SOW - Att 01 - Farnsworth - Bldg 110 - CFA Exp Study - Residential Recovery Prg - Honolulu.pdf

Building 110 Center for Aging (CFA) Post-

Traumatic Stress Disorder Recovery Rehabilitation Program

(PRRP) Addition

Krukowski Rd/ Building 110 Honolulu, HI 96819

August 3, 2022

VAPIHCS, Facilities Management and Engineering Services/ Building 110 CFA PRRP Addition Honolulu, HI

VCI / FARNSWORTH GROUP / 1

TABLE OF CONTENTS

1.0 EXECUTIVE SUMMARY

1.1 Project Scope

1.2 Background

1.3 Project Approach and Methodology

1.4 Recommendations

1.5 Cost Overview

2.0 EXISTING BUILDING INFORMATION

2.1 Record Drawing Review

2.2 Site Information

2.3 Existing Building Description

2.4 Engineering Systems

3.0 CONCEPTUAL FLOOR PLAN ALTERNATIVES

3.1 Conceptual Option 1

3.2 Conceptual Option 2

3.3 Conceptual Option 3

3.4 Renovation

4.0 ENGINEERING SYSTEMS ALTERNATIVES

4.1 Mechanical Design Options

4.2 Electrical Design Options

4.3 Plumbing – Domestic Hot Water

4.4 Other Issues and General Engineering Systems

5.0 COST ESTIMATES

5.1 Expansion Alternatives

5.2 Renovation Alternatives

5.3 HVAC System Alternatives

6.0 APPENDICES

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1.0 EXECUTIVE SUMMARY

1.1 PROJECT SCOPE

Farnsworth Group was engaged to perform a feasibility study at VAPIHCS, Building 110 Center for Aging (CFA) to evaluate the existing B110 (43,305 BGSF) footprint and identify critical building systems requiring repair or upgrade to support an expansion of 12,000 SF for the Post-Traumatic Stress Disorder Recovery Rehabilitation Program (PRRP). A Program For Design (PFD), dated 28 Jan 2022, was developed by the VA to establish the program requirements for the PRRP expansion which included 13,167 departmental gross area and an overall building gross area of 16,722. As part of the scope of work, the project may only include 12,000 SF of building expansion and as such a review of possible co-location of the PRRP program within the existing Building 110 footprint was required.

A renovation scope of up to 15,000 SF was also included in the project to address areas for possible co-location of the PRRP program. The VAPIHCS Engineering Services has also maintained a Facility Conditions Assessment (FCA) document outlining the condition and age of materials and building systems within the existing building. While providing project corrections noted on the FCA is not a directive in this project, any areas undergoing renovation as part of this project is understood to correct any deficiencies in the representative renovation areas.

Project Code Requirements include:

PG 18-12 INPATIENT MENTAL HEALTH (IPMH) & MENTAL HEALTH RESIDENTIAL REHABILITATION

TREATMENT PROGRAM (MH RRTP) DESIGN GUIDE (JANUARY 2021)

o PRRP Program

PG 18-12 SMALL HOUSE (SH) MODEL DESIGN GUIDE (JANUARY 2017, REV. MARCH 2019)

o CLC Program

PG 18-12 SPINAL CORD INJURY/ DISORDERS CENTER DESIGN GUIDE (NOVEMBER 1, 2020)

o CLC Program

2021 NFPA 101 LIFE SAFETY CODE

PHYSICAL SECURITY DESIGN MANUAL FOR VA LIFE-SAFETY PROTECTED FACILITIES (JANUARY

2015) o APPLIES TO THE EXISTING BUILDING 110 ONLY o DOES NOT APPLY TO PRRP BUILDING EXPANSION

The facility is served by seven air handling units with Dx Cooling. There are nine outdoor condensing units providing cooling to the seven air handling units. Heating is provided by terminal units with electric reheat coils. General exhaust fans serve restrooms and other support spaces. The existing HVAC System is original to the building and is recommended to be updated. A New HVAC Upgrade Project is planned to be in construction in 2023. The scope of the HVAC Upgrade project is:

1. One air-cooled chiller will replace all nine outdoor condensing units.

2. New AHUs to serve the existing space; existing AHUs to be abandoned in-place

3. Replace existing terminal units with new terminal units to control supply air into the spaces

Currently, the Domestic hot water system does not have any issues since recirculating pumps and various fittings have been renovated to maintain the system.

The normal and emergency electrical equipment and gear is original to the building. It is recommended that the emergency generator be replaced. The existing generator will be replaced with a new diesel

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generator and the existing transfer switches will also be replaced with new bypass isolation transfer switches. Refer to Section 4.2 for discussion.

To determine the ability of the existing normal service to accommodate expansion and renovation loads, electrical metering of current usage is required. Based upon issues including outage scheduling, this was unable to occur. It is assumed a new, larger electrical service is required to serve the expansion and backfeed the existing service. The new service gear will be located in an addition to B110A.

Many low-voltage systems have either already been upgraded (nurse call) or there are current projects underway to upgrade them (fire alarm, internet). There is also a project underway to integrate the duress and nurse call systems. Low voltage systems will be extended into the expansion area and updated in the renovation areas.

Lightning protection and seismic bracing are critical infrastructure items noted in the FCA that have yet to be addressed by the facility.

