediately upon occupancy and potentially in the future. The specific procedures

Exterior (top) and interior new build of Wisconsin Institute of Urology in Neenah, Wisconsin.

being performed establishes some of the code criteria in effect;

anticipated staffing numbers per shift (for confirmation of parking stall counts); and

specific accreditation requirements. Overall, the facility was set up well for our client’s use. Wanting to take into consideration possible future challenges, we flagged code-man- dated updates to the mechanical and electrical systems plus miscellaneous life-safety construction modifications involving fire-rated wall construction, exit

signage and door construction

types. The biggest hurdle was estab- lishing the complete fire-rated sepa- ration between the ASC and adjacent

clinic, including distinct waiting and reception spaces for both. Establishing this scope of work confirmed it was much more cost-effective to undertake the renovation of this former ASC than to start from scratch in another loca- tion. The client entered into their lease agreement and embarked on the reno- vations needed to provide a code-com- pliant space that meets the needs of their practice.

Adaptive Reuse Now, let’s return to the client I men- tioned in the beginning of this column, a nationally recognized digestive health expert looking at a car dealership for their new ambulatory center. This client


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