One of the exceptions to an inevitable downturn in commercial construction in the coming months lies with the business of health care. I’ve cited the apparent industry-wide immunity to the coming slump in previous columns, and it doesn’t take a crystal ball to figure this one out. A huge demographic of aging baby boomers with health care issues, ginormous federal subsidies and a recent pandemic are three glaring conditions that continue to tax existing facilities and stimulate response to demand for more hospitals, clinics and medical office buildings.
Of course this is good news for commercial framing/drywall contractors who are sophisticated enough to tackle the intricacies involved with the large, complex projects currently emerging. But along with the blessing of activity comes a plethora of “gotchas” unique to the health care industry (and to hospitals in particular) that should be daunting to expert bidmeisters, even those of the soundest minds and the stoutest hearts. Hence, the following is an itemization (albeit, an admittedly incomplete one) of common pitfalls that await the brave wall/ceiling quantifiers who dare to delve into the complexities of health care work.
Interference walls. Time constraints generally prohibit commercial drywall estimators from wading too deeply (if at all) into the mechanical plans to identify any overhead ducting located where it may conflict with the construction of full-height rated walls—typically, ducts that occupy the same space and direction as the wall. But in a hospital setting, requirements will demand that those partitions will be located, identified and constructed before duct installation is commenced to avoid any arduous dismantling of the HVAC assemblies. Therefore, it falls incumbent on the drywall exactimator to determine where these conflicts occur, and to include in his estimate any time-consuming offsets in the wall that will allow the rated partitions to reach the underside of the deck uninterrupted.
Water resistant board. Early installation of framing as described above usually mandates early installation of drywall as well—at least above ceiling height. This is often done before the roof is dried in, and so front-end directions typically require water-resistant board for “top-out” at interference walls, walls adjacent to hard-framed drywall ceilings, and sometimes the interior side of exterior walls. The trick here is determining what grade of water-resistant board is required. Most of the time, simple mold-resistant drywall will suffice, but some architects require something more stringent, like glass-mat tile backer at this condition. As the project manual probably does not specify, astute bidmeisters will opt for the cheaper board, but qualify it in the proposal.
Interior heavy gauge framing. With deck heights in hospital projects usually allowing for light gauge (typically, 20-gauge) framing for interior walls, there are several exceptions that apply here more often than not. Obscure plan notes or front-end directions frequently require 16-gauge, double-stud framing at interior door jambs at patient, exam and operating rooms to withstand the impact of gurney collisions. This makes sense at those areas, but notes and directions often fail to specify where the requirement applies. It is a common error among estimators to apply the requirement to all door frames, including office doors where it is simply overkill and a budget-buster. In addition, I would warn bidmeisters to be wary of details that require arduous structural framing for sliding glass doors that are so common at patient rooms. An omission of this condition could be fatal if awarded the project.
Backing. While flat-strap backing for fixtures is a common inclusion with the commercial drywall/framing scope, once again, health care projects come with their own unique provisions for backing. Chief among these items is the extensive backing required for crash and bump rails at corridors. Locating the provision of these conditions can be maddeningly murky, but they often appear on an obscure “wall protection” sheet, hidden among the interior design plans. Note that there are frequently multiple runs of these rails, and the backing details usually call for labor intensive let-in track rather than the usual quick-and-dirty flat-strap condition. Another surreptitious backing detail lies in wait with patient room curtain tracks, in which backing may or may not be included with the ACT scope.
Head walls. Another rather ambiguous (but major) detail comes with locating and allowing for patient room headwalls. These wall sections containing numerous connections for med-gas, vital sign monitors and electrical receptacles are often prefabricated panels assembled off-site and may or may not be included in the main project’s framing and drywall scope. Either way, the framing/drywall estimator will be required to include framing an opening and installing the panel as part of his proposal.
As stated, this is only an incomplete list of common pitfalls that are likely to emerge during a takeoff of a typical health care project. Veteran bidmeisters will surely recognize these conditions and can accept this writing as a friendly reminder. But less experienced estimators may be seduced into uncharted waters by the strong activity in the medical industry. Let this piece be a fair warning of potential hazards to newcomers.
Vince Bailey is an estimator/project manager working in the Phoenix area.