1.2 BACKGROUND

The existing building was designed under the 1991 Uniform Building Code (UBC) with construction completed in 1997. The Center for Aging, Building 110, is a 43,305 GSF building including a 60-bed licensed CLC program which also includes Acute Rehab (GREC). Since the onset of COVID-19 in 2020, modifications for the program use of the building were made to accommodate a temporary co-location of the PRRP program comprised of (8) double-bed rooms on the South side of B-Wing. With the support functions for the PRRP program also in this area, the current maximum bed capacity for the PRRP program is 12 beds but operates at a lower quantity due to COVID and the need for quarantine.

The A-Wing is comprised primarily for administrative functions, serves as the primary entrance, includes major engineering support functions, kitchen, and dining, as well as the Acute Rehab program. The B- Wing generally includes double bed bedrooms with shared bathrooms for the CLC program, along with the temporary co-location of the PRRP program. The C-Wing includes the most vulnerable population and hospice in single bedroom with bathroom for the CLC program.

The facility is served by seven air handling units with Dx Cooling. There are nine outdoor condensing units providing cooling to the seven air handling units. Heating is provided by terminal units with electric reheat coils. General exhaust fans serve restrooms and other support spaces.

Domestic hot water is served by two natural gas boilers with re-circulating pumps to maintain hot water in the pipes. There is also a 460-gal storage tank to provide adequate hot water to the facility.

The normal power service is fed from a 500kVA, 11.5kV to 480Y/277V exterior pad-mounted transformer which services an 800-amp main distribution panel (MSB). Emergency power is provided by a 200kW diesel generator with a day tank and an above-ground exterior fuel storage tank. The generator, day tank and transfer switches are in one room in B110A; normal distribution panel MSB is in another room of B110A. B110A is located in the south end of the parking lot of the facility.

The overall footprint broken into 3-wings of the existing building generally extends across the entire property and encloses a series of courtyards used by the residents. Available space on the property is limited in supporting the proposed 12,000 SF expansion for the PRRP program.

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1.3 PROJECT APPROACH AND METHODOLOGY

Farnsworth Group was provided a full record set of drawings from the original construction, as well as a recently completed (March 2022) HVAC System Upgrade project through 100% Construction Documents.

A code analysis was performed to understand allowable building area requirements to support the 12,000 SF building expansion. In general, the existing building footprint of 43,305 GSF is already near the allowable building area for an I-2 occupancy, sprinklered building, with limited frontage availability.

As such, an alternate construction approach for the expansion including fire walls and independent structure is included. A detailed code review is provided later in this study.

A site visit was conducted on 16 March 2022 which included a review of the existing building to better understand expansion opportunities. With the building footprint stretching across the entire property and enclosing courtyards that are heavily used by residents, it quickly became evident that alternate expansion opportunities needed to be explored. The property to the South includes an elevation drop of approximately 20’-30’ and connects to an existing parking lot that serves the Army Corps of Engineers. Even though this area is outside of the existing Building 110 CFA property boundary, the steep slope lends itself well to provide for a 2-story addition with separate and distinct entrance for the PRRP program with a shared parking lot with the Army Corps of Engineers.

Further review is required to provide for a shared agreement between the Spark M. Matsunaga VAMC and Army Corps of Engineers.

Interviews with key stakeholder as well as a review of their existing program space provided insight into potential drawbacks in co-locating space between the CLC, Acute Rehab (GREC), and PRRP program areas. Both the CLC and Acute Rehab (GREC) programs do not have enough space to support the staff required to operate the programs and does not currently have space to share. Additional safety and health concerns in co-mingling CLC residents and PRRP patients is also an issue.

Four (4) conceptual plan alternatives were evaluated:

The available building expansion space at the CFA Building 110 space is very limited and not conducive to expand the requested 12,000 SF for the PRRP program without taking over important courtyard space for the CLC program. Concerns for how the two programs intermingled was also an overall constraint for how best to locate the PRRP expansion. Four (4) expansion alternatives were explored to identify appropriate CLC and PRRP program adjacencies while being sensitive to the health and wellbeing of the CLC residents and their access to the outdoors. These options include:

Option 1: 2nd story addition over A-Wing Option 2: C-Wing Expansion (2-story) Option 3: C-Wing Expansion (2-story) Option 4: B-Wing Expansion (2-story)

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1.4 RECOMMENDATIONS

The overarching success factors in providing a recommendation for expansion include a relatively strong separation between CLC and PRRP functions including a separate entrance and minimal overlap of residents and patients within the building. Additional considerations include minimal to no downtime in building occupancy and use during construction as well as maintaining access to the already existing courtyards for resident use.

The recommended PRRP option to serve the new expansion is Option 3 which includes a 2-story expansion from C-Wing with the primary Patient Care Unit and adjacent spaces on the Lower Level and Patient Services on the Main Level.

1. Creates its own identity distinct for the PRRP program for the Patient Care Unit on the Lower Level.

2. Patient Services area included on the 2nd story provides the potential for sharing of exam room space, while still providing a distinct separation between CLC and PRRP programs.

3. Provides a visual and noise separation with Patient Care Unit separated on its own building level.

4. Provides for a direct connection of the PRRP patients directly to the exterior courtyard, and includes both a enclosed, private courtyard as well as a more open covered patio.

Three HVAC Options were provided for this Design Study to serve the New Expansion Building. See Section 4 and Appendix 7.6 for detailed information of each option.

