Introduction

The Greater New York Hospital Association (GNYHA) represents over 160 hospitals and health systems in the New York region, and is an integral component of the regional COVID-19 pandemic response. On March 18, Governor Andrew Cuomo issued a mandate for hospitals to increase their inpatient bed capacity by at least 50% and as much as 100% to accommodate an unprecedented surge of patients that threatened to overwhelm the health care system. GNYHA received an outpouring of offers from commercial property owners and non-hospital health care facilities that wanted to contribute their unused or decommissioned spaces to be either occupied or reactivated as alternative care sites for critical, acute, or post-acute care. 

GNYHA recognized a need to support hospitals and governmental agencies to quickly evaluate these unused clinical and non-clinical spaces for their maximum potential bed count and appropriate acuity level. For guidance on addressing this unmet need, GNYHA contacted the office of Peter J. Romano and Company, through a referral from a member hospital. The response from the architecture, engineering, construction, and the location scouting professional communities far exceeded GNYHA’s expectations and could serve as a model for future sustained patient surge events. 

Taskforce Formation

On March 20, GNYHA contacted the office of Peter J. Romano and Company (PJRCo) seeking assistance with locating and assessing potential sites that could provide additional surge bed capacity to support the health care needs due to the rising COVID-19 pandemic in New York City and surrounding areas. PJRCo is a development and project management firm having extensive experience the delivery of health care projects and has worked with many of the major health care institutions in the New York metropolitan area.  

Given the timeframe available to assess and implement the surge beds, PJRCo suggested assembling multiple teams of design and construction professionals having experience in the delivery of health care projects.  By the morning of March 23, the first meeting of the GNYHA Surge Bed Capacity Taskforce with six teams of health care design, engineering, and construction management firms convened.  A crew of film and television locations scouts joined the Taskforce via a social connection at GNYHA. 

GNYHA thanks the following firms for their generous participation:

Area of Expertise Firm Names
Architecture
  • Ewing Cole
  • NBBJ
  • NK Architects
  • Perkins Eastman
  • Perkins & Will
Construction
  • Lendlease
  • Skanska USA
  • AECOM Tischman
  • Turner Construction Company
Development
  • Peter Romano & Company
Engineering
  • ARUP
  • Jacob Feinberg Katz & Michaeli Consulting Group
  • JB&B
  • Syska Hennessy Group, Inc.
Expediting and NYC Code Consulting
  • Milrose Consultants
  • Municipal Expediting Inc.
Health Care Consulting
  • Cicero Consulting Associates
Site Scouting
  • International Brotherhood of Teamsters Local 817
  • Location Managers Guild of America
  • United Locations Department Workers

The Taskforce met three times weekly from March 23 until April 10, at which time the flattening of the infection curve and the proliferation of government-supported alternate case sites in New York City obviated the need to continue assessing additional facilities. Individual teams continued to support the State evaluate sites outside the City until those projects were terminated due to lack of projected need.

Collaborating with Government Agencies

Beginning early in the pandemic response, GNYHA attended daily New York City Office of Emergency Management (NYCEM) meetings focused on expanding surge capacity throughout the region, including discussion of facilities under evaluation for use as alternate care sites (ACS). GNYHA coordinated with NYCEM and the State to avoid duplication of ACS evaluation and served as a conduit to relay information to guide the Taskforce activities and priorities. Eventually, the State Department of Health (DOH) also enlisted the GNYHA Taskforce to evaluate multiple facilities for potential use in a later phase of the pandemic response. 

To implement the work, it quickly became apparent that immediate buy-in and support would be needed by other State and City agencies having jurisdiction including DOH, the New York City Department of Buildings, Fire Department of the City of New York and Con Edison. Each agency was contacted and became participants in the Task force.  Additionally, as the assessment of potential sites began, the teams were supplemented with City expediting firms and firms with relationships at DOH to help cut through the red tape. This was truly a coordinated effort of design and construction experts and government agencies coming together to address one of the greatest challenges the health care industry has ever faced.

Site Evaluation

Over the course of three weeks, the Taskforce assessed 29 locations.  Many of the sites evaluated went on to have temporary test-fits, engineered solutions, along with cost and schedule impacts prepared. Out of these more detailed evaluations five sites were deemed feasible.  At the end of the third week of this charette, the COVID-19 curve had peaked and was beginning to descend, and the bed capacity needs in the City and surrounding areas stabilized. Further, as steps were taken to operationalize the five sites, it became clear that the constraint to implementation was not the actual beds, but was in fact, the staff and supplies needed to operate those beds. The below table lists each Taskforce team and their assigned sites, with links to the final evaluation of each site. An interactive map, prepared by the film location scouts, is also available to locate facilities assessed or considered by the Taskforce.

Taskforce Team Facilities Evaluated
Team 1:
Architect: NK Architects
Engineer: JB&B
Construction Manager (CM): Lendlease
Expeditor: Municipal Expediting Inc.
Team 2:
Architect: Perkins Eastman
Engineer: Syska Hennessy Group, Inc.
CM: Turner Construction Company
Expeditor: Municipal Expediting Inc.
Team 3:
Architect: Perkins & Will
Engineer: Jacob Feinberg Katz & Michaeli Consulting Group
CM: AECOM Tischman
Expeditor: Municipal Expediting Inc.
Team 4:
Architect: NBBJ
Engineer: ARUP
CM: Skanska USA
Expeditor: Milrose Consultants
Team 5:
Architect: EwingCole
Engineer: Syska Hennessy Group, Inc.
CM: Turner Construction Company
Expeditor: Milrose Consultants
Team 6:
Architect: Perkins Eastman
Engineer: JB&B
CM: Lendlease
Expeditor: Milrose Consultants