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Lake Nona is slated to get a new nonprofit rehabilitation hospital to provide care for patients who have suffered from brain, spinal cord or orthopedic injuries or strokes.

Jacksonville-based Brooks Rehabilitation will start construction on a 60-bed rehab hospital in late 2021 inside the master-planned community in southeast Orlando. The organization expects to hire 170-200 new employees once the hospital is built, CEO Doug Baer told Orlando Business Journal.

A construction team for the project has not been selected.

“We are in the early stages of planning for the new hospital, so we don’t have the specific details yet,” Baer said. “It will be located in the heart of Lake Nona’s health and life sciences district.”

The hospital will have the space to double its bed count eventually if needed.

“Brooks Rehabilitation’s hospital brings a new, specialized, medically complex rehabilitation solution to the Central Florida community further enhancing our region’s robust health care ecosystem with plenty of room to grow into the future,” Rasesh Thakkar, senior managing director of Tavistock Group, said in a prepared statement. “What impressed us further about Brooks is their commitment to research and education in addition to specialized care, enhancing people’s lives not just in the present, but innovating continuously with an eye to a brighter future.”

When completed, the hospital will join Nemours Children’s Hospital, Orlando VA Medical Center and the soon-to-open UCF Lake Nona Medical Center in Lake Nona. UCF’s hospital with Nashville, Tennessee-based HCA Healthcare Inc. is set to open in March 2021.

In Central Florida, Brooks operates a 40-bed inpatient rehabilitation hospital in partnership with Halifax Health in Daytona Beach. Brooks’ portfolio includes a research center, 40 outpatient therapy clinics, assisted-living and memory care facilities, two skilled nursing facilities, a 160-bed hospital in Jacksonville and a future second hospital in Jacksonville set to break ground in the coming months.

The planned Brooks hospital in Lake Nona is not the only rehab hospital being built in Central Florida. Birmingham, Alabama-based Encompass Health Corp. plans to build a 100-bed, 83,500-square-foot facility in Clermont on State Road 50. That facility will be built out in multiple bed phases and the hospital is expected to open in 2022.


Source:  OBJ

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The Cape Coral Economic Development Office reveals that there are six new medical offices planned to go up in that area. These long-awaited projects will help Cape Coral residents find more convenient care.

On the corner of Kismet Parkway and Del Prado Boulevard, construction crews are building a new medical clinic. Catherine Allen of North Fort Myers says, it’s about time. “I know that when people go to the emergency room they have to wait forever,” said Allen.

Cape Coral’s Economic Development Manager Ricardo Noguera said that the construction marks the beginning of a medical building boom, of sorts. It’s just one of six new medical offices set to open in Cape Coral.

“We are now at 200,000 people. We are more than double the population of Fort Myers so the medical community is taking note and they’re realizing do I want my folks to continue crossing that bridge or do I want to come to my folks? And they’re now coming,” said Noguera.

Noguera says he will continue to fight the good fight and get even more medical facilities to come to the area. Encompass Health is set to open on Pine Island Road.

The 80-room inpatient rehab hospital will be the first of its kind in Cape Coral. Annie Grove lives in Cape Coral and says they need more full-service hospitals.

“I think they’re always needed, extra hospitals, especially with the older generation here,” Grove said.

The city projects that all six of the new medical facilities could be open by as early as 2021.


Source:  Wink News

2000, 2008 and 2010 N. Orange Ave.

An Orlando medical real estate developer is looking to sell a trio of buildings near downtown.

Developer Tim Majors’ Headquarters Investments LLC wants to sell three properties — 2000, 2008 and 2010 N. Orange Ave. — for $13 million, according to LoopNet. NAI Realvest Partner Paul Partyka is marketing the properties, which have a combined market value of $4.1 million, according to Orange County records.

The properties include Majors’ headquarters, which was named an OBJ “coolest office space” in 2019, the vintage car-themed M Bar and the rooftop M Lounge that offers skyline views of downtown.

Majors bought the properties for roughly $3.6 million between July 2015-May 2018, according to Orange County records. The properties feature a 21,150-square-foot office building built in 1996, a 5,000-square-foot retail structure built in 1954 and a 5,057-square foot retail building built in 1928.

The properties — on 0.82 acres — can be sold separately or together and “can be combined with other adjacent properties to make a major presence especially if in the medical field or any complementary use,” according to marketing materials.