1. HVAC-1: Air-Cooled Chiller and Air Handling Unit

a. Match existing maintenance and operation

b. Provide chiller redundancy

2. HVAC-2: Air-Cooled Chiller and Fan Coil Units

a. Provide chiller redundancy

b. Ease of installation and operation

c. Available supply

3. HVAC-3: Variable Refrigerant Flow (VRF) System

a. Ease of installation

b. Ease of maintenance and operation

i. Does not require chiller technician

c. Available supply

d. Lower first cost

Option 3: C-Wing Expansion – Main Level

Option 3: C-Wing Expansion – Lower Level

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The recommended HVAC Option to serve the new expansion is HVAC-3: VRF System due to the following:

5. Lower capital cost

6. Ease of installation

7. Simple operation and maintenance

8. Available supply of parts

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2.0 EXISTING BUILDING INFORMATION

2.1 RECORD DRAWING REVIEW

Record architectural, mechanical, plumbing, fire protection, electrical, and structural engineering CAD drawings from the original construction of the building, dated May 29, 1998, were made available to Farnsworth Group for this feasibility study. Farnsworth Group utilized the record drawings to determine how the building is configured, to understand how the building is currently used programmatically by department, and to understand the space utilization and adjacencies. The engineering systems were used as a baseline for what was currently installed to perform an analysis of capacity and condition of engineering systems.

A recently completed 100% CFA HVAC System Upgrade Minor project, dated March 25, 2022, was also made available. It is understood that this project will be constructed by the next fiscal year, 2023, and as such were reviewed with the understanding that these systems would be in place as part of the implementation of the findings in this feasibility study.

Table # 2.1 Record Drawings Referenced for Feasibility Study

Date Discipline Drawing Issue Arch/Eng of Record Comments 29 May 1998 Structural Record Drawings SSFM Engineers, Inc. Original 29 May 1998 Architecture Record Drawings Architects Hawaii Limited Original 29 May 1998 Mechanical Record Drawings Cedric Chong & Assoc., Inc. Original 29 May 1998 Electrical Record Drawings Douglas Macmahon, Ltd. Original 29 May 1998 Plumbing Record Drawings Cedric Chong & Assoc., Inc. Original 29 May 1998 Fire Protection Record Drawings S.S. Dannaway Assoc., Inc. Original 29 May 1998 Civil Record Drawings Sam O. Hirota, Inc. Original

25 March 2022 Architecture, Mechanical, Electrical

100% Construction Documents

Apogee Consulting Group, P.A.

HAVC

System

Upgrade

2.2 SITE INFORMATION

The CFA Building 110 is a single-story building with several access points around the building at the end of each wing and in between each building wing. Entry and exiting from these exterior doors is connected to a series of sidewalks that wrap around the building which generally are not convenient to serve as a permanent main entrance to the building. The main entry point to the CFA Building 110 is from the East and includes a drive-under canopy, adjacent parking lot, and service delivery area at the Southeast. Overflow parking is located to the South at the adjacent Army Corp of Engineers property parking lot. Access from this parking lot includes a sidewalk and several sets of at-grade steps. Site circulation for deliveries and waste management are located on the South side of A-Wing.

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The remainder of the property includes a decorative metal fence on the North, West, and South side providing a boundary to the courtyard areas available to the residents.

These courtyards are very important to the health and wellbeing of residents and are frequently used for outdoor programming and general everyday use. For the past two years (2020-2022) during COVID-19, the PRRP program has utilized a designated courtyard area to the North adjacent the Multi-purpose room. The CLC staff has also temporarily given access to the South courtyard to the PRRP program during this time. The CLC program desires to have all of the existing courtyard back to serve the CLC residents when the PRRP program moves to their final location. In general, the South courtyard has a slight slope to it and provides the best views to the ocean. The overall property is relatively flat, but slope down to the South and a series of retaining walls are included to address the dramatic drop-off to the Army Corps of Engineers property to the South. A topographic survey is not included in this study, but an estimate of +/- 30’ is assumed.

2.3 EXISTING BUILDING DESCRIPTION

The single-story Center for Aging building at Building 110 at VAPIHCS includes an existing 43,305 BGSF footprint separated into three wings (A, B, & C). Wing A is comprised primarily of the administrative functions including the main entrance and porte cochere, primary building support systems, kitchen and dining, building deliveries, as well as rehabilitation program services.

CFA Building 110 – Existing Building Use (Pre-COVID)

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The CLC program in Wing B is primarily comprised of double bedrooms with shared bathrooms (4-beds/1-bath), along with a handful of single bedrooms, and a centralized nursing station at the center.

The PRRP program is temporarily using the South portion of Wing B since COVID-19 in 2020.

Wing C is used by the most vulnerable population and hospice within the CLC program and is comprised of single bedrooms with adjacent bathroom (1-bed/1-bath).

CFA Building 110 Building Use – Existing Wing A (Pre-COVID)

CFA Building 110 Building Use – Existing Wing B (Pre-COVID)

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The original construction consists of 4” thick metal stud walls with E.F.S. exterior, pitched metal clay tile roof with structural steel frame and metal decking, with roof insulation at underside of metal deck. The roof is comprised of clay roof tiles and generally a 4’ deep overhang. The original construction met 1991 Uniform Building Code requirements. Reference Appendix 6.9 for additional information regarding the Structural Code Analysis and Design Criteria requirements for the proposed PRRP expansion project.

A Facility Conditions Assessment (FCA) documenting the age, condition, and projected lifespan of materials in the building is in place to help guide overall maintenance of the existing building.

