FEASIBILITY STUDY EXECUTIVE SUMMARY

The Foundation for Historical Louisiana Medical Center of New Orleans - Charity Hospital

TABLE OF CONTENTS
INTRODUCTION PROJECT DIRECTORY ACKNOWLEDGMENTS PREAMBLE SCOPE OF WORK METHODOLOGY ASSESSMENT FINDINGS STATEMENT OF SIGNIFICANCE URBAN DESIGN ANALYSIS FUNCTIONAL ANALYSIS CONCEPT PLAN FUNCTIONAL NARRATIVE IMPLEMENTATION CONCLUSION CONCEPT PLANS 4 7 9 11 12 15 19 23 25 27 29 31 35 39 43

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except for the 3rd floor. after 12 weeks of intense assessments. and up-to-date healthcare planning efforts. 6. 2008 Foundation for Historical Louisiana P. Existing floor plates are workable and complimentary for a first class healthcare facility. the building has held up remarkably well through hurricanes. has the floor plates to accommodate a world class hospital and this work can be accomplished more expeditiously than undertaking a new building project in an unknown location with all the associated and time lost in challenges of such an effort. The floor plans included in this report show how Charity can be transformed into a modern healthcare facility. All interior partitions. In conclusion. 4. but we believe the cost of resolving any issue will be far less than the cost of a comparable new building. PA 19107-3502 T +1 215 636 9999 F +1 215 636 9989 www. windows. Philadelphia.O. there is a significant cost to doing that. The structural system is sound. major calamities.The Foundation for Historical Louisiana Medical Center of New Orleans . and we have determined that all of them can be resolved in a positive way. which has large lower floors acting as a functional podium to support bed floors above. The complete report includes all of our documentation and back-up information. which we do propose enlarging. The building envelope. New interior fit-out of the entire building. This enclosed Executive Summary presents our findings. is necessary. RMJM HILLIER © 4 20 AUGUST 2008 . We trust that both documents provide you with the information necessary to make informed decisions regarding the future of this important landmark structure to the citizens of Louisiana.com August 19. Suite 1500.rmjmhillier. and by adding a limited number of beams in certain areas. Naturally. we believe that this venerable landmark can have a great future as a world class medical facility that will symbolize the rebirth of New Orleans. celings. 5. 2. it will be fully functional. especially New Orleans. LA 70821 RMJM Hillier is pleased to submit our final report on the Charity Hospital building to the Foundation for Historical Louisiana and the named parties in House Concurrent Resolution #89. The basic volumetric composition of the building. Our findings indicate that after over 75 years. will work well as a modern hospital. The factors include: 1. Thanks to the original design vision and the construction of the building. can be effectively restored. Box 908 Baton Rouge. our findings indicate that there is no compelling reason for this historic landmark structure not to be rehabilitated to its full potential. The RMJM-Hillier Design Team has looked at many critical factors in this feasibility study. neglect and deferred maintenance. including exterior walls. and roof. using state of the art technology. One South Penn Square.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY The Widener Building. indepth study by experts. 3. as well as an innovative entrance atrium. and finishes will be removed. Our analysis and planning study demonstrates that “Old Charity” can be renovated at a reasonable cost. to make sure that no environmental concerns remain.

000. and the hospital’s floor levels are all above the Katrina flood line. Their estimate comes to a total of $484. Our findings indicate that at a minimum. This expedited schedule is a compelling reason to restore and renovate Charity instead of building new. as compared to building a new facility.000.Charity Hospital 7. which would require acquiring a very large parcel of land. along with our experience in healthcare and preservation projects. is that the design concept presented here in this assessment has a high potential for success.” This will require a significant investment. The answer to the question of whether or not Charity can be re-made into a modern hospital is “yes. The resulting comparable number is approximately $620. and added the cost for land acquisition. Charity can be restored and renovated at a cost of approximately 20% less than the cost of building a comparable new building on a new site. Our view. and the expenditures associated with operating temporary facilities for an extended period. R. and building from scratch a brand new building. We urge the named parties to seriously consider this option for providing an excellent hospital facility in New Orleans. but it is a cost-effective option that will save considerable time. The recommended design will meet the latest code requirements for hurricane-force winds. It will also reduce “soft” costs such as the cost of borrowing money over a longer time period. relocating the people who live there. The cost of all of the above work is included in our construction cost estimate. In order to have an “apples to apples” cost comparison. AIA Principal 20 AUGUST 2008 5 RMJM HILLIER © . provided by VJ Associates. It will provide a significant savings in construction costs by reducing the timeline for labor and material costs escalation. Beyond base construction costs. Having this valuable and structurally sound building shell already in place should save at least two years off the delivery date of a new building. an experienced estimator for both hospital and historic preservation projects. it will put the hospital on a prompter path towards generating a revenue stream.000. based on facts and figures. This percentage will undoubtedly increase when taking into account other construction costs of the new hospital.000. Finally. we also believe there would be significant savings in years of time of construction required for Charity. Stephen McDaniel. RMJM-Hillier asked VJ Associates to also estimate the construction cost of the new hospital facility that is being planned in New Orleans.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . Sincerely yours. such as the demolition of the structures on the new site and the associated remediation.

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VANDERWEIL ASSOCIATES LANGAN ENGINEERING AND ENVIRONMENTAL SERVICES. ARCHITECTS ROBERT SILMAN ASSOCIATES GEORGE BALLARD GEOTECHNICS. INC. INC.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . G. VJ ASSOCIATES COST CONSULTANTS 20 AUGUST 2008 7 RMJM HILLIER © . ARCHITECTS WAGGONNER & BALL. R.Charity Hospital PROJECT TEAM MEMBERS RMJM HILLIER.

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under the direction of the Foundation for Historical Louisiana. the RMJMHillier/Waggonner & Ball design team was supported by Robert Silman Associates (structural engineers).Charity Hospital ACKNOWLEDGMENTS This Feasibility Study represents an effort by the Project Team. 20 AUGUST 2008 9 RMJM HILLIER © . address the functional and programming needs of a state-of-the-art healthcare facility and provide appropriate and proper stewardship of a historic resource that has been an intricate part of the community fabric for over 250 years. During the course of preparing the feasibility study. FHL Executive Vice Chair. and assistance in completing localized investigative probes. for her enthusiasm in embracing the historic preservation issues of this project. and investigations of existing conditions and development of recommended treatments by the project team. who provided a lift for access. GB Geotechnics (thermal imaging and non-destructive testing). and VJ Associates (cost estimating). electrical and plumbing engineers). LA. The team was also supported by Brice Building Company. The project team would particularly like to acknowledge Sandra Stokes. The Report is the result of several months of collaborative efforts. G. The design team would like to thank the Foundation for Historical Louisiana (FHL) board members for their insights and excellent support for this project. Vanderweil Engineers (mechanical. informed by input from LSU and community representatives. and for her tremendous contributions towards making the preparation of this Feasibility Study possible. including archival research and photographic documentation. her coordination efforts. Langan Engineering (hazardous materials assessment). R. Baton Rouge.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . to arrive at a plan that provides guidance on how to take best advantage of the significant and spectacular features of Charity Hospital.