Source:  OBJ

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A recent virtual groundbreaking event officially began a clinical expansion project at West Kendall Baptist Hospital, part of Baptist Health South Florida.

At the heart of the project, scheduled to be completed in early 2023, is a new four-story, 126,000-square-foot tower that will house 35 additional emergency department treatment rooms, 70 new observation/inpatient beds and growth areas for imaging services and more.

The groundbreaking event on Nov. 18 was streamed live via Zoom and hosted by Lourdes Boue, CEO of West Kendall Baptist Hospital, and Aida Shafer, chair of the West Kendall Baptist Hospital Board of Directors, alongside a group of socially distanced Baptist Health executives and community leaders.

“Since our opening in 2011, we have been a vital part of the neighborhood,” Boue said during the event. “We are committed to providing an excellent patient experience along with the most advanced technology. This expansion is an investment in our community.”

When it opened, West Kendall Baptist Hospital was Miami-Dade County’s first non-replacement hospital in more than 35 years. The hospital supported a vision of West Kendall as a convenient central hub where area residents can live, work and play, and the campus’ award-winning design anticipated rapid growth in the area.

The new construction will match the modern Mediterranean style of the existing hospital and feature the same eco-friendly features that earned the hospital LEED Gold certification for Leadership in Energy & Environmental Design, a green building certification program used worldwide.

West Kendall Baptist Hospital is part of Baptist Health South Florida, the largest healthcare organization in the region, with 11 hospitals, nearly 23,000 employees, more than 4,000 physicians and more than 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties.


Source:  Community Newspapers

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Clearwater, Fla.-based Morton Plant Hospital Association purchased a medical office building and vacant land, both located north of the hospital, the Catalyst reported Nov. 25.

Morton Plant paid $1.4 million for the assets. The association owns several vacant parcels of land on the block but does not own the entire block.

The medical office building is 13,200 square feet. It formerly housed the Orthopaedic Surgery Center of Clearwater.

Morton Plant is exploring options for the property, and will pursue deals for other plots on the block.


Source:  Becker ASC

West Palm Medical Plaza in West Palm Beach, FL has been purchased by WPB Medical Office LLC, an affiliate of a local investment group, for $5.2 million.

The three-story, 43,797-square-foot, multi-tenant property, located at 4700 N. Congress Ave., is currently 63% leased; occupied by seven medical-related tenants. The building is subject to a long-term ground lease.

Situated on 5.1 acres of land, the medical office building was originally built in 1987 and underwent renovations in 2011.

Located near Interstate 95 and 45th St. in northern Palm Beach County, the property offers access to Palm Beach International Airport, Downtown West Palm Beach and the nearby Mangonia Park Tri-Rail Station. The property is additionally situated in close proximity to JFK Medical Center and St. Mary’s Medical Center.

Colliers International Florida’s executive director, Harry Blyden and senior associate, Bastian Laggerbauer represented the seller in the transaction and brokered the sale.

“At a time of so much uncertainty, medical office buildings remain a bright spot in commercial real estate,” Blyden stated. “Closing this deal required overcoming several challenges but the tenacious efforts and cooperation of all parties involved in the transaction made it possible. More than ever, it pays off thinking outside the box and having strong relationships in the real estate market.”

The healthcare real estate sector has continually experienced increased demand and low vacancy rates within South Florida, due to the area’s expanding, aging population.

“We’re very pleased to have represented the owners of West Palm Medical Plaza in the sale of this rare, value-add opportunity involving a highly-desirable medical office space in the Palm Beach County market,” says Laggerbauer. “Investors and users are aware of the space supply constraints in South Florida at a time when demand is being fueled by demographic changes, advances in technology, and policy changes. The medical office sector remains attractive in terms of both stability and diversification with demand peaking to 3.6 million square feet of space across South Florida over the past three years.”


Source:  GlobeSt.

Berger Commercial Realty/Corfac International Senior Vice President Stephen Hyatt represented the seller, TDH 2866, LLC and TDH 2870, LLC, in the sale of two freestanding medical office buildings located at 2866-2870 East Oakland Park Blvd. in Fort Lauderdale.

Sun Medical Center consists of two newly renovated buildings located adjacent to one another. The 2866 building comprises approximately 12,113 square feet on 3 floors. Broward Health, one of the 10 largest health systems in the U.S., is the main tenant in the building. The 2870 building comprises 1,940 square feet. Extensive renovations featuring Class A medical finishes were completed in 2018. The subject also features ample surface parking to accommodate medical use.