Systems identified in the FCA include:

Architectural / Life Safety Structural Mechanical Plumbing Electrical Energy Information Technology

The FCA is a living document and a handful of corrections are documented as well as updates when new systems are provided (i.e. photovoltaic panels), but in general, any areas of the building affected by a proposed renovation in this study should address these identified corrections.

Per the Physical Security Design Manual for VA Life-Safety Protect Facilities (January 2015), a Center For Aging (CFA) building is required to meet Mission Critical (MC) and Life Safety Protected Structures requirements. It was not in the scope of this study to provide a review of the compliance of the existing building with this code requirement, however if the MC requirements of the Physical Security Design Manual are enforced several components of the CFA will be affected in renovation. A physical security Risk Assessment provided by the VA is needed to understand the affected scope.

CFA Building 110 Building Use – Existing Wing C (Pre-COVID)

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2.4 ENGINEERING SYSTEMS

HVAC System

The building is served by seven Dx Air-Handling Units (AHUs) with nine Outdoor Condensing Units.

Cooling is provided by the outdoor condensing units to the AHUs. Refrigerant piping are installed in trenches from the condensing units to the AHUs in the building attic spaces. Each zone or space in the building is served by a terminal unit with electric reheat to temper the air. Thermostats in each zone monitors the zone temperatures and the existing Building Automation System (BAS) controls the HVAC System to enable cooling or heating depending on the space temperatures.

The existing HVAC System is original to the building and is recommended to be updated. A New HVAC Upgrade Project is planned to be implemented next fiscal year. The scope of the HVAC Upgrade project is:

1. One air-cooled chiller will replace all nine condensing units.

2. New AHUs to serve the existing space; existing AHUs to be abandoned in-place

3. Replace existing terminal units with new terminal units to control supply air into the spaces

Domestic Hot Water System

The Domestic hot water system is in the mechanical room near the loading dock. Hot water is provided by two natural gas boilers and recirculation pumps to serve all lavatories hot water within seconds and a 460 gal storage tank to provide adequate hot water. There are currently no issues with the existing Domestic Hot Water System. Recirculating pumps and various fittings have been renovated to maintain the system.

Electrical - Normal Power Service

The normal power service is fed from a 500kVA, 11.5 kV to 480Y/277V exterior pad-mounted transformer located to the west of emergency generator building 110A. It is owned and maintained by Tripler Army DPW. Per base building drawings, the transformer is fed from 3-1/C 250 MCM 15 kV cables and contains an integral 3-PSN 200A, 15 kV loadbreak switch with interlock and non-loadbreak fuse canisters. Upstream of the transformer are two medium-voltage feeders from Switch Station B, circuits 3 and 9, either of which can serve the transformer, thus providing some redundancy.

The pad-mounted transformer serves an 800 amp, 480Y/277v main distribution panel MSB located in generator building B110A. The MSB room does not appear to be mechanically ventilated or cooled.

MSB in turn feeds the building’s two transfer switches, 100-amp panel ERNH, and 600-amp panel DPNH, which is located within B110 and is the primary distribution panel for the facility. A 55kW solar photovoltaic system atop a carport parking structure provides a renewable power source and is tied into main distribution panel MSB. Outside of the PV system, all equipment appears to be original to the building. Staff has noted that the breakers in the main gear are not exercised regularly.

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Electrical - Emergency Power Service

Emergency power is provided by a single 480Y/277v 200kW Caterpillar diesel generator located inside B110A, in a separate room from MSB, with a day tank inside the generator room and an above-ground fuel storage tank outside of the generator room. The capacity (gallons) of the above-ground tank is not known. The generator and fuel tanks are original to the building. The generator serves a 100-amp life safety automatic transfer switch (ATS) and a 175-amp critical branch automatic transfer switch which supply backup power to selected lighting and power loads. There has been no current metering on the two ASCO transfer switches to understand the overall demand load on the generator. Per the Facility Conditions Assessment, owner input, and industry standards, the generator as well as the transfer switches are nearing the end of their useful life. The Facility Conditions Assessment also notes that ATS control parts are no longer available. Per service records, NFPA 110 and NFPA 99 remote annunciation as well as block heaters for the genset do not exist. Service records also indicate issues with the coolant, oil pressure and temperature sensors, generator starter, main breaker, and exhaust pipe rain cap.

Note: the base building drawings indicate loads connected to the life safety branch that are not allowed to be on the life safety branch per current codes (MATV equipment, nurse call system). Conversely, the base building drawings also indicate loads on the critical branch that are required to be on life safety (med gas alarm panel).

Electrical – Power General

Staff has noted no issues related to power. The VA has also advised that the existing electrical gear is not located in areas prone to flooding. An arc flash study was performed in 2019.

An HVAC upgrade project has been designed; the owner has advised that no load studies were performed as a part of the design of this upgrade project. The HVAC project documents show a net add of six (6) amps to the facility; however, the electrical load of the mechanical equipment is calculated at a 60% demand factor. Per review of project, it does not appear that the HVAC project is designing controls to prevent the system from operating at 100%. If the system operates at 100%, it appears that distribution panel DPNH will be overloaded. Refer also to the mechanical section for discussion and recommendations.

Lighting

Interior lighting is generally original to the building, which includes fluorescent and compact fluorescent troffer, downlight, sconce and exit sign fixtures. Staff noted that during normal conditions, lighting is adequate; staff is unaware if there is enough emergency lighting in egress corridors. Exterior carport lighting and parking lot luminaires utilize LED lighting. Additional exterior lighting has been installed in some exterior areas.