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That is. In May 2008. In 2006. ensured that Charity was firmly rooted in its community as a beacon for healthcare supporting patients’ families and caregivers. by unanimous vote.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans .0. New Orleans’ Charity Hospital has been at the forefront of healthcare.2 -Artist’s Rendering of Charity Hospital. the Superdome and the French Quarter. Figure 0. charging the Foundation for Historical Louisiana (FHL) to do an independent assessment of Big Charity Hospital. 20 AUGUST 2008 11 RMJM HILLIER © . Tulane School of Medicine. the history of healthcare has been written on its walls. and the establishment of the first blood bank to the recent installation of a hyperbaric chamber. The FHL was “to work with the State office of Facility Planning in the Division of Administration. Its mission of providing healthcare for all within an educational setting fostered the growth of the surrounding medical community and schools of medicine. As the longest continually operating hospital in the United States. as laid out in HCR 89. passed House Concurrent Resolution No. the Louisiana Legislature. and the LSU Board of Supervisors in this evaluation and (…) report finds to each of those entities and to the legislature upon completion of the evaluation”. Louisiana. as well as residential neighborhoods. from its early breakthroughs in anesthesia. the Central Business and Municipal Districts.0. technology and medical education.1 -Contextual Historic Rendering of Charity Hospital. 89 (HCR 89). until it was determined that the impacts of Hurricanes Katrina and Rita were reason for this landmark to be shuttered and abandoned as a medical facility. Charity was designed as a teaching hospital. Its proximity to LSU Medical School. the Louisiana Recovery Authority. Figure 0. put forth by Representative Odinet. the design team lead by RMJM Hillier was selected to complete the feasibility study. medical research. the VA and University Hospital. In March of 2008.Charity Hospital EXECUTIVE SUMMARY PREAMBLE Since its beginnings. the FHL issued a Request for Qualifications for the preparation of an Existing Conditions and Facilities Assessment Report on the “Big Charity” Hospital building at 1532 Tulane Avenue in New Orleans. embracing the convergence of healthcare.

and Poverty” By John Salvaggio. Chief medical Officer of LSU Health Services Division and Danny Mahaffey.4 -Image of Charity Hospital at Present. Louisiana State University Medical School Alumni Affairs Files. rendering the provision of interim medical facilities at Charity unnecessary. Russell Klein and Louis Castaing. funded. Activating only three floors would require creating a dedicated new base building infrastructure for the three floors (boilers. From Across Tulane Avenue. Finally. and built. They stated that interim medical and clinical services were already being provided at Lord & Taylor and that interim emergency services were already being provided at University Hospital. M. Letters from the State Commissioner of Administration and from the State Director of Facility Planning confirmed that interim use is currently addressed by the reconfiguration of University Hospital. etc).” HCR-89 also requires that the independent evaluation team “… evaluate the operating room and intensive care units to determine the feasibility restoring the trauma unit to pre-Hurricane Katrina status. thereby making trauma services available to the citizens while a new trauma unit is being designed.D. and separating all vertical chases and connections between the base and the tower portion of the building. psychiatric services. and establishment of clinics and subspecialty clinics. The first three floors comprise the base/podium of the entire building supporting the tower section both structurally and in terms of building systems. the FHL and RMJM Hillier met with Dr Michael K. HCR-89 requires the assessments of “…. base distribution.the first three floors of the structure. the return of mental health care through the lease at DePaul Hospital.” On June 10.. Butler.0. thereby reestablishing a revenue stream that will be essential to the viability of a new facility” and “examine and evaluate the entire Big Charity structure to determine the advisability of repairing or restructuring the entire facility. A significant abatement program – far larger than the three floors – would also have to be undertaken to ensure that the three floors would be free of contaminants and hazardous substances. and a considerable waterproofing and envelope protection effort would have to be undertaken above the three floors to ensure that there are no moisture threats 12 20 AUGUST 2008 Figure 0. Director of Facility Planning to discuss programming for the Charity Hospital study.The Foundation for Historical Louisiana Medical Center of New Orleans . to determine their viability for interim use to provide medical services including emergency services. chillers.0. Figure 0. courtesy of Dr. the exterior envelope would require repairs and window replacement.3 -Image of Charity Hospital During Construction. 2008. It must be noted that focusing on the first three floors only would not have been a prudent and cost effective way of addressing both interim and long term potential reuse scenarios. excluding the basement. RMJM HILLIER © . and the use of renovated space at the New Orleans Adolescent Hospital. Image from the Book “New Orleans’ Charity Hospital: A Story of Physicians. Politics.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY SCOPE OF WORK The first key decision of the Design Team was to determine the scope of the conceptual study.

assuming that renovating the first three floors was accepted. 20 AUGUST 2008 13 RMJM HILLIER © .Charity Hospital from areas still in serious need of repair. Indeed. and respect and enhance significant historic features. Now that the building has been vacated. provide state-of-the-art facilities and amenities for a modern hospital and Level 1 trauma facility. Furthermore. The fact that the facility had to remain up and running made any much needed renovations and infrastructure upgrades extremely difficult to undertake and costly. as well as outdated mechanical systems were a major concern. utilities and bridges that connect these sites.0.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . and be completed within three-and-a-half years. and the extent and cost of mitigation. with a comprehensive.6 . The design team concludes that the best approach is to address the entire Charity structure. quicker than it would take to build a new structure. As a result of all of the above considerations. Figure 0. Using the existing infrastructure of tunnels. Services within Charity could be shared with the VA.Present Condition of West Wing Roof. This comprehensive renovation work would use available funds promptly and effectively. or cost-effective.0. abatement. Newly renovated state of the art facilities sat next to outdated noncompliant departments. given the fact that there would be intensive construction . innovative design that would allow a permanent re-use of the core and shell of the building. This approach also takes advantage of existing associated structures on adjacent sites in order to house necessary support system(s). a new opportunity presents itself: to reassess the potential of this historic landmark to be reborn as a world class healthcare facility. support facilities would be upgraded to meet current code requirements and would be designed to continue to support adjacent facilities such as the VA and Tulane.the equivalent of erecting a new hospital – above an occupied medical critical care facility. the option of interim use was no pursued by the design team. it would have been almost impossible to upgrade the building to a state of the art facility without massive temporary relocations of departments and the disruptions that such an approach would cause.Present Condition of a Typical Corridor. the long term use of the remainder of the building would be far more expensive than renovating the entire building as a vacant facility. the condition assessment findings demonstrate that many issues requiring remediation affect the building as a whole. lead and mold. Hazardous materials such as asbestos. Inpatient bed floors could be rented out to the VA during construction of its’ new hospital.5 . Before Katrina all floors of Charity Hospital were in use. and at lower cost. allowing built-in future expansion for the Medical CenFigure 0. repairs and building systems upgrades required for a limited re-use of existing clinical operating rooms and intensive care units is not functionally optimal. Indeed.

