In most ways AdventHealth Palm Coast Parkway, as the crescent-shaped 100-bed hospital rising in the heart of the city will be called, is a construction site like any other, just bigger: there is no larger construction site in the city or the county. Almost every inch of the 10-acre site swarms with heavy equipment, piping, rebar, slabs of all shapes, a giant red crane, and any one of the 112 hard-hatted men and women appearing and disappearing behind the naked tilt-up concrete panels of what will be a 158,000-square foot structure four stories high when it opens in the spring of 2023.
In another way it’s the living metaphor of the permanent mission ahead: a hospital is nothing if not a reconstruction zone for human bodies, with physicians and their specialized teams soon to be spunlaced rather than hard-hatted in the very same spaces, repairing, excavating, soldering, cauterizing and curing, using equipment that operates on the same principles as the heaviest construction-zone equipment, but on a more atomized, more organic scale.
Since “Erection Day,” as a felt-tipped notice jotted on one of the whiteboards in the general contractor’s conference room referred to what the Amish would call a barn-raising–the days when the 60-foot panels started going up, transfiguring the site into an apparition–drivers along both sides of Palm Coast Parkway have been seeing a Coliseum-like structure take shape before their eyes, and possibly wondering what it must be like in there. AdventHealth’s marketing team, seeing that long dry spell of splashy stories between groundbreaking and ribbon-cutting, must’ve figured this was a good time to give people a peek inside. So reporters were invited today to take a tour–escorted and prefaced with a safety briefing in keeping with OSHA regulations. As the assistent superintendent put it, “We have some semi hazardous work in progress.”
When AdventHealth first announced plans for the hospital in January 2021, it was to be a $100 million project–$1 million a bed–with a scheduled opening of late 2022. Five months later the plans added a two-story medical office building to go up simultaneously, rather than the previous phased-in approach. When AdventHealth officials gathered to choreograph and tape what was to be a virtual groundbreaking last September–as Covid was still on a rampage–the cost of the project had risen to $145 million. Today, that cost is $164 million, according to David Gordon, AdventHealth’s program director of major projects, who was among the officials leading the tour.
“There have been challenges, but we’re working through them,” Casey Mabe, Robins & Morton’s superintendent, said this morning. “Nothing that’s going to impact the opening of the project or anything else like that. We’re managing it properly.”
Contractors across the country have seen construction costs spiral from a combination of high demand–construction has been brisk–and strained supplies, because of supply-chain issues. AdventHealth itself is currently developing 12 construction projects in Central Florida alone, David Breen, AdventHealth’s external communications manager, said, including the construction of an in-patient tower in Winter Garden and a new emergency room at another facility.
AdventHealth Palm Coast Parkway–a name likely to cause confusion for first responders and 911 dispatchers in a hurry, given its kinship to AdventHealth Palm Coast–will initially open with 80 beds, not 100, and will have its own emergency department, imaging, five operating room suites, two endoscopy suits, with support services and the 30,000 square foot medical office building, with outpatient rehab services, orthopedic services and so on. On opening day there’ll be about 400 jobs, with an average wage of $67,000 a year, assuming Weimar-type inflation doesn’t affect that too much. At the groundbreaking last year, AdventHealth officials said there would eventually be up to 700 jobs on that campus alone. Combined with the more than 900 jobs at the existing AventHealth Palm Coast, the company, already by far the largest private-sector employer in Flagler County, could eventually surpass the Flagler County school district as the largest employer, period. The district has 1,800 employees.
It’s not just nursing that’s driving the new jobs, Gordon said. “We’ll have entry level will have semi professional clinical non clinical opportunities,” he said.
The guts of the construction site themselves are not remarkable in the main, until you start taking note of certain unexpected details: for all the ongoing construction, it is somehow remarkably clean, as the interior bare concrete floor were being regularly swept and shined. All the tilt-up concrete panels, 9 inches thick at ground level, 12 inches thick above it, were poured and cured for weeks at a time on site, as they will be again once the medical office building is built. (See how such walls are built and insulated here and here.) The hospital’s structure will withstand up to 150 mph winds and will be among the safest buildings in the county. Mabe said. If just 112 workers were on site today, construction employment will more than double over the next few weeks and months as activity multiplies with the pouring of the last floor and the roofing, than the interior construction accelerates.
It is all astoundingly efficient, as Mabe, the superintendent, illustrates, taking out his mini iPad-like device and riffling through any and all building designs and plans he needs at any given time, in any given spot. Previously, everything was hand-drawn, and every drawing had to be kept in a trailer or trundled through the site, using up time and lending itself to misplacements or error. No more. It’s now all in the palm of the superintendent’s and others’ hands. Every model is computerized to the slightest detail and schematized along a timeline: here’s what it looks like now, here’s what it looks like when done. Every element is coordinated, from sanitary piping to electrical wiring to any other behind-the-walls anatomy.