Sun Medical 2866 LLC, a New York-based investor, purchased the 1967-built, building for $4.4 million. The deal closed July 24. The buyer intends to occupy a portion of the building for its own medical practice.

The property is located on well-traveled East Oakland Park Boulevard, just east of Bayview Drive and west of the Intracoastal Waterway.

“There is tremendous demand for medical office buildings due to the stability of the sector and historically long-term tenants,” commented Hyatt. “The medical office building sector continues to be at the forefront of leading real estate sectors, even in this challenging market, and continues to show encouraging signs for acquisition as well as development.”

The buyer was represented by Lyman Phillips with Karlington Commercial.


The Orlando Health Medical PavilionSt. Cloud located on the corner of U.S. Highway 192 and Budinger Avenue is now officially opened to the public.

A ribbon cutting ceremony was held on Monday, July 27 with Brent Burish, president of Orlando Health St. Cloud Hospital; Thibaut van Marcke, senior vice president, Orlando Health Southeast Region, and president of Orlando Health Dr. P. Phillips Hospital; and Mayor Nathan Blackwell, City of St. Cloud to unveil the new facility.

“This is truly an exciting time for Orlando Health St. Cloud Hospital,” said Mr. Burish. “As more of our neighbors choose Orlando Health St. Cloud, we’re continuing to invest in services that advance care and better our community’s health. The specialty services inside this medical pavilion will make it easier for our patients to manage their healthcare closer to home.”

The 50,000 square feet, two-story building on the hospital’s campus comprises the St. Cloud Medical Group physician practices, which includes both specialty care practices and primary care offices. Ancillary hospital departments have also moved into the new space, which features space for private retail, new outpatient services, and private physician offices.

By late August 2020, a walk-in clinic will open with extended hours to provide medical services for minor or acute illness. An outpatient lab is set to open at the same time.


Source:  Positively Osceola

As medical offices struggle to keep their doors open during COVID-19, they’re often going to their landlords to request relief.

While medical office landlords might be inclined to provide this relief rather than seeing their tenants go out of business, Allison Nelson, co-deputy chair of Akerman’s real estate group, says laws specific to the healthcare sector could open landlords up to compliance issues. The main threat is violating The Stark Law and the Anti-Kickback Statute, which is a set of federal laws that prohibit physician self-referral.

These laws may be applicable when a physician or healthcare practitioner or an immediate family member of a physician is leasing or subleasing from another healthcare provider or hospital. Making things even thornier is that there could also be state corollaries to these laws.

“The [medical office] lease has to be at fair market value, and the parties can’t give concessions to each other or remuneration outside the contract,” Nelson says. “So that’s where you could get into issues with giving rent relief, which could inadvertently be considered a kickback in exchange for referrals of patients between the parties.”

In these situations, Nelson advises landlords to get their attorney involved to determine if Sark law or the Anti-Kickback Statute governs a leasing arrangement. They should also determine if the lease or sublease provides a provision that allows for a concession.

But there are situations where Nelson thinks rent relief may be acceptable. “If the healthcare system just closes down its entire medical office building and bars a tenant from use of the space, that’s probably a pretty easy example of an instance in which a rent concession is allowed,” Nelson says. “The tenant was denied access, and the whole building was shut down.”

The Anti-Kickback Statute is generally an intent-based law, according to Nelson. So if the landlord creates a policy for all tenants, that could help establish that there was no intent.

“Under The Anti-Kickback Statute, there has to be an intent to induce referrals,” Nelson says. “So if they are creating consistent policy across the board, it’s going to help mitigate that intent to induce referrals.”

Government agencies have moved to provide relief. The Centers for Medicare & Medicaid Services offered blank waivers for arrangements governed by the Stark law if related to a COVID-19 purpose. The Office of Inspector General also issued guidance that it wouldn’t prosecute or enforce agreements subject The Anti-Kickback Statute. “Hospitals and healthcare systems are looking to those blanket waivers now to give them some means for providing written concessions or other types of relief to their tenants,” Nelson says.

Nelson advises her medical office clients to create a protocol for dealing with rent relief requests.

