by Thaddeus Minshall
Between the healthcare industry’s mission to reduce hospital visits and consumer preferences among the aging baby boomer population, the surge of healthcare facilities and medical office buildings (MOBs) is expected to continue. From standalone facilities to medical office complexes, many investors view MOBs as one of the safest bets in real estate, with success dependent on developers’ degree of field-specific knowledge.
The specialized nature of a MOB fit-up involves more extensive investment than a standard office building; this investment is generally rewarded in the form of longer leases, higher rents, and lower tenant turnover. While these factors make MOBs a popular target among developers open to the added up-front costs, it’s critical to understand that designing and building a MOB requires specialized expertise in areas such as building materials, nuanced MEP needs, accessibility, office flow, and acoustics.
First, medical office buildings come with a set of rules as to acceptable building materials (non-slip flooring, durable walls and doors, vinyl-coated surfaces for easy cleaning, etc.). MOB developers must be knowledgeable of the best practices for outpatient facilities prior to the preconstruction and design phase.
Also, given the need for exam room sinks and additional restrooms, MOBs come with advanced plumbing needs. Likewise, HVAC systems must meet the setting’s more stringent ventilation requirements, from reducing the risk of airborne pathogens to venting facilities such as those storing anesthesia gas or involving radiation. Speaking of which, radiology equipment is also a good example of the potential need to plan for specific power demand; some medical equipment requires and/or draws power in ways that developers must plan for from the project’s outset.
Accessibility is another key consideration, and the Americans with Disabilities Act includes legal requirements for health care facilities that developers must know. For example, exam rooms must include a clear space of at least 60 inches by 60 inches so that those in wheelchairs can turn without restriction. Beyond legal requirements, MOB developers must also possess awareness of medical office flow to best align the experience of patients and practitioners with the reality of day-to-day operations. A savvy developer can accomplish this feat with efficient and cost-effective design solutions.
Sound is another key factor in MOB development. Under HIPAA, MOB walls must be rated for a sound transmission coefficient that protects patients’ sensitive information from being overheard between exam rooms. Also, to create a peaceful environment, the building envelope should be designed to minimize the level of exterior noise that can be heard inside.
This is a small sampling of considerations integral to MOB planning. With requirements satisfied, developers can often attract highly desirable tenants to multi-tenant medical office buildings by pairing a primary care firm with specialists who might benefit from referrals as well as complementary service providers, such as those who do lab or imaging work. Regardless of the composition of the MOB, it is critical for developers – and ideally, if possible, prospective tenants – to review plans and costs early and carefully to achieve success.
Everyone involved must meet the unique demands of the MOB. By working closely with clients and consultants on patient and practitioner needs, developers can ensure that a medical office building delivers an experience in tune with its core purpose: care.
Thaddeus Minshall
Thaddeus Minshall is vice president of real estate/development at Connolly Brothers, Inc.