LSU currently owns 23 buildings on adjacent sites.0. Additional long term hospital expansion could be served through LSU-owned sites to the West. as they did prior to Katrina as well as to provide flexibility for change and long term future growth of the Medical Center.not demolition and social displacement .Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY ter. such as Old Charity. A renovated state-of-the-art Charity Hospital. than the reuse of a nationally significant and iconic historic landmark.The Foundation for Historical Louisiana Medical Center of New Orleans . RMJM HILLIER © 14 20 AUGUST 2008 . many of them ideal for functioning as the ambulatory-care component of the Medical Center. reinforcing the value of sustainability . It also underscores how sound preservation principles can be creatively integrated with modern design parameters. The previous experience of the design team working with people in the healthcare community in New Orleans has afforded us the opportunity of discovering a history of compassionate care and a dedication to the supporting clinical programs.as a key component of the future of architectural development. The rich history of the architecture in the city is a fundamental part of the city’s success.7 . Figure 0. and South across Gravier Street. redevelopment and growth in areas ravaged by Katrina. including the most stringent healthcare requirements. and there can be no better example of leadership and commitment to sustainability. The revitalization of the hospital will be an important step in the redevelopment of New Orleans. with new technology and centers of excellence. will once again provide such compassionate and efficient care.Proposed Main Entrance Along Tulane Avenue.

and building system(s). It then uses these components to assess the architectural. understand and assess the physical conditions of Charity Hospital’s envelope (ma sonry façade and windows).Charity Hospital METHODOLOGY House Concurrent Resolution No. the discovery process. • Evaluation of the suitability of building site.Historic Photograph of Charity Hospital Taken Shortly After Construction Completed. This analysis is essential to recognize the historical integrity and significance of the building. Figure 0. cultural.8 .” RMJM-Hillier and the Design Team complied with these requirements with an extensive existing building conditions assessment and the development of a concept design.0. these components inform the determination of the feasibility of the re-use of Charity Hospital. their extent. The discovery process aims to identify existing conditions. • Review of historic photographs and descriptive accounts pertaining to various renovation and construction cam 20 AUGUST 2008 15 RMJM HILLIER © Figure 0.9 . ASSESSMENT The assessment component of this report includes four steps: • Historical analysis of the physical and historic context of Charity Hospital.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . 89 (HCR-89) requires that this feasibility study “assess the condition of the facility and evaluate its potential uses as a location from which medical services may be offered to the population of the Greater New Orleans area” and “evaluate the entire Big Charity structure to determine the advisibility of repairing or restructuring the entire facility. • Discovery process to describe. and a description of the building and site arrangement. and the probable factors that caused or contributed to them. • Summary analysis of the findings of the historical background and context. . Together. a discussion of previous site uses. and the architectural evaluation. through a multi-layered approach that includes: • Field comparison of drawings and existing arrangements.0. structural framing. and the costs associated with such a renovation.Original Structural Plan of the Twelfth Floor Auditorium. technological and historical significance of the structure. floor plate and architectural layout to accommodate the functional and clinical needs of a cutting edge hospital with new technology and centers of excellence. The historical analysis of the physical and historic context of Charity Hospital provides an overview of the history of the hospital.

The drawings helped clarify the timeline and observed conditions. Drawings showing construction details in areas where observed existing conditions were considered to be in poor to critical conditions were helpful in identifying factors causing the deterioration and developing recommended treatments. The drawings include architectural. structural components. ranging from January 1937 to January 1938.10 .Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY paigns. Review of the evidence yielded by the above investiga- Figure 0. The design team reviewed full size copies of select original engineered drawings for the Charity Hospital of Louisiana – Main Building – New Orleans project obtained from the Louisiana State University Health Sciences Center (LSUHSC-MNCLO) Facilities Management Department archives. followed by extensive survey level observations of envelope features. • Review of photographs and descriptive accounts pertaining to Hurricane Katrina. and assisted in the determination of a period of interpretation for the recommended treatments. • Thermal imaging of the elevations and non-destructive exploration at select locations • Investigative probes and observation of concealed conditions at select locations. the project team completed a preliminary existing condition reconnaissance and photographic documentation of the hospital. and mechanical. electrical and plumbing (MEP) distribution systems. The design team also reviewed drawings obtained from LSUHSC archives that inform the scope and nature of more recent construction campaigns of the past thirty years. • • Photographic documentation. • • tion Notation of materials conditions.0. • Review of Hurricane Katrina damage assessment reports and proposed mitigation . structural and MEP systems drawings. The observation included the following: • Visual observations conducted from the ground and RMJM HILLIER © 16 20 AUGUST 2008 . After this initial review.View of the Center Tower from the West Wing Roof.The Foundation for Historical Louisiana Medical Center of New Orleans . • Discussion of conditions and problems with facility operations and maintenance personnel. Survey-level observation of accessible surfaces.