“Maybe the tenant has to prove that they sought loans under the Paycheck Protection Program or that not getting this relief will cause an economic hardship for them that could put them out of business,” Nelson says. “That’s important with these blanket waivers. They have to be related to a COVID-19 purpose.”

Nelson says that purpose could include a lease at a below fair market value rate so a physician could treat COVID-19 patients at a hospital. “Some argue it could include rent relief to ensure medical practices stay open to serve the community,” she says.


Source:  GlobeSt.

Limiting entries, enhancing HVAC systems, compartmentalizing spaces, and creating hot zones are some of the recommendations made by local architecture firm HKS to prepare healthcare facilities for current and future pandemics. HKS released a report with details for short and long-term strategies that will help healthcare systems prepare for a potential second wave of COVID-19.

The company organized an ER COVID-19 Design Task Force made up of design, clinical, and engineering experts to compile and review effective strategies. The Task Force analyzed news stories, successful and unsuccessful facility responses, and previous publications to list eight possible concepts to help healthcare systems combat a second wave of COVID other infectious diseases.

Enhance Entry Functions

As COVID numbers began to rise, medical facilities started limiting the number of entries. Many even implemented a single-entry control point. Besides controlling entry levels, entry portals can also be used for many screening and safety functions such as providing protective personal equipment, collecting patient information, and identifying highly infectious patients.

Some short-term considerations for enhancing entry functions include providing PPE to wear when entering the facility, the use of various technologies such as rapid testing and temperature screening, and the installation of temporary materials like dry wall, plastic, or plexiglass.

Long-term considerations include providing storage for supplies like PPE and wheelchairs, inserting hand-washing stations near the entry, creating negative pressure capabilities, and providing space for new technologies that could strengthen diagnostic and security can help facilities manage future pandemics.

Support and Reinforce Personal Protective Equipment Management

PPE is an effective way to protect not only patients but health care workers. Different circumstances require different levels of PPE and how often it needs to be changed. Some hospitals have even created policies for reusing PPE in order to conserve it.

“PPE for decades has really been an afterthought design, which puts nurses in the position of using mobile or makeshift solutions for storage,” Sarah Holton, Vice President at HKS, said during an online seminar about the report. “Our opportunity as a design leader is to really advance the strategic placement of PPE in the design process. By carefully integrating PPE in the design dialogue, we more effectively support the principles of infection, prevention, and its use.”

Potential strategies to be implemented now include placing PPE at key entries, creating areas for donning and doffing the equipment, designating space for cleaning reusable PPE, and installing foot-operated door pulls. Looking ahead, the Task Force suggests separating donning and doffing PPE areas away from patient care areas, installing a sink at doffing areas, creating disposal stations into rooms near exits.

Bolster Resistance to Pathogens

Implementing effective policies can help strengthen resistance to pathogen threats and reduce the risk of infecting patients and staff. The concept of bolstering resistance to pathogens strategies considers water integrity, all surfaces, and air purity. Another thing to take into account when developing resistance to pathogens is the ability to remove all items from a room. One short-term modification is to use carts.

“We consider the use of carts rather than permanent cabinetry that can be removed so the room can be fully clean. Carts could be removed if unnecessary during the particular patient course of treatment.” Holton said. “Placing equipment outside of the room when possible to limit the need to go in and out of the room is very helpful.”

Other immediate modifications include implementing temporary negative pressure with exhaust to enhance isolation areas, placing select equipment outside of the patient’s room, covering high-risk surfaces with adhesive films that can be easily cleaned, labeling high-touch surfaces with specific signals that indicate to housekeeping staff that frequent cleaning is required, and using hydrogen peroxide misting or UV light disinfection.

Health care facilities can implement strategies such as using cleanable surfaces, using high touch strip concepts to enhance cleaning, providing access to equipment from outside of the room, creating a unidirectional flow suite that separates doffing and donning areas to help reduce contamination.

Enhance Heating, Ventilation, and Air Conditioning Systems

HVAC systems in medical facilities play an important role in stopping and destroying a virus from spreading throughout the hospital. Because many diseases can spread through the air, enhancing HVAC systems is an important step in limiting the transmission of diseases to patients and medical staff.

“Being a global company, we had the ability to start getting an understanding of what other regions were doing in Asia and in Europe,” Nolan Rome, Senior Vice President at engineering firm WSP, said. “It really came down to the basic premise of all healthcare, which is that directional airflow of clean to less clean and to pull that air using negative pressure and the contaminator away from the caregiver, as they provide care to the patient.”