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Fire Alarm

The current fire alarm system is Notifier AM2020. There is currently a project in design to replace/upgrade the existing fire alarm system. It is unclear from the upgrade project what new fire alarm panel will be provided.

IT and Communications Systems – In use

Nurse call - Hill Rom NaviCare - This is a new system that replaced the prior system, is installed throughout the facility, and is used by both the CLC and PRRP.

Duress – Vocera – Staff wear a device on a lanyard to notify of duress. The VA is currently working with Hill Rom for integration of the Vocera system with nurse call, which would require both systems to be on the same network. PRRP uses Vocera but needs a PRRP hub.

Intercom – Intercom is currently functioning in the building, but rarely used due to how loud and intrusive it can be for residents. Staff noted it is only used in an emergency and they primarily rely on the Vocera system for notifications. Staff report that they are not able to hear codes outside.

Internet – Spectrum (provider) – There is a current project underway with the provider to expand coverage within the building as more residents use internet to connect with family and the bandwidth is limited. There is currently no internet in patient rooms. There is a VA-specific internet provided to staff only.

Patient Elopement – WanderGuard – The facility reports that this system is working well. This system is used by the CLC but not by the PRRP.

PACS (Physical Access Control System) – PACS includes card readers on doors; the WanderGuard system is tied into the PACS.

Cable TV – Spectrum (provider) – The CATV system utilizes a coax infrastructure; the provider reports there is a basic cable service at the facility.

IT – The VA advised that the IT cabling is or will be upgraded per EHRM.

Security - The facility is currently working on installation of cameras to view patients as they go to group activities. Video surveillance is not used in clinical care areas. The A-Wing is secured with access control from the remainder of the B-Wing. Residents can move freely within B-Wing and C-Wing. The PRRP is not a locked unit. The exterior gates are locked at 10pm, open at 5am.

Other Electrical Two items in the Facility Conditions Assessment, seismic bracing and lightning protection, have not yet been addressed.

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3.0 CONCEPTUAL FLOOR PLAN ALTERNATIVES

The available building expansion space at the CFA Building 110 space is very limited and not conducive to expand the requested 12,000 SF for the PRRP program without taking over important courtyard space for the CLC program. Concerns for how the two programs intermingled was also an overall constraint for how best to locate the PRRP expansion. Four (4) expansion alternatives were explored to identify appropriate CLC and PRRP program adjacencies while being sensitive to the health and wellbeing of the CLC residents and their access to the outdoors. These options include:

Option 1: 2nd story addition over A-Wing Option 2: C-Wing Expansion (2-story) Option 3: C-Wing Expansion (2-story) Option 4: B-Wing Expansion (2-story)

Additional considerations to accommodate a 12,000 SF building addition relate to the overall allowable area of the building in adherence to the building code. An I-2 occupancy, sprinklered building, with limited frontage availability allows for a maximum building square footage of 44,000. The PRRP program expansion of 12,000 SF will require a 2-hour fire wall separation to provide for independent structure on either side essentially created two independent buildings. A building expansion joint will be included and utilities that traverse between the existing and new building will require flexible connections.

Furthermore, the full PRRP program requested includes 13,167 SF of departmental program with a planned gross area of 16,722 GSF; and as such requires the sharing of space within the existing building to achieve the full PRRP program. As described by the CLC and Rehab staff, this program is already undersized and has limited to no availability to share program space. Additional concerns of intermingling CLC residents with PRRP patients were also identified as a barrier to sharing space.

Therefore, due to the constraints of the study and total project budget, the expansion is limited to 12,000 SF and several requested PRRP program spaces have not been included in the conceptual floor plan expansion alternatives. In review of the Program for Design (PFD) with the PRRP user group, several spaces were identified for removal or potential reduction including:

Laundry Room Resident Admission – Functional Area: Patient Care Services (120 SF) o Requested to be removed from the project since there is a second laundry room (150

SF) planned within the Functional Area: Patient Care Unit Laundry Room – Functional Area: Patient Care Unit (200 SF) o Opportunity for a reduction in size to 150 SF, and right-size for the program Toilet/ Shower Resident Admission – Functional Area: Patient Services (60 SF) o Requested to remove the shower from this room as it will only be used for resident intake drug testing and visiting public and family.

Lactation Room – Functional Area: Patient Services (75 SF) o Requested room identified as nice to have but may be omitted if necessary. A lactation room is a viable opportunity to allocate a shared space within the existing Building 110 CFA as the project is further developed.

For easy reference, requested space identified in the PFD that are currently not included in the conceptual floor plans options have been shown on the right side of each drawing.

Challenges to the program involve square footage associated with necessary building infrastructure that will be required, but not currently identified in the PFD and include:

Mechanical Room – Functional Area: Support (100 SF) o Mechanical equipment (i.e., hot water heater, re-circulation pump) as well as

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mechanical shafts to support the expansion. The current existing mechanical room located in Wing-A is at capacity and a long distance away.

Electrical Room – Functional Area: Support (100 SF) o Electrical room / electrical closets to support the expansion. The current electrical room located in Wing-A is at capacity and a long distance away.