and microbial impacted materials. The assessment includes a due diligence hazardous materials (hazmat) assessment that included an inspection of the building to identify the presence/absence of asbestos containing materials (ACM). structural framing. such as depth of stone and embedded steel.Thermal Imaging of the Main Courtyard. and potential hazardous materials • Non destructive testing of the façade assembly through thermal imaging. • Investigative probes to confirm envelope assembly details noted on the drawings and through non-destructive testing. preliminary layout plans and stack diagrams. The assessment included sampling. and preliminary field observations.0. Impulse Radar data and metal detection collected at specific locations provides complementary information on concealed features. Lead Based Paint (LBP). The scope of visual observation include the façade masonry and windows. with a collaborative design vision integrating current healthcare design principles with sound preservation techniques.13 . A final summary analysis of the findings of all of the above resulted in a qualitative rating of all observed conditions.11 . building systems. CONCEPT PLAN The conceptual plan focuses on the feasibility of the re-use of Charity Hospital. This is realized through programmatic analysis. with a focus on the envelope.Measurement of a Cracked Masonry Unit.0. Figure 0.0. complemented by impulse radar assessment and metal detection.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . Polychlorinated Biphenyls (PCB)/Mercury containing electrical components.12 . and including all visible surfaces. floor plate and architectural layout to evaluate their suitability to accommodate the functional and clinical needs of a cutting edge hospital with new technology and centers of excellence. 20 AUGUST 2008 17 RMJM HILLIER © . East Wing. This was followed by conclusions as to what areas or components might require remediation. The assessment was conducted concurrently with an analysis of the building site. including confirmation of the summer diurnal thermal cycle (façade temperature change). laboratory testing of samples collected and an itemized inventory of hazmat identified in the building. and ascertain visually the condition of select embedded steel elements. and sustainable technology. building systems. recommendations for the treatment of Figure 0.Charity Hospital accessible roofs using binoculars. with the exception of areas concealed by adjacent building components or structures. Thermal imaging provides information on the typical thermal characteristics of each façade. Figure 0. Investigative probes were conducted at three locations identified by the design team after a review of the historic architectural and structural drawings. and floor plate.Selective Probing to Determine Window Assembly Attachment.

detailed conceptually in technical narratives. RMJM HILLIER © 18 20 AUGUST 2008 . concept design drawings and preliminary sketches and diagrams that form the basis for the feasibility study implementation budget. The feasibility study concludes with a description of the work items that will be required to implement the proposed renovation.The Foundation for Historical Louisiana Medical Center of New Orleans . and the remediation of the limited deficiencies noted in the assessment.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY historic fabric.

and the normal weathering over seventy years.0. and inform the proposed interventions. limited areas of more extensive cracks where the integrity of the masonry unit may have been compromised.Corner Cracking with Exposed Corroded Steel and Failing Cementious Repairwork. or areas of water entry that may result in embedded steel corrosion and corro20 AUGUST 2008 19 Figure 0. There is limited displacement of façade limestone units at areas where the original detailing provided inadequate bonding of the limestone skin with the masonry backing.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . The pattern of diagonal cracks between the first and third floors appears to be the result of differential structural subsidence. RMJM HILLIER © .14 . Figure 0. as well as miscellaneous spot soiling (mortar. the assembly detailing. The pattern of vertical cracks at select building corners is likely the result of stress from the corrosion of the embedded steel columns. In general. heavy atmospheric soiling. This is consistent with the design details provided in the original structural and architectural drawings. and no additional façade anchoring. localized instances of water runoff streaking. and biological growth.Charity Hospital ASSESSMENT FINDINGS BUILDING ENVELOPE Non-destructive testing confirms that all of the scanned areas of the façade exhibit similar arrangements of embedded structural steel columns. copper and ferrous staining. This displacement is sometimes exacerbated by a building orientation that has resulted in high moisture retention. the façade masonry does not exhibit any significant failures.Typical Biological Growth Found on Courtyard Elevations. The presence of corroding embedded steel was indicated at these areas of masonry distress through the nondestructive testing. This will help determine whether the cracks are progressive or cyclic. and subsequently confirmed when limited destructive probes were done. paint). The conditions observed are consistent with the period and quality of construction. flaws. The presence of any residual movement taking place can be confirmed using crack monitors and strain gauges over a cycle of seasons. with a repeating pattern of varying facing block thicknesses. Overall conditions observed throughout the building envelope include deteriorating mortar joints and soft joints. Instances of non-structural cracks observed in façade stone units require minimal treatment. guano. require more elaborate interventions.15 . A thermal imaging analysis of daily temperature variations within the masonry envelope concludes that it is unlikely that dimensional changes due to thermal expansion of either the frame or the wall assemblies are a significant factor in the observed masonry conditions.0. and became apparent within one year of completion of the structure. or distress.

0.17 . M.19 .0.Photographic Documentation of Location at Present.0. Politics. Figure 0.0. courtesy of Dr. Figure 0.The Foundation for Historical Louisiana Medical Center of New Orleans .Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0.Thermal Imaging of ca. 1940). RMJM HILLIER © 20 20 AUGUST 2008 .Image of Cracking Due to Settlement Shortly After the Building’s Completion (ca. Figure 0.D..Diagram Showing the Locations of Structural Steel Elements Behind the Exterior Masonry. and Poverty” By John Salvaggio. Louisiana State University Medical School Alumni Affairs Files. Image from the Book “New Orleans’ Charity Hospital: A Story of Physicians.18 . 1940 Image.16 . Illustrating Retained Moisture in Facade and Directional Cracking. Russell Klein and Louis Castaing.

Charity Hospital sion jacking. or new mechanical equipment. the load capacity of the one-way corridor slabs remains in question.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . Applying current code requirements and concrete design standards and using the design information available in the original documents yielded service load capacities less than desirable. and potentially conduct testing in order to develop a more accurate estimate of the floor load capacities and verify whether any form of enhancement is necessary. and performance over the years does not appear to have been deficient. and new vertical circulation and mechanical shafts. site observation has found no slab areas exhibiting significant distress.Deteriorated Rooftop HVAC Units. This report concludes that there are no fatal flaws in the building structural integrity aand capacity that would impede Figure 0. This report concludes that the cracks and displacements observed in the façade have not translated into the main building structural element assembly.0. Figure 0. There are no fatal flaws in the building envelope that would impede the rehabilitation of Charity Hospital into a state-of-the art healthcare facility. lack of maintenance and the effects of Hurricane Katrina.Typical Original Window Frame.20 . Investigative probes have demonstrated the presence of corrosion at limited areas of embedded steel. this report assumes the more conservative approach that the slabs will require some form of structural enhancement. However. WINDOWS The majority of the existing windows have exceeded their life expectancy. ROOF The roof and associated rainwater drainage system will require complete replacement. 20 AUGUST 2008 21 RMJM HILLIER © .0. such as MRIs and radiation rooms. most notably the corner columns. All windows. both original and replacement. For the purposes of the development of the cost estimate of proposed work items. Additional areas that will require reinforcement design include areas supporting new heavy medical equipment and appliances. To reconcile this apparent discrepancy it will be necessary to obtain additional information on the existing slab. there is no physical evidence that corrosion has affected the structural integrity of the building as a whole.21 . The load capacity of the pan-joist system is suitable for the proposed use. have been significantly damaged through alterations. BUILDING STRUCTURAL STEEL FRAME The observation of accessible areas did not indicate any sign of distress in the structural elements. however.

