Concrete (Div 03)

Improvements in Third Party Owned Buildings

Facility name: Ogden Regional Medical Center

Project name: OGDNMC-012020M-New Rehab Unit
Location: OGDEN, UT
Project classification: Hospital – Shell Buildout
Project type: MOB
Project number: 3441500009
Lesson Learned number: 182
Impact: Cost, Schedule, Quality, Scope

Cost impact: $65,000 Schedule impact: 10 days

Lesson Learned/Best Practice

For HCA Tenant Improvement Projects located in 3rd Party Owned Buildings, verify existing construction is suitable to allow work to start and avoid schedule delays.

Suggested Actions for Future Projects

HCA Design and Construction, the Design Team, and the Contractors should walk the area as soon as access is available to review the existing construction conditions.

At any point during planning, design, or pre-construction that a non-compliant issue arises, it should be communicated to all parties so solutions can be determined prior to planned construction start.


New 3rd Party Owned Medical Office Building utilizing Fiber Mesh Concrete Reinforcement in slabs which lead to severe cracking and fiber “residue” in existing slab. Cracking is a structural issue that needs review by a structural consultant. “Residue” of Fibers on the face of the slab affects flooring installations and required a planned solution.


3rd Party Owned Buildings, Severe Slab Cracking, Fiber Mesh Reinforcing Residue, Renovation

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Evolving HCA standards

Facility name: Medical City McKinney

Project name: MCMKNY-102017M-BH & Rehab Relocation
Location: MCKINNEY, TX
Project classification: Hospital – Horizontal Expansion
Project type: Psych
Project number: 3833300011
Lesson Learned number: 148
Impact: Cost

Lesson Learned/Best Practice

With HCA’s ever evolving design standardization there needs to be a fixed point where design is frozen for each specific project. 

Suggested Actions for Future Projects

Document date and version of HCA standards utilized within CD drawing set,  validate HCA standards with planning manger, design manager, HCA engineering and construction manager.


HCA Standards, MEP guidlines

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Exterior Skin Finish

Facility name: Menorah Medical Center

Project name: MENORA-092018M-Bed Tower Expansion
Project classification: Hospital – Horizontal Expansion
Project type: Acute Care
Project number: 0972300007
Lesson Learned number: 137
Impact: Cost, Quality

Lesson Learned/Best Practice

During EDI two different finish types were selected.  Precast concrete was selected for the lower level and EIFS was selected for the upper levels in order to reduce cost.  Both finish colors were selected to closely match the existing building however, with the two different skin types, the different finishes stand out.  There is a texture difference between the two skins as the precast has a rough finish and the EIFS is smooth finish.  Now that both skin elements have been installed it is apparent how different they are raising concern from the facility on the appearance.

Suggested Actions for Future Projects

We recommend that in future tie-in expansions, where the goal is to match existing finishes, that only one skin element is used.  This will help to give the match a consistent look.

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Steel erection and soil conditions

Facility name: Aventura Hospital & Medical Center

Project name: AVENTU-New Tower
Location: AVENTURA, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3092000015
Lesson Learned number: 63
Impact: Schedule, Scope

Lesson Learned/Best Practice

Building in south Florida due to the soil type, the structural columns are set below grade two foot or greater. Due to the weather (mostly rain) we constantly fought to keep the sand from washing down around the columns after they have been cleaned out.

Suggested Actions for Future Projects

Review steel erection plan then get phasing plan set for all columns prior to steel erection beginning. Once work commences set columns, plum column, tighten all bolts, weld washer (as required). Then form up three of four sides, grout all base plates and then finish forming the fourth side. Let steel erection complete so if any pulling is required to connect beams there is play but the columns are formed up so no dirt can wash around prior to concrete pedestals poured.

Set up a coordination meeting with structural steel and concrete subs to layout a phasing plan to dig around, grout base plate, and form up the columns as to avoid have the earth wash back down around the column prior to pouring the column wraps below grade.

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Analysis of complete vs. selective demolition

Facility name: Memorial Health UMC Savannah

Project name: MEMSAV-032018M-Children’s Hospital
Location: SAVANNAH, GA
Project classification: Hospital – New & Renovation (Blend)
Project type: Acute Care
Project number: 2696000002
Lesson Learned number: 62
Impact: Cost, Scope

Lesson Learned/Best Practice

During the pre-construction and bidding process, selective demolition and pour back of an existing 4″ slab on grade was priced to account for plumbing and electrical underground systems. The process of selective demolition, as well as trenching for underground MEP systems, resulted in areas of cracked or unusable slab, which required additional demolition and pour back on a T&M basis. This additional work had minimal to no schedule impact, but did have a cost impact as described below.

5,000 SF of selective demolition and pour back was captured in the original scope of work at $17,242. The additional selective demolition and pour back totaled $23,752 for a cumulative scope cost of $41,476. Conversely, complete demolition and pour back of the entire slab (23,453 SF @ $3.55/SF) would total $83,258. While this cost analysis indicates that selective demolition and pour back is the most cost efficient process, we propose that an allowance be captured in the bidding phase to account for cracked and unusable slab following demolition and installation of MEP underground systems. Factoring such an allowance at the bidding phase will allow for competitive pricing to work in the Owner/GC favor, as T&M work may exceed competitive bidding costs.

Suggested Actions for Future Projects

Perform a cost analysis of complete versus selective demolition on existing slab on grades during the design/bidding process, and if selective demolition is found to be most cost efficient (as is the case here), include an allowance for additional selective demolition in the competitive bidding process.

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Calculating Concrete Deflection

Facility name: Northeast Methodist Hospital

Project name: NRETME-092018M-Inpatient Expansion
Location: LIVE OAK, TX
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3438500010
Lesson Learned number: 55
Impact: Cost, Schedule, Quality

Lesson Learned/Best Practice

One general number was given for the overall maximum deflection that turned out to be inaccurate based on the beam sizes and the concrete pour area and resulted in JE Dunn stopping the pour.  Define whose responsibility it is early on to calculate maximum deflection tolerances based on structural beam sizes and location before concrete pours.

Suggested Actions for Future Projects

Have the engineer of record calculate the estimated beam deflection in different areas of the pour based on the size and location of the beams rather than giving a general overall deflection of the entire slab.

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