Vertical circulation (Elevator) Vertical circulation (Stair)

3.1 OPTION 1 – 2ND LEVEL EXPANSION OVER AREA A

The building expansion in Option 1 includes the addition of a second story to Area A which allows for the complete separation of PRRP patients from entering into the CLC resident spaces in areas B and C. It is understood that the Tripler property has sight line view standards for any buildings on the campus that will not prohibit views from the hospital to the ocean. This standard was not available at the time of the study, but it is generally assumed that the existing roof peak of the pitched roof over Area A would be similar in height to a second level expansion with a flat roof.

The entire PRRP program is located on the second floor with renovation on the main level to add circulation for a stair and elevator. The means and methods to construct a second level would involve a complete renovation of Area A and would completely utilize the entire 15,000 SF renovation budget allotted to the project. Furthermore, a 2-hour fire wall would need to be introduced near the Area A and B wings intersect and completely isolate the roof structure to meet the building code allowable area.

POSITIVE OUTCOMES

Access to the PRRP program is directly from the main entrance and does not cross through CLC resident areas.

Dedicated area solely for the PRRP allows for sound control from CLC and Rehab courtyard program uses.

NON-FAVORABLE OUTCOMES

The building could not remain in operation during construction and existing CLC and Rehab patients and staff would need to be relocated. Area A provides the vital services to support the functions of Areas B and C.

The most favorable outcome for the renovation budget would be to remedy the 4 beds to one bathroom configuration in the CLC areas. The entire 15,000 SF renovation budget is expended in the administrative functional space in Area A.

Access to a designated courtyard and existing Multi-Purpose room for the PRRP staff would continue to occupy the courtyard to the North adjacent the Multi-Purpose room. The CLC and Rehab program has requested to have this area returned back to their program.

Summary:

Overall Option 1 feedback (PRRP, CLC, Rehab user group): Least favorable, and not likely to pursue.

Option 1 was not further refined as part of this study.

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3.2 OPTION 2 – C-WING EXPANSION (2-STORY)

The building expansion in Option 2 includes a 2-story addition with the main entrance serving the PRRP program at the adjacent Army Corp of Engineers parking lot in a lower level to the South with a connection to the C-Wing on the main level. The lower level primarily includes the main entrance and resident intake and public interface program area. Exam/Consult rooms are also located on the lower level separate from the Patient Care Unit. The Multi-Purpose Room on the lower level provides for a direct connection to exterior recreational areas.

The main level primarily supports the Patient Care Unit program with (16) bedrooms (one bed) and all of the requested functional area included in the PFD to support the Patient Care Unit. Security to provide a lockable corridor for gender separation is provided on the South end of the main level expansion. The building connection to the CLC program resident corridor in C-Wing includes a 2-hour fire wall separation. The connection provides direct access to the existing exterior courtyards, and could include additional access control measures between the CLC and PRRP program if needed.

For the building expansion in Option 2, very little area within the existing Building 110 CFA is affected for renovation. This leaves the majority of the 15,000 SF renovation area allocated for this project available to support high priority areas within the existing building for renovation.

POSITIVES OUTCOMES

Access to the PRRP program has its own separate, dedicated entrance.

Dedicated, separate exterior courtyard for the PRRP allows for sound control from CLC and

Rehab program courtyard uses.

Existing courtyards (temporarily used by PRRP program) could be returned to the CLC and Rehab programs and are not reduced from an expansion to the building.

Patient bedrooms located on the main level which provides for a separation for the sleeping units from patient services, and the primary entrance.

NON-FAVORABLE OUTCOMES

PRRP patients require access to the Dining room in Area A, which may either require patients to traverse through Wings B and C or travel outside along the sidewalk to Area A.

Summary:

Overall Option 2 feedback (PRRP, CLC, Rehab user group): Well-liked, desirable option.

3.3 OPTION 3 – C-WING EXPANSION (2-STORY)

The building expansion in Option 3 is similar to Option 2, however the Patient Care Unit program with

(16) bedrooms (one bed) and all and all of the requested functional area in the PFD to support the Patient Care Unit is located on the lower level. Security to provide a lockable corridor for gender separation is provided on the East end of the lower-level expansion. Patient Services and Support program area are located on the main level.

For the building expansion in Option 3, very little area within the existing Building 110 CFA is affected for renovation. This leaves the majority of the 15,000 SF renovation area allocated for this project available to support high priority areas within the existing building for renovation.

POSITIVE OUTCOMES

Access to the PRRP program has its own separate, dedicated entrance.

VCI / FARNSWORTH GROUP / 17

Dedicated, separate exterior courtyard for the PRRP allows for sound control from CLC and Rehab program courtyard uses.

Existing courtyards (temporarily used by PRRP program) could be returned to the CLC and Rehab programs and are not reduced from an expansion to the building.

Patient Services program such as Exam/Consult rooms could be shared with the CLC and are located immediately adjacent the Wing C corridor.

NON-FAVORABLE OUTCOMES

PRRP patients require access to the Dining room in Area A, which may either require patients to traverse through Wings B and C or travel outside along the sidewalk to Area A.

Overall Option 3 feedback (PRRP, CLC, Rehab user group): Well-liked, desirable option.

3.4 OPTION 4 – B-WING EXPANSION (2-STORY)

The building expansion in Option 4 includes a 2-story addition with the main entrance serving the PRRP program at the adjacent Army Corp of Engineers parking lot in a lower level to the South with a connection in the middle between B-Wing and C-Wing on the main level. The lower level primarily includes the main entrance and resident intake and public interface program area. Exam/Consult rooms are also located on the lower level separate from the Patient Care Unit.