The Foundation for Historical Louisiana Medical Center of New Orleans - Charity Hospital

FEASIBILITY STUDY EXECUTIVE SUMMARY

the rehabilitation of Charity Hospital into a state-of-the art healthcare facility. BUILDING SYSTEMS All of the electrical distribution equipment located in the basement was damaged from the flooding during Hurricane Katrina and are no longer suitable for use. Furthermore, the configuration of the existing essential power system does not meet current codes; the fire alarm system throughout Charity Hospital is a mix of old devices and newer devices installed as part of a retrofit. All of the electrical power distribution system, distribution equipment, emergency generators, and existing essential power system will require replacement The heating, ventilation and cooling (HVAC) equipment ranges from large air handlers to multipurpose air conditioning units, located in mechanical rooms from which air distribution duct and risers branch out in all three component wings. Most of the existing equipment is beyond normal life expectancy and is no longer suitable for use. The HVAC system in Charity Hospital will require full replacement. Much of the plumbing infrastructure (distribution piping and equipment) is more than 40 years old and beyond its useful life expectancy. Numerous renovations since 1939 have taxed the existing plumbing systems beyond their intended functional capability. The plumbing infrastructure at the basement suffers from flood and post-flood damage as well as suspected extensive wear, and fixtures and equipment in many areas do not meet modern standards for use in non-ambulatory healthcare facilities. Medical gas systems have become contaminated from the flood and post-flood time periods and cannot safely be reused. It is strongly suspected that the potable water distribution system is extensively contaminated and should not be reutilized. The plumbing system in Charity Hospital, including infrastructure, fixtures and equipment, potable water distribution system, wastewater management systems, and medical gas systems will require full code-compliant replacement. HAZARDOUS MATERIALS In general the paint associated with building components is identified to be non-lead based paint. However; asbestos containing materials are present in friable and non-friable forms, as are PCB-containing ballasts/capacitors, mercury vapor lamps, and florescent light bulbs. There is also substantial mold growth on surface materials, and it is highly likely that elevated mold spore concentrations also exist behind walls and above ceiling plenums.

Figure 0.0.22 - Selective Probe Revealing Steel Relieving Angle Behind Exterior Masonry.

Figure 0.0.23 - Deteriorated Mechanical Equipment.

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The Foundation for Historical Louisiana Medical Center of New Orleans - Charity Hospital

STATEMENT OF SIGNIFICANCE
Charity Hospital possesses National Architectural Significance as a premier example of Art Deco architecture in transition to streamline modern in New Orleans, designed by the firm of Weiss, Dreyfous & Seiferth (WDS), which also designed the Art Deco State Capitol in Baton Rouge. The architecture achieves its power of effect through mass, sober symmetry, unity of design and simple yet effective, decorative details. The design also maximizes the use of the site through vertical design, and with an “H-shaped” floor plate that suits programmatic needs and optimizes density without sacrificing natural light. Charity Hospital possesses National Cultural Significance as a public welfare institution and unique model of publically funded care for the poor and uninsured that has serviced New Orleans’ indigent community continuously since the first “Charity Hospital” was established in 1737 - one of the longest continuously running hospitals in the nation. Charity is also culturally significant as a preeminent medical teaching institution at the forefront of medical practices and training since its first days in Jean Louis’ Hall, and as an institution that always admitted black patients in the South, first slaves then freedmen, well before post-Civil War laws banning racial discrimination. Charity Hospital has National Technological Significance as one of the two largest hospitals in the country when constructed, a state-of-the-art facility of its time, and a hub of innovation. When completed, it was the largest state hospital for acute and contagious diseases in the world, and offered both Tulane and LSU medical schools equal laboratory and clinical facilities. Over the years, it remained one of the richest clinical experiences for training physicians, at the forefront of key technological innovations such as early intravenous technology and early prototypes of iron lung technology. Charity Hospital has National Historical Significance as the most extensive representative of the hospice charity healthcare model, constructed in New Orleans as part of Governor Huey Long’s “Share the Wealth” program. It is also significant as an illustration of the changing twentieth century healthcare landscape in Louisiana, and the competition between state owned institutions and a burgeoning private institutions sector. Although Charity Hospital is a landmark with national, regional and local architectural, cultural, and historical significance, not all of its components have the same level of significance. The functional hierarchy is reflected in the original significance of the spaces, with main assembly areas containing the most architectural and technologically significant features. Circulation and support service(s) areas are of a scale matching that of the building, but with they exhibit few features of
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Figure 0.0.24 - Main Entry Courtyard and Original Serpentine Walkways.

Figure 0.0.25 - Historic Image of Charity Hospital Twelfth-Floor Amphitheater (ca. 1947).

The Foundation for Historical Louisiana Medical Center of New Orleans - Charity Hospital

FEASIBILITY STUDY EXECUTIVE SUMMARY

particular significance. Over the years, various renovation campaigns, shifts in use, and attrition have resulted in some loss of original building fabric. Throughout, the hospital has retained significant exterior and interior historic fabric, with a high degree of architectural or technological design and finish, which could be preserved or restored. These mainly include the main building limestone-clad facades, the Tulane Avenue courtyard, pavilions and covered walkways, the first floor main entrance and lobbies, the twelfth floor auditoriums, and the east and west wing “sun rooms.” Appropriate treatment of these areas is key to the interpretation and stewardship of this exceptional resource.

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Figure 0. Tulane School of Medicine.Charity Hospital URBAN DESIGN ANALYSIS The site of Charity Hospital is ideal for a healthcare facility.Site Access Diagram.26 . and University Hospitals.Connection Diagram Illustrating the Relationship Between Charity Hospital and the City of New Orleans.0. The proximity of I-10 makes it ideal for a level-1 trauma facility. 20 AUGUST 2008 25 RMJM HILLIER © .27 .28 . Figure 0.Diagram Illustrating Site Access via Interstate 10.0. Clinical and academic experiences are enhanced by the ability to draw students and faculty from LSU Medical School.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans .0. Proximity to the downtown and surrounding neighborhoods make it easily accessible by both vehicle and pedestrian. Figure 0.

East Section Illustrating the Proposed Atrium and Programmatic Stacking.0.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0.The Foundation for Historical Louisiana Medical Center of New Orleans .29 . RMJM HILLIER © 26 20 AUGUST 2008 .

