For mechanical contractor McCarthy Building Companies Inc., the health care market makes up 45 percent of the total revenue — not that there are a tremendous amount of projects, but some of those they have been handling are pretty darn big. “Less frequent but bigger” is how project director Jeff Boyer describes it.

The three mechanical contractors described in this article see a mix of various types of health care projects: from huge new construction developments to the predominantly smaller projects (clinics).

McCarthy sees trends toward mega projects, not only private but also those that are federally funded, Boyer said. “Our average-size project is less than $10 million. Mechanical-electrical-plumbing (MEP) is anything that’s probably over $250 million; a number are out there, a number are out on the horizon.”

The contractor mainly works in acute care and specialty care hospitals, along with some outpatient facilities as well. The projects and relationships are developed slowly over time. “Medical offices are not on the higher quantity trends,” Boyer said. However, “The federal government is spending billions; the VA especially is spending a lot.”

Project Types

A lot of these projects are completely new facilities, he continued. In existing build-ons, on the other hand, there are tie-ins to existing systems.

“Then there are some clients where it’s continuous work, continuous renovation,” Boyer said. “Some make it look pretty, others are upgrades. Some of the projects definitely have an MEP side, it can be 50-60 percent of the job.” When MEPs are design-build, McCarthy’s MEP preconstruction group gets involved with the designers.

The work, though, is mainly new construction (95 percent) and retrofits (5 percent, strictly gutting and remodeling). The hospitals use their own internal staff for service-maintenance.

Kevin Almon, owner of Vital Mechanical Service Inc., Kent, Wash., said health care makes up 60 percent of the mission-critical company’s work, mainly hospitals and clinics. These clients’ top concerns are “keeping the facility operating and revenue and patients coming in the front door, while reducing operating costs and mechanical system reliability.”

Ventilation, Quarantine

Negative-pressure quarantine areas are part of the contractor’s regular work. “In a hospital, the entire facility is pressure sensitive from one room to another room, or to hallways,” said Almon. “Operating suites and patient care areas are positive with high air turnovers. Pharmacy and chemo drug-compounding rooms are highly negative,” he continued. “Health care regulations control even room pressure gradients from one room to another.

“Quarantine rooms have been around for years; in the old days they were called TB rooms,” he said. “Flip a switch and the room goes negative.”

Within this market, Almon said he has noticed “increasing interest in improving system infrastructure to improve longevity, energy efficiency, and compliance with health care regulations.”

Michael A. O’Connor, Leed AP and chief operating officer, Alltek Energy Systems Inc., Waterford, N.Y., said that the company designs and installs HVAC mechanical systems in the Albany area. “Approximately 18 percent of our work is in the health care industry,” or about $1.5 million. Hospitals and clinics make up the bulk of this work.

“We have installed emergency rooms with negative pressure-rooms for quarantine design by engineer. This has always been a requirement in this area on hospitals we have worked in.”

Top concerns among the contractor’s clients are “fresh air, filtration, and keeping air systems clean of airborne particles.” The company specializes in chemical cleaning “and making sure equipment is operating as designed,” O’Connor said. “Some of the biggest changes are demand ventilation to reduce costs of operating systems with outside air.”


In general for the health care market, “I would say that the opportunities are coming back,” said Boyer. “During ’08 and even into ’10, they were shelving their projects and sitting on cash. A number of big projects were put on hold.

“The economy has become a new normal,” he said. “We’re starting to see some things come back.”

Clients are still concerned about cost; “it’s always at the top of the list,” Boyer said. But they also are interested in “designing and constructing to maximize the efficiency of their equipment, doing things to work with public utilities, expandability, and remodeling.

“The health care world always seems to be renovating,” he added, “so make sure the building can be expanded and changed in the future; maybe include more valves?” Many owners also have a continued focus on sustainability. “Some want to take it to full LEED, others just want a green focus.”

What it still all comes down to, said Almon, is service. “It’s easy to talk about, hard to do well.”

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Publication date: 10/31/2011