The main level primarily supports the Patient Care Unit program with (16) bedrooms (one bed) and all of the requested functional area included in the PFD to support the Patient Care Unit. Security to provide a lockable corridor for gender separation is provided on the South end of the main level expansion, however this area would need to be unlocked for access through to the dining room in Wing A. The building connection to the CLC program resident corridor in C-Wing includes a 2-hour fire wall separation. The connection provides direct access to the existing exterior courtyards and could include additional access control measures between the CLC and PRRP program if needed.

For the building expansion in Option 4, very little area within the existing Building 110 CFA is affected for renovation. This leaves the majority of the 15,000 SF renovation area allocated for this project available to support high priority areas within the existing building for renovation.

POSITIVES

Access to the PRRP program has its own separate, dedicated entrance.

Dedicated, separate exterior courtyard for the PRRP allows for sound control from CLC and

Rehab program courtyard uses.

Patient bedrooms located on the main level which provides for a separation for the sleeping units from patient services, and the primary entrance.

NEGATIVES

PRRP patients require access to the Dining room in Area A, which may either require patients to traverse through Wings B and C or travel outside along the sidewalk to Area A.

The South courtyard that serves the CLC program is greatly reduced in size. This is also the courtyard with the best views.

Overall Option 4 feedback (PRRP, CLC, Rehab user group): Somewhat favorable option, but not as desirable as Options 2 or 3.

VCI / FARNSWORTH GROUP / 18

3.5 RENOVATION – EXISTING BUILDING

3.5.1 (2) Bed Patient Bedroom/Bathroom Renovation

The renovation includes (2) two-bed bedrooms that share

(1) bathroom of approximately 728 SF per two room block. The single existing bathroom will be completely removed and reconfigured to provide for two bathrooms each serving one 2-bed bedroom. Associated electrical and low-voltage updates include new recessed lensed LED lighting with individual patient controls in both the bedrooms and bathrooms. Showers will have wet location listed shower lights. In addition to new lighting, the renovated bathrooms will have new power receptacles, nurse call devices, and fire alarm strobes. To provide negative pressure in the rooms, the existing exhaust fan serving the bathrooms will need to be replaced with a larger exhaust fan coupled with additional exhaust ducts to serve each new bathroom. There will be some water piping modifications to serve the new fixture-units but larger branch pipes will not be needed.

The remainder of the existing bedrooms include an overall finish upgrade for the flooring, walls, and ceilings.

The bedroom door into the corridor is relocated to accommodate the new bathroom configuration and includes a sliding door function. CLC staff noted that the existing swing door locations already created an overall cramped space within the bedrooms.

The intent of showing the renovation in (2) room blocks is to provide for phasing and the ability to duplicate this renovation repetitively as available.

Facility Conditions Assessment – identified deficiencies corrected in renovation include:

Wing B – (2) Bed Patient Bedroom/Bathroom Renovation

VCI / FARNSWORTH GROUP / 19

Table 3.5.1: (2) Bed Patient bedroom/bathroom Renovation – Wing B: FCA Project Corrections FCA_ID System Subsystem Description Pending

Remaining Life

Project Correction

115158 Architectural Interior Finish/Door

Most areas have vinyl composition floor tile that is blistering due to water infiltration from slab on grade.

Recommend fluid applied vapor barrier to concrete surface below & replace tile and vinyl base.

Exceeds Install fluid applied vapor barrier to concrete surface prior to replacement of finished floor

107583 Architectural Interior Finish/Door

Most interior finishes are in average condition

Exceeds Replace interior finishes

107569 Architectural Signage/ Wayfinding

Interior signs in average condition.

1 year Replace signage at bedroom and bathroom

365445 Architectural Interior Finish/Door

Ceramic tile showers do not have a flexible joint installed. Recommend cleaning corner joints of hard grout and installing a flexible silicone joint.

Exceeds Issue is void with new bathroom reconfiguration

107574 Architectural Windows Aluminum double glazed windows in average condition. Mix of fixed units & operable units (at beds).

6 years Replace windows

365473 Structural Non- Structural Components & Equipments

- Seismic

Ceilings are Non- Compliant

* Provide seismic bracing. Item remains deficient from previous assessment

365478/ 365479

Structural Non- Structural Components & Equipments

- Seismic

Mechanical and Electrical Equipment are Non-Compliant

* Provide seismic bracing for panelboards used in renovation

365480 Structural Non- Structural Components & Equipments

- Seismic

Light Fixtures are Non- Compliant

* Provide seismic bracing for new light fixtures used in renovation

VCI / FARNSWORTH GROUP / 20

3.5.2 (1) Bed Patient bedroom/bathroom Renovation

Renovate shared bedroom and bathrooms into single user bedrooms with private bathroom meeting current VA standard design guidelines. The entire B-Wing would be gutted and reconfigured with all new interiors and MEP systems. Associated electrical and low-voltage updates include new recessed lensed LED lighting with individual patient controls in both the bedrooms and bathrooms. Showers will have wet location listed shower lights. In addition to new lighting, the renovated bathrooms will have new power receptacles, nurse call devices, and fire alarm strobes. To provide negative pressure in the rooms, the existing exhaust fan serving the bathrooms will need to be replaced with a larger exhaust fan coupled with additional exhaust ducts to serve each new bathroom. There will be some water piping modifications to serve the new fixture-units but larger branch pipes will not be needed.