The hospital’s first floor level did not flood and is above the required flood level. complies with modern hospital design goals of enhancing daylighting and providing views from all rooms. and hardware. Charity is well suited for hurricane and flood resistance. clearance.Charity Hospital FUNCTIONAL ANALYSIS As an essential services building. After the levees broke during Katrina there was only flooding in the basement. Functionally. A life and safety code analysis indicates that there are a number of generally noncompliant existing conditions throughout the building. such as operating rooms. The first floor can be adapted to comply with modern hospital design criteria for a wide podium for the first two or three floors. which support the bed tower floors above. On the upper floors. The existing floor to floor height is 17’-0” at the 1st and 2nd floors. 20 AUGUST 2008 27 RMJM HILLIER © . Remaining floors 4 and above are 12’-6”. perfect for inpatient beds. because of the large size of departments. radiology and emergency services. The punched openings are suitable for the installation of hurricane proof windows. Elements to remain will require remediation or corrective action approved by the local authority having jurisdiction. and a wide-floorplate podium with narrow-floor-plate blocks above. providing a podium to accommodate large and complex medical and surgical functions. with its H-shape. the design and setbacks emphasize the verticality of the building. The mass and width of the footprints of the building give it ample stability for resisting high wind loads. The design of Charity Hospital is a simultaneous composition of elegant towers that meet the ground. ideal for operating rooms and diagnostic facilities and all elements that make up a modern diagnostic and treatment podium. Architecturally. inappropriate stair widths. The building footprint. and the hospital remained accessible from the street via 5-ton army trucks. The third floor is 13’-0” and would easily accommodate an obstetrics department with its Cesarean procedure rooms. the east and west wings’ widths and column spacing lend themselves to state of the art code compliant private patient rooms and corridors.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . such as door size. they conform to modern healthcare facilities standards. that make up the diagnostic and treatment podium. egress issues such as excessive common paths of travel. or required partition fire-rating. corridor widths.

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Restored historic features will provide the reassurance of familiarity. incorporating community spaces. elevated mood. and increased quality of life for hospital patients. higher patient satisfaction. focus on wellness and education and the importance of being rooted in the surrounding community. pleasant smells. It will be operationally and aesthetically balanced. All of these are linked to shorter lengths of stay. In addition. the re-use of existing buildings is the most sustainable building strategy. and will provide a positive environment for patients and visitors. the health care industry is recognizing the need for early diagnosis. and access to art and to indoor and outdoor healing gardens. fostering health. Its sheer size of one million square feet makes the demolition of Charity a major undertaking. The design vision for Charity is one that integrates cutting edge healthcare design with sound preservation principles. and sustainable technologies. Tomorrow’s Charity Hospital will be the optimal patient centered environment. using water features.Charity Hospital CONCEPT PLAN As people are living longer and medical procedures are becoming more expensive. family-centered. its proximity to downtown and the surrounding community make it ideal for encouraging walking and the use of public transportation. As the health of the planet and the cost of energy are becoming increasing concerns. retail and wellness centers: inviting places that are as much about health and life as they are about treatment. Charity’s location and interconnectedness and its familiarity as a healthcare icon for New Orleans make it extremely well suited as a location for a state of the art healthcare facility that embraces its neighbors.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . neighborhood safety and the conservation of resources. There is no building type that warrants a healthy facility more than a hospital. Modern state of the art facilities are becoming more and more connected with their surroundings. and reminders of a better past. soothing music. modern healthcare facilities are embracing sustainable design more than ever before. 20 AUGUST 2008 29 RMJM HILLIER © .

Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0.The Foundation for Historical Louisiana Medical Center of New Orleans . RMJM HILLIER © 30 20 AUGUST 2008 .Proposed Entry Portals Along North Facade.30 .0.

20 AUGUST 2008 31 Figure 0. Figure 0. support services and patients.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . all normal support services functions are located in the lower levels of the hospital above.Vertical Circulation Diagram. The design also reinforces existing teaching relationships and clinical partnerships.0. such as the main lobby and the walk-in emergency room are located at the first level with access to all major public elevators. New spaces supporting the balance of academic medicine and best clinical practice offer the opportunity for new space and stronger collaboration. registration. As a result. surgery and diagnostic imaging. The reuse of the existing hyperbaric chamber is an integral part of the Level I Trauma Center.0. Complete separation of vertical transportation is realized as elevator systems. with limited exceptions. with facilities that are comfortable and simple to navigate. A new covered. Public entrances.31 . It is a dedicated inpatient surgical/procedure environment supporting the ED.33 . organized in treatment areas zoned to create team areas and reduce disorganization in the environment. All critical services and functions are located on the 1st level or above in order to maintain operations during major catastrophic events. The second level is the center for interventional procedures. are located on an entirely dedicated 4th floor. All mechanical support services. in order to provide a facility which supports and promotes family centered care and patient safety. as well as entrance portals for hospital service lines through openings cut into the building. and limiting unauthorized or inadvertent access. The idea is to create the best patient and family experience. materials management and support services distribution and trash and recyclables movement.Charity Hospital FUNCTIONAL NARRATIVE The new hospital is planned and designed with staff efficiency in mind. providing state of the art surgical services for the Level 1 Trauma center. Figure 0.0.32 .Proposed Functional Stacking Diagram. while enhancing staff productivity and essential wayfinding. there are no basement functions. RMJM HILLIER © .Proposed Center of Excellence Reception. air conditioned main hospital lobby in the Tulane Avenue courtyard houses cafeteria dining. The new Charity Hospital will provide Level 1 Trauma care on the first floor. An additional set of elevators provides a distinct and separate connection between trauma/emergency and surgery/intervention. old and new. waiting areas. allowing complete separation from the clinical environment. Radiology/ Imaging located in the department to facilitate efficiency in reducing steps and minimizing patient movement. are reorganized to allow distinct separation between public and staff. Integrated Team Stations for the Trauma/Resuscitation rooms will be incorporated into the general exam team areas to provide flexibility. and entries into the elevator lobbies.