In a short time, all areas of the building will be tagged with QR codes that, the moment they’re scanned, it’ll pull up “what the room is, the ceiling height, what utilities are in there, what changes have been made, pretty much anything about it if there’s been like a request for additional information about the room, anyone can come out here with that application,” Mabe said. “The old way of doing it, you have to go back to the office, ask the project manager, hey, I need this drawing. It’s amazing.” Then he describes the capabilities of 3D cameras.
That’s why the contractor could set up offices well off the property, in the Roma Court center, a long walk from the building under construction. But technology has made those distances irrelevant, all of it helping to make construction more efficient and speed up construction. Bad weather can still interfere. Three days of rain-outs per month are built into the construction schedule.
When built, the hospital and patients’ rooms–all private, single-occupancy–will not be distinctly different from those at AdventHealth Palm Coast. As construction stood today on the third floor, a vast smooth-concrete plaza rimmed by those outside walls but as yet not subdivided into rooms in the least, the telltale signs of each room were delineated by their sleeved pipes in the floor–where the shower will be, where the lavatory will be, room after room curving around the structure, and the placement of the future nurses’ station near the middle.
The floors below have started to be subdivided, looking more like thickets of skeletal scaffolding and steel or aluminum framing. It still doesn’t look like a hospital, except in the ether. But it’s a matter of months. Before long the hospital’s permanent role as reconstruction zone will replace hardhats with masks, hammers with scalpels, rebar with silk. After the boasts and projections and ribbon-cutting pride and banal speeches will follow hope and sorrow, pain, comfort, grief, relief, despair and joy and all the other heavy equipment of existential bottom lines. Only then could it be called a hospital.
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David Schaefer says
Interesting, but I feel they could have expanded the E.R. , patient rooms to 180 beds , built more O.R.’s and saved millions of dollars at the current location on Rt 100. Also give what the citizens are asking for a Labor & Delivery wing and Pediatric unit.
Meredith Martin Davis says
Agreed and good luck to Advent finding nursing personnel since there is no affordable housing for young middle income working people. This new Advent wont be much different than the other Advents around the area. More so-so.
LetsBeReal says
The average Nurse salary in the United States is $87,923 as of February 25, 2022. The range for our most popular Nurse positions (listed below) typically falls between $45,438 and $130,408.
https://www1.salary.com/Nurse-salary.html
Nurses don’t have a problem. Last time I looked AdventHealth had a $10,000 sign on bonus.
Mark says
LetsBeReal, Nurses are a small percentage of a hospitals staff. Most hospital jobs are on the lower end to make a hospital work 24/7.
LetsBeReal says
@ Mark – I thought the subject was Advent finding nursing personnel. My bad.
Robert Deak says
Well Said….
Advent cannot even find patients in a 100sq.ft.
Office…
Finding ….
Never before heard of ‘DISCOUNT/
Dollar OFF HOSPITALS BUT I GUESS THIS IS EXACTLY WHAT PALMCOAST GETS FOR OUR MONEY!!!
Denali says
While I agree that the listed services/additions are necessary, it becomes a financial decision driven by the CMS. During the last expansion Advent was limited to the numbers of beds added because of Medicare/Medicaid requirements. Back when I was involved in hospital design we often found it to our clients benefit to build a second facility rather than add on to an existing.
Another issue on this new site is that there is absolutely no room for expansion, watch O’Riley’s to find their lease canceled or not renewed.
Shawn says
The state determines how many beds the facility can be licensed for based on need. The license can be increased at a layer date if it can be shown the need has increased.
Skibum says
I’m pleased with the progress and appreciate the update. One thing is still concerning to me, which was thankfully mentioned in this update, and that is regarding the proposed name of our new hospital. I have been saying from day one that AdventHealth needs to come up with a name that is not so close to the name of our current hospital on Rd. 100 because that will inevitably cause confusion for patients and their families as well as for 911 dispatchers and first responders. I had proposed calling the two hospitals AdventHealth South for our current hospital, and AdventHealth North for the new one, but something else besides AdventHealth Palm Coast Parkway PLEASE!!!
ASF says
Interesting, considering that whenever the current Palm Coast Adventhealth Hospital gets beyond being 20-30% filled to capacity, their ability to render acceptable service decreases dramatically. Sometimes, you need more than just bed space and fancy equipment to render quality medical care.
BMF says
His anyone nows what’s building across from the new hospital in Palm Coast Parkway next to Wends ? Thank You !!!!
Joe Stolfi says
I agree with your statement — kind of .
I can’t comment on capacity being the determination of rendering quality care
at the local Palm Coast Adventhealth Hospital .