The remainder of the existing bedrooms include an overall finish upgrade for the flooring, walls, and ceilings.

The bedroom door into the corridor is relocated to accommodate the new bathroom configuration and includes a sliding door function. CLC staff noted that the existing swing door locations already created an overall cramped space within the bedrooms.

The intent of showing the renovation in (2) room blocks is to provide for phasing and the ability to duplicate this renovation repetitively as available.

Facility Conditions Assessment – identified deficiencies corrected in renovation include:

Table 3.5.2: (2) Bed Patient bedroom/bathroom Renovation – Wing B: FCA Project Corrections FCA_ID System Subsystem Description Pending

Remaining Life

Project Correction

115158 Architectural Interior Finish/Door

Most areas have vinyl composition floor tile that is blistering due to water infiltration from slab on grade.

Recommend fluid applied vapor barrier to concrete surface below & replace tile and vinyl base.

Exceeds Install fluid applied vapor barrier to concrete surface prior to replacement of finished floor

107583 Architectural Interior Finish/Door

Most interior finishes are in average condition

Exceeds Replace interior finishes

Wing B – (1) Bed Patient Bedroom/Bathroom Renovation

VCI / FARNSWORTH GROUP / 21

107569 Architectural Signage/ Wayfinding

Interior signs in average condition.

1 year Replace signage at bedroom and bathroom

365445 Architectural Interior Finish/Door

Ceramic tile showers do not have a flexible joint installed. Recommend cleaning corner joints of hard grout and installing a flexible silicone joint.

Exceeds Issue is void with new bathroom reconfiguration

365473 Structural Non- Structural Components Equipments

- Seismic

Ceilings are Non- Compliant

* Provide seismic bracing. Item remains deficient from previous assessment

107574 Architectural Windows Aluminum double glazed windows in average condition. Mix of fixed units & operable units (at beds).

6 years Replace windows

365478/ 365479

Structural Non- Structural Components Equipments

- Seismic

Mechanical and Electrical Equipment are Non- Compliant

* Provide seismic bracing for panelboards used in renovation

365480 Structural Non- Structural Components Equipments

- Seismic

Light Fixtures are Non- Compliant

* Provide seismic bracing for new light fixtures

VCI / FARNSWORTH GROUP / 22

3.5.3 Expansion of administrative team rooms – Wing A

The CLC and Acute Rehab (GREC) program identifies a gap in the available office support space to serve this program. Typical VA standards for office space include both single office standardized space as well as shared team spaces. The NE corner of Wing A has great potential for reducing the generally oversized single office functions and has the potential to provide for ten (10) team work stations in an Open Office shared workspace.

The large open office immediately adjacent the primary entrance has mechanical issues which limits the quantity of people able to use the space. A renovation of 572 SF of this room to correct the mechanical ventilation issue by reconfiguring ductwork and balancing the system is required. New furniture systems to provide for a more efficient workspace environment to increase capacity is also included.

Facility Conditions Assessment – identified deficiencies corrected in renovation include:

Table 3.5.3: Expansion of administrative team rooms: FCA Project Corrections FCA_ID System Subsystem Description Pending

Remaining Life

Project Correction

115158 Architectural Interior Finish/Door

Most areas have vinyl composition floor tile that is blistering due to water infiltration from slab on grade.

Recommend fluid applied vapor barrier to concrete surface below & replace tile and vinyl base.

Exceeds Install fluid applied vapor barrier to concrete surface prior to replacement of finished floor

107583 Architectural Interior Finish/Door

Most interior finishes are in average condition

Exceeds Replace interior finishes

107569 Architectural Signage/ Wayfinding

Interior signs in average condition.

1 year Replace signage

(2) signs

365448 Architectural Interior Finish/Door

Interior door frames are in need of new paint

10 years Repaint (7) door frames in project area.

365478/ 365479

Structural Non- Structural Components Equipments

- Seismic

Mechanical and Electrical Equipment are Non- Compliant

* Provide seismic bracing for panelboards used in renovation

365473 Structural Non- Ceilings are Non- * Provide seismic

Wing A – Administrative Team Room Expansion

VCI / FARNSWORTH GROUP / 23

Structural Components Equipments

- Seismic

Compliant bracing. Item remains deficient from previous assessment

365480 Structural Non- Structural Components Equipments

- Seismic

Light Fixtures are Non- Compliant

* Provide seismic bracing for new light fixtures

3.5.4 Nurse Station Renovation – Wing B

Renovation of 1,524 SF of the central circulation area of Wing B to create a space that feels less institutional and more resident focused. The existing centralized nurse station is planned to be relocated to the side of the corridor area to allow for centralized space for resident lounge functions. The CLC noted that direct line of site to each resident bedroom from the nurse station is not a need for the program. In addition to the nurse station reconfiguration, the remainder of the renovation is primarily focused on finish related upgrades for the floor, walls, and ceilings.

Deficiencies noted in the Facility Condition Assessment that are affected by this renovation and are planned to be corrected as part of this renovation include:

Table 3.5.4: Nurse Station Renovation – Wing B: FCA Project Corrections

FCA_ID System Subsystem Description Pending Remaining Life

Project Correction

115158 Architectural Interior Finish/Door

Most areas have vinyl composition floor tile that is blistering due to water infiltration from slab on grade. Recommend fluid applied vapor barrier to concrete surface below & replace tile and vinyl base.

Exceeds Install fluid…