Chris McMenemy, vice president for administration at Ortmann Healthcare Consultants in Columbia, S.C., lists four considerations on dealing with architects and general contractors in constructing new ASCs.
1. Choose experienced firms. The architect and builder you choose should not simply have "medical" experience, such as designing medical offices, but should have direct experience with ASCs. Surgery centers are much more complicated, with gas outlets, air pressure systems for ORs and extensive safety requirements.
"This is the one step that can save you the most money in your project," Ms. McMenemy says. "If your project is not designed to meet specific regulations, you may be knocking down a wall to find space for an additional room."
2. Don't just choose someone you know. Having a good relationship is important, but don't choose the architect or builder who helped you build your home. It sounds obvious but some physician-owners have actually done that, Ms. McMenemy says. In addition to the risk of big mistakes, these people may charge more because they have to read up on everything. "Always use someone who has experience in ASC design and who knows your state’s regulations and the Medicare guidelines," she says.
3. Consider architect-builder relations. The architect may want to choose the builder, arguing that this will help him monitor construction quality, but is it good for you? While having a general contractor the architect can trust can keep the process running smoothly, it may cost more because you weren't able to ask for competitive bids. One solution would be to ask the architect for two or three names and invite all of them to bid on the project.
4. Meet frequently with the crew. Meeting regularly with the architect, general contractor and perhaps key subcontractors means you can pick up on mistakes or misunderstandings as soon as possible. Ms. McMenemy recommends monthly on-site meetings and weekly calls initially and making them more frequent toward the end of the project.
The job of meeting with the crew falls to the physician designated by the physician-owners to work on the project. But too often, this physician doesn't hold meetings and gets out of touch with the construction process. Ms. McMenemy says this is more likely to occur in large groups of owners than when only one or two physicians are involved.
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