I can, as a retired RN, comment on quality care as being:
1. having adequate staffing ratios,
2. having necessary equipment and supplies,
3. having a management that considers people as patients and not customers,
4. understands that their greatest asset is their employees – and treats them like that ..
Of course what I can wish for, and the reality of those wishes,
have been negated by the bean counters .
I do remember when hospitals were run for, and considered a patients condition,
during their stay, discharge, and follow up care . SADLY, it seems to me this is long lost .
I don’t hold much hope for this new hospital to be anything other than another money mill ..
Charlie Ericksen Jr says
Especially in the Emergency room Where there are no Fill time MD’s in the ER areas and then need to be taken out of the floor staff. Last week end , when I was in ER, there were no MDs on duty, and the wait was 2-4 hours ,,,The doctors are the ones also providing patient care on the floors..
Mischa Gee says
I am not convinced that the building will withstand 150mph winds, since all the exterior walls have buttesses holding them up. This tells me the cross beams between both sides of exterior walls will be the only thing keeping the building from falling. If the wind causes too much sway, will those cross beams really be enough?
I also think having a hospital situated between the East and West bound lanes of an already overly busy roadway will have a very negative impact on traffic flow, especially based on the increase in population.
In that regard, I agree with Mr. David Schaefer, the current hospital location is in an area where there’s plenty of room. They could have built another hospital building just for obstetrics and pediatric care, a separate cancer treatment building and added more in patient rooms with little to no impact on traffic at it’s current location.
When is the town council going to really sit down and think things through to not just how they think something will work in the short term, but also how it might affect the community as it grows.
We don’t have enough through streets as it is, getting to and from that hospital location will become a nightmare for f no future alternative through routes are developed.
Corporal Obvious says
Holy smokes! What are all those architects, structural and civil engineers and politicians thinking for not consulting with Mischa Gee of Palm Coast, Florida because making what will clearly be a collossal mistake by everyone involved, regardless of background, education and experience.
Mischa Gee says
I am asking questions, because we haven’t been given information. Let’s hope the structural engineering is sound, buildings have failed before.
The bigger problem will be when the development of Saw Creek is completed, the Senior Living room s completed, and more of the vacant lots in that part of town have houses and businesses on them the traffic will be a nightmare. This town is not built with enough through roads on a grid system. All the developments eventually dump out onto Palm Coast Parkway, Matanzas Woods Road and Rt 100 going east/west and Rt 1, Belle Terre Parkway , Interstate 95, and Old Kings Road going north/south. I have already experienced having to drive in excess of 5 miles out if my way because of a road being closed due to an accident,. These roads are already handling very high levels of traffic. Without other through roads going five miles could take an hour. Imagine what an Ambulance, PD or FD vehicle will get entangled with during an emergency.
Where was the background, experience and education when Levitt and Sons laid out all these picket developments?
I guess they weren’t really thinking ahead.
Some times all it takes is common sense, which has become less common since I was a kid, to see the ramifications of action taken without forethought.
Nope says
Took my partner to Advent because she was having chest pains and issues breathing. 8 hours later, we got a room. Two hours later, she was dismissed to her primary saying welp can’t find anything, follow up with them. Got the bill yesterday – $3475.
Ten years ago, they waited too long to operate on her uncle. He died in the operating room from a massive heart attack. We took a chance going there but nope. Never again. I’ll drive 90 to Baptist before I ever step foot in Advent.
Cindy says
I hear you…the place is sub par.
Mark says
Too large for a 10 acre parcel and too tall so close to the residences. A regular eyesore that should have never been okayed for that land. After the employees park where are the visitors supposed to park? Problems lay ahead with traffic too for that location. Will a stop light or two be installed for those traversing Bridgehaven between the Parkway? Lack of maternity services should have been addressed for this building too, population over 85,000 and have to travel 20+ miles for maternity services, ridiculous.
Peaches McGee says
Average US nurse salary is far different from NE Florida. Advent Health routinely ‘forgets’ to survey nursing salaries against competitive facilities.
Mary Fusco says
Any state only pays the going wage for any job. My daughter is an RN. Moved here from NY several years ago. Took a huge pay cut.
Rick says
Thank you for the update, great article.
As mentioned in the comments above is the building on the southside of Pam Coast Parkway a parking garage? Will there be a raised pedestrian walkway or crosswalk with stoplights there? With a speed limit of 45 mph I hope this is in the planning.
Mark says
Appears it might be for utilities or something for the main building, no windows just a front entrance. Lots of pipes laid before building even started. Would be interesting if it is for utilities, bore under the Parkway or dig up the Parkway for months to cross it.
Carvalho says
At least it’s not another – car wash – pizza joint or gas station !!!!!
Flatsflyer says
All the new storage facilities will be converted to studio apartments for the new workers. Rackem and stackem. Good foresight other part of our city fathers.