Second Floor Reception from Parking Garage. Figure 0.Proposed Atrium Interior.0.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0.35 .0. RMJM HILLIER © 32 20 AUGUST 2008 .The Foundation for Historical Louisiana Medical Center of New Orleans .34 .

laundry.0. A new atrium and stair connects both floor for shared where day facilities will be constructed. This includes central receiving. acute behavioral health/alcohol-drug abuse beds and behavioral support space. Antepartum beds are located with LDR suite for patient safety. All semi-tractor trailer traffic will be shifted to the Support Services Building. intensive care bed units (ICU) with ICU pharmacy and e-ICU.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . The Laboratory/Pathology Department is to provide comprehensive services to all patients served by the hospital. Figure 0.0. The twelfth and thirteenth floors are dedicated to general behavioral health and dual diagnosis beds.36 . the GYN inpatient unit is located on the fifth floor.Proposed Patient Suite Plan. if planned appropriately. inpatient pharmacy. impatient pulmonary services. bulk food service. core laboratory. The fourteenth floor and all floors above house administrative functions. A separate Support Services Building is proposed to house the majority of support services such as materials management. from minimally invasive and interventional cases to inpatient surgical suite offering standardization and future flexibility in space utilization.37 .0. 20 AUGUST 2008 33 RMJM HILLIER © . The eleventh floor also includes on-call suites and physician’s lounges. inpatient bed units. Figure 0.Proposed Patient Suite. same-handed. separate and secure inpatient unit is dedicated to prisoners requiring inpatient treatment. These standardized. The second level also includes state of the art diagnostic imaging services. dialysis and neo-natal ICUs. A distinct. The fifth to eleventh floors are fitted out with single bed inpatient nursing units and associated support functions as programmed. bulk storage. Also included are inpatient noninvasive cardiology and neurology. deliveries via underground tunnels as well as “small truck” deliveries and daily (or “as needed”) supply distribution to each patient care area in the new hospital. The units include endoscopy. biomedical engineering. clinical research inpatient unit. acute care rehabilitation and rehabilitation therapy centers. identical patient room units follow one of today’s most publicized recommendations related to designing for patient safety. such as the VA or local hospitals. Recovery room with Post Partum rooms sized for rooming in. and other nearby hospitals. crisis intervention unit.Charity Hospital and a wide range of patient types. Delivery. Women’s Center Services are consolidated on the third level. with deployed radiology modalities close to specific patient populations supporting a collaborative care environment. The eighteenth floor’s double height space.38 . Figure 0. as well as general lab work to a range of external customers. originally a gymnasium. and patient escort services. environmental services. may be fitted out as a multi-purpose space. The proposed model for Obstetrical care is a Labor.Proposed Sixth Floor Circulation Space.

The Foundation for Historical Louisiana Medical Center of New Orleans .Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0.0. Figure 0.Proposed Atrium and Main Entrance.39 .Proposed Entry via Tulane Avenue.40 . RMJM HILLIER © 34 20 AUGUST 2008 .0.

etc. there will always be a tension between preservation and stewardship concerns. .Parking Diagram Along LaSalle Street. and a full new building fit out as required to create a modern state of the art 446 bed Inpatient Hospital. The scope of work for the Charity Hospital renovation and retrofit consists of complete demolition. public visitation. Because of the unique nature of the needs of a healthcare facility.42 . Charity Hospital is a historic landmark and symbol. and limited building additions.0. abatement and mitigation of the interiors. Some of the work is part of the base bid.Two-Lane Patient Drop-Off Along Tulane Avenue. a new Emergency Department entry for walk -in with new drop-off ramp. • Improve vertical circulation with the removal of exterior stairs and constructing new interior and exterior vertical circulation. other work consists of alternates that have been included in the cost estimate The base work includes: • Improve access and circulation with a new two-lane patient drop off for vehicular patient access from Tulane Avenue. The scope of work also includes all remedial work required to address code deficiencies that were identified in the building assessment phase.Charity Hospital IMPLEMENTATION The proposed concept design represents the Project Team’s exacting commitment to provide excellence in healthcare while respecting and enhancing this unique historic resource and complying with the Secretary of the Interior’s Standards for the Treatment of Historic Properties.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . hospital experience that takes advantage of significant and spectacular features of Charity Hospital. patient-centered. but it is also a healthcare facility. logistics. and provides proper stewardship of a historic resource by returning it to the public as a center of excellence and compassion in healthcare for the community. special equipments. 1995. 20 AUGUST 2008 35 RMJM HILLIER © Figure 0. and non-preservation factors such as functionality. and public visitation. and reversibility of future changes and/or improvements. The key factor in deciding what future changes might be acceptable for Charity Hospital were preservation of extant historic fabric. with practical implications in terms of operational requirements. It offers an optimal. Figure 0.41 . codes and regulations. security concerns. preserving and restoring certain historic elements such as the existing main lobby.0. and a new air conditioned glass enclosed addition in the Tulane Avenue courtyard. • Improve stormwater and subsurface water drainage with a new storm drainage system to convey rainwater from the roof of the building to site storm sewers and a new peripheral drainage system discharging to the site storm system.

0.Proposed Atrium Space. RMJM HILLIER © 36 20 AUGUST 2008 .44 .43 .The Foundation for Historical Louisiana Medical Center of New Orleans .0.Proposed Rehabilitation of Historic Lobby.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Figure 0. Figure 0.

extant elements or features of original construction are incorporated in the design. • Provide structural reinforcement at corridor slabs. and a full fit out with additions as required to create a modern state of the art inpatient hospital. mechanical equipment. general plumbing and specialized drainage systems. wall and ceiling finishes. with the demolition. abatement and mitigation of the interiors. storm water. electric. • Replace all doors and windows with new doors. • Repair the façade masonry to reduce water entry and moisture saturation. improve appearance. masonry repointing and cleaning. sanitary sewer. Restore the twelfth floor auditorium in the same man- • Rehabilitate remaining building interior to suit the proposed program and projected capacity.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . reconstructing the original configuration of the lobby as documented in historic photographs. including domestic water service. • Infill existing courtyards on the south side of the building with new construction up to the third floor. including the molded crown. improve original detailing where required. clinical and vacuum systems. IT/communications. water service. • New building systems including fire protection. performance and durability of masonry. 20 AUGUST 2008 37 RMJM HILLIER © . • ner. site lighting and electric supply. to match existing. interventional diagnostic suite on the second. and facilitate long-term maintenance. and as needed to accommodate new vertical shafts. cooling and ventilation systems. to accommodate the emergency department on the 1st floor. The work will include stone repairs. windows or louvers required to accommodate the new mechanical systems. natural gas. and designing an information desk that is compatible with the overall architectural fabric and decorative features. fire service. • Restore the main lobby to its original state by removing later additions. drawings or narratives.Charity Hospital • New utility services. recreating the 1939 flooring. and heating. and obstetrics and the sterile processing department on the 3rd floor. gas. Whenever possible. security. or programmatic needs and related medical equipment. All windows and louvers meet hurricane-borne debris requirements. restore deteriorated masonry assemblies.

and that will include minimal finishes that will require only hose down after catastrophic flooding. all above flood level. • Construct a new helipad. • Provide accessibility to roofs at the twelfth floor to provide exercise yards. The Project Team envisages a forty-two month implementation period.Charity Hospital FEASIBILITY STUDY EXECUTIVE SUMMARY Alternate work beyond the base building includes: • Convert the existing basement to a secured staff parking garage that will extend below the new atrium space.The Foundation for Historical Louisiana Medical Center of New Orleans . including six months in design and a three year construction period. RMJM HILLIER © 38 20 AUGUST 2008 . • Construct a new 900-car multi-story parking garage off site that includes support services and laboratory facilities on the first floor.