Potential near-term policies that could help enhance HVAC systems include upgrading filters in air handling units to include High Efficiency Particulate Air final filters, operating the air handling units serving COVID-19 areas at 100 percent outside air with full exhaust, creating temporary negative pressure rooms with direct exhaust through HEPA filtration, and installing temporary ante-rooms for negative pressure isolation rooms with HEPA filtration.

Looking ahead, healthcare systems should consider pressure monitors for all areas that require pressure compartmentalization, designing air handling units for emergency department areas to handle 100 percent air for pandemic operation, implementing purge mode that will allow the entire ED to be exhausted, and validation of directional airflow patterns.

Strategize for Compartmentalization

The strategy of compartmentalizing a department into multiple zones can be effective in caring for different groups of patients. In order to successfully compartmentalize units, health care facilities must take into account access to critical resources, equipment, and supplies as well as accessibility, stairs and elevators, existing fire safety plans, and interstitial spaces.

“Looking at the long-term considerations and essentially something we do in our Asia practices regularly is to start to look at creating areas of compartmentalization,”Rome said. “We start to give ourselves a seasonal pandemic or a seasonal flu plan where we can isolate entire parts of the body and isolate entire patient wings, so we can give ourselves a parallel path to be able to treat our acute and relatively well patients in a way that allows for revenue stream that also allows us to process the pandemic patients at the same time.”

Changes in the near future for compartmentalization include using secured interlocking double doors, using tape, sealers, and caulk to limit air leaks, stock adequate supplies and equipment in each zone, and color-coding areas to visually represent the risk/precaution level and help establish safe behavior.

Long-range considerations include designing ventilation systems to isolate cohort compartments, using air pressure gradients that match the level of disease spread, and taking advantage of fire door requirements to create compartments.

Delineate Safe Zones and Hot Zones

During a pandemic, it may be difficult to establish a completely safe zone. Nevertheless it is important to create an area where healthcare workers are able to operate with less PPE and be safe from contamination. In order for the safe zone to be effective, medical staff need to easily understand the level of safety a zone needs and the delineation of the zone.

“This takes a look at how you would alter the corridor going into the room in a very simplistic way. Number one, outside of the room, you would have a great area which is for donning,”Jim Lennon, an ED Specialist said.  ‘On the door and wall is a color-coded system representing various levels of infection. Similarly, you try to make your exit on the left side with hand sanitizer and some kind of PPE disposal.”

Other solutions to establish clean safe zones include using tape or stanchions in circulation areas to separate clean and potentially contaminated flows, creating color-coded floors, walls, or doors, making sure signs are simple to read across languages or creating universally recognizable icons, using portable screens to separate zones, and adding physical barriers where appropriate.

Color-coded doors, embedded LED lighting that change color to represent different conditions, the usage of different colors in flooring materials, and pass-throughs for equipment can help medical facilities establish effective safe zones in the future.

Expand and Facilitate Telemedicine Usage

During the pandemic, telemedicine became more widespread. Telemedicine prevents exposure and allows for the preservation of equipment.“We want to develop a security structure that utilizes all of these tools and establish a space that can support medical professionals providing telemedicine services and dedicated telemedicine rooms,” Holton said. “The idea is that [the telemedicine rooms] should ensure acoustic privacy, good speech clarity, adequate lighting, and clarity space expressions.”

Long-term strategies including considering a center where telemedicine can be coordinated, including a health system logo on the room or on the feed, considering on-site tele-triage, and establishing patient spaces for incoming telemedicine support.

Provide Surge Capacity

During the pandemic, ERs have been running at or beyond their capacity levels. In planning for the future waves, every space near the ER must be considered for re-purposing in order to handle the influx of patients.

Portable equipment to minimize the need for bedside electrical, rapid assembly of surge structures, using rigid structures, providing well stocked areas with high use clinical and cleaning supplies, zoning immediately adjacent surface parking areas for environmentally controlled deployable, and rapidly connecting to existing hospital sources of medical gases, water, electrical and data outlets.

When designing new facilities, features such as slightly over-sized ED treatment rooms, docking area for temporary structures, ED canopies that can be easily enclosed to become indoor spaces, pre-wire and pre-plumb common spaces with power increases a hospital’s ability to surge during a crisis.


Source:  Healthcare DMagazine