Orthopedic Center

After successful completion of the UHS Vestal Physician Office Building in 2012, UHS Hospitals reengaged NexCore Group to develop its 69,000 SF Orthopedic Center. The orthopedic/musculoskeletal center of excellence will sit adjacent to the Vestal Extension Clinic, creating a full-service healthcare campus along the high-growth retail corridor of Vestal Parkway in the underserved market of Vestal, NY. 

A Long-term Partnership

From 2009 to 2012, NexCore worked closely with UHS to deliver the Vestal Physician Office Building, the system's first off-campus, integrated multispecialty clinic. After the successful delivery of the clinic, UHS partnered again with NexCore in April 2014 to fee develop/project manage the system's Orthopedic Center. 

Complementing the clinical and ancillary services available in the Vestal Physician Office Building —primary care, cardiology, imaging, walk-in center, women’s center, lab, and pharmacy—the Orthopedic Center will provide orthopedics and sports medicine, consolidated physical therapy, podiatry, rheumatology, and chiropractic services.

To ensure successful completion of the Orthopedic Center, NexCore is leading:

• Site analysis
• Site master planning alternatives
• Coordination of owner consultants (traffic, geotechnical and environmental services, construction materials testing)
• Contractor selection
• Assistance with negotiation of the long-term ground lease
• Estimates of project cost
• Project approvals (including state and local entitlements and approvals)
• Complete project management services (to be continued through occupancy)

Building a Vision

The Orthopedic Center will build on UHS’ vision to prioritize orthopedics as a signature service line. The facility has been programmed and designed to meet the following strategic objectives:

• Implement a new vision for comprehensive orthopedic services to regain market share.
• Recruit a complementary mix of specialty providers.
• Integrate completely with the adjacent Vestal Extension Clinic.
• Create a highly visible, integrated outpatient campus along the high-growth retail corridor of Vestal Parkway.
• Build on the developing relationship with the adjacent SUNY Binghamton University campus.

UHS sports medicine experts already provide care for several of Binghamton University’s key athletic teams. With the development of the Comprehensive Orthopedic Center right across the street from the university campus, BU athletes will be able to access comprehensive care in a state-of-the-art facility close to where they live and train.

The Vestal Extension Clinic has also proven to be a win-win facility for UHS and BU. During the clinic’s first four months of operation, BU students made up 20% of the walk-in center’s traffic. 
 

Familiar Site. New Challenges.

 
The state and local entitlements and permit approvals for the Orthopedic Center were quite different from those of the Vestal Physician Office Building. On top of parking concerns, ground lease negotiations took longer than expected: UHS was not able to gain permission for site access for geotechnical test borings or pre-demolition environmental testing.
 
New NYS Department of Health (DOH) approvals of Schematic Design (SD) and Construction Documents (CDs) also threatened the construction timeline. On top of these significant roadblocks, NexCore needed to design a foundation to combat the soil’s poor bearing capacity around the site—while still keeping the project on budget.

Overcoming Obstacles

Creative Entitlements Approvals — NexCore spearheaded a creative approach, engaging another state agency, the Dormitory Authority of the State of New York (DASNY), to review the SD documents on behalf of the DOH. This alternative approach saved weeks of wait time and increased the predictability of the approvals, especially the NYS Certificate of Need (CON) approval. The team was also able to obtain approval from DOH for an “Early Start” of demolition and abatement, saving nearly two months of overall project schedule.  

Site Access Solutions — After considerable research, the project team was able to obtain copies of old environmental and geotechnical test data as well as conceptual drawings of the existing building additions to allow design and documentation to continue as scheduled.

Phased Permits — Planning and building permit approvals from the Town of Vestal were phased to allow the environmental abatement and demolition of an automobile dealership to proceed, with limited environmental clean-up for NYS Department of Environmental Quality (DEC) approval.  

Responsive Foundation Design — After considerable analysis and pricing of foundation alternatives, the UHS project team selected a deep foundation system of aggregate piers to combat the poor bearing capacity of the 20-foot-deep soil, dominant throughout the site.  

Site Design — NexCore’s creative approaches to site access, patient drop-off, service delivery, and local transportation access (a local public bus stop shared between the two UHS buildings) allowed the 4:1,000 SF parking ratio to meet the minimal zoning code requirement for the 4.7-acre site. The adjacent ~5:1,000 SF parking site at the clinic will be available for overflow parking.