The cost of all of the above work is included in our construction cost estimate. and finishes will be removed. and roof.000. but we believe the cost of resolving them will be far less than the cost of a comparable new building. The floor plans included in this report show how Charity can be transformed into a modern healthcare facility. Charity can be restored and renovated at a cost of approximately 20% less than the cost of building a comparable new building on a new site. and the hospital’s floor levels are all above the Katrina flood line. an experienced estimator for both hospital and historic preservation projects. The building envelope.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans .000. 7. There is a significant cost to doing that. The recommended design will meet the latest code requirements for hurricane-force winds. except for the 3rd floor. In order to have an “apples to apples” cost comparison. and has determined that all of them can be resolved in a positive way. windows. 4.000. Existing floor plates are workable and complimentary for a first class healthcare facility. This percentage will undoubtedly increase when taking into account other construction costs of the new hospital. ceilings. 6. The factors include: 1. and by adding a limited number of beams in certain areas. 3. including exterior walls. and added the cost for land acquisition. such as the demolition of the structures on the new site and the associated remediation. The basic volumetric composition of the building. 2. The resulting comparable number is approximately $620. it will be fully functional.Charity Hospital CONCLUSION The Design Team has looked at many critical factors in this feasibility study. All interior partitions. will work well as a modern hospital. can be effectively restored. provided by VJ Associates. Their estimate comes to a total of $484. 5. 20 AUGUST 2008 39 RMJM HILLIER © . as well as an innovative entrance atrium.000. The structural system is sound. New interior fit-out of the entire building. which we do propose enlarging. to make sure that no environmental concerns remain. which has large lower floors acting as a functional podium to support bed floors above. RMJM-Hillier asked VJ Associates to also estimate the construction cost of the new hospital facility that is being planned in New Orleans. Our findings indicate that at a minimum. is necessary.

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The answer to the question of whether or not Charity can be re-made into a modern hospital is “yes. and building from scratch a brand new building. Having this valuable and structurally sound building shell already in place should save at least two years off the delivery date of a new building.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans . It will also reduce “soft” costs such as the cost of borrowing money over a longer time period. 20 AUGUST 2008 41 RMJM HILLIER © . we also believe there would be significant savings in years of time of construction required for Charity. based on facts and figures. and the expenditures associated with operating temporary facilities for an extended period. it will put the hospital on a prompter path towards generating a revenue stream. as compared to building a new facility. relocating the people who live there. which would require acquiring a very large parcel of land.” This will require a significant investment. This expedited schedule is a compelling reason to restore and renovate Charity instead of building new. but it is a cost-effective option that will save considerable time.Charity Hospital Beyond base construction costs. Finally. We urge the named parties to seriously consider this option for providing an excellent hospital facility in New Orleans. It will provide a significant savings in construction costs by reducing the timeline for labor and material costs escalation. is that the design concept presented here in this assessment has a high potential for success. along with our experience in healthcare and preservation projects. Our view.

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621 $���������������� 50.954 15.601.829.00% 13.829.098.00% $���������������� 26.482 $�������������� 320.385 $�������������� 338.438 $���������������� 58.073 2.�bond�and�insurance.13% 15.154.813.845.629.853.320.881 $�������������� 387.�and�cost�escalation 4�-�Land�acquisition�costs�based�on�MCLNO�Master�Plan�-�Adams�2007�-�Cash�Flow�Forecast�-�Escalated�8%�to�2008 20 AUGUST 2008 43 RMJM HILLIER © .000.753.�J.094.FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans .250.00% 3.850.00% 2.021 $����������� 483.793 $�������������� 388.069 $�������������� 535.650 3. design�and�construction�contingencies.031.414 $���������������� 51.417 5.692 $����������� 484.�overhead�and�profit.�Associates 2�-�Cost�estimate�includes�base�building�only�for�Charity�Hospital�and�base�building�and�land�acquisition�for�new�hospital. 3�-�Construction�cost�includes�labor�and�materials.170.00% $���������������� 58.091.00% $���������������� 89.009.000 $����������� 483.000.650 $�������������� 367.438 $����������� 620.517 New�Hospital�on�New�Site 1.000 $����������� 620.000.Charity Hospital Charity�Hospital 1.00% $�������������� 305.347 20.751.761 $�������������� 439.50% 5.771.132 $���������������� 11.984.260.000 5.236 $������������������ 6.000 1�-�Construction�Cost�Estimate�by�V.�contractor�general�conditions.695.240.175 $���������������� 43.000�SF $�������������� 349.649 $���������������� 15.105 $�������������� 331.020.469.209.423 $�������������� 380.00% $������������������ 7.393 $�������������� 445.� Cost�does�not�include�any�auxiliary�structures.000�SF TRADE�COST GENERAL�CONDITIONS Subtotal GC�OVERHEAD�&�FEE Subtotal BOND�/�INSURANCE SUB�TOTAL�:�CONSTRUCTION�COST DESIGN�CONTINGENCY Subtotal ESCALATION Subtotal CONSTRUCTION�CONTINGENCY TOTAL�PROJECT�COST LAND�ACQUISITION TOTAL�PROJECT�COST TOTAL�PROJECT�COST�ROUNDED Notes: 10.692 $��������������������������������- $����������� 561.487.00% $���������������� 17.714.50% $���������������� 12.000.

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FEASIBILITY STUDY EXECUTIVE SUMMARY The Foundation for Historical Louisiana Medical Center of New Orleans .Charity Hospital CONCEPT PLANS SITE PLANS GROUND FLOOR PLAN SECOND FLOOR PLAN THIRD FLOOR PLAN SIXTH-THROUGH-EIGHTH FLOOR PLAN EAST SECTION NORTH SECTION 20 AUGUST 2008 45 RMJM HILLIER © .