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Planning for Added Hospital Floors: A Cautionary Tale

Hey, we can always build more floors… Mount Sinai spokespersons offered dotted lines above the proposed 14th Street 70-bed hospital to indicate that they were ready to build more floors if they needed additional beds. We asked our Architectural Editor, Brian Pape, to recreate the trauma and cost of encasing a working hospital in scaffolding.

—George Capsis


Mount Sinai announced plans for a new Beth Israel 70-bed hospital at 13th Street and 2nd Avenue, an emergency department several blocks away (but no Trauma I center), and expanded outpatient facilities at three sites. Once that is completed, hopefully in 2020, the existing 852-bed hospital nearby will be sold, hospital officials said.

PLANS FOR A NEW HOSPITAL: The rendering above showcases the design of the new Mount Sinai Downtown Beth Israel Hospital, planned at 2nd Avenue between East 13th and 14th Streets. Image by SAN/copyright.
PLANS FOR A NEW HOSPITAL: The rendering above showcases the design of the new Mount Sinai Downtown Beth Israel Hospital, planned at 2nd Avenue between East 13th
and 14th Streets. Image by SAN/copyright.

The new plan, shown by Perkins Eastman Architects (collaborating with Ennead Architects) to a community forum on October 27th, calls for future floors added along 13th Street.

New York land is expensive, so building up makes sense in most cases. For Mount Sinai to add two or three floors above (by then) an existing operating hospital, extraordinary measures will be required. First, of course, the building’s foundation and superstructure will have to be stronger, costing at least 20% more in original structural construction.

When the future floors are constructed, new scaffolding will envelope the building and material lifts will be installed. Noisy construction may need to be limited to working hours; interruptions may be frequent. The entire roof below the work will need protection from heavy falling objects until a new floor is built over it, and kept waterproof. The entire operation will probably carry a 30% to 50% premium in total typical construction costs.

Other notable NYC buildings were designed for additional floors to be added later, and serve as cautionary tales about how difficult it is to predict the future.

William Randolph Hearst built his headquarters near Columbus Circle in 1928 with the capacity for a skyscraper above the six-story base, but the Depression cut it short. In 2006, Sir Norman Foster designed a tower inside Joseph Urban’s historical landmark shell right down to the foundation, saving only the decorative facade.

In 1909, the MetLife Tower was built, adding to its original 1893 headquarters, and was the tallest building in the world. Then, in 1928, another MetLife building, called the “North Building” across East 24th Street, was designed to be an immense 100-story Art Deco tower. However, only 29 floors were built before construction stopped in 1932. Although the structure is there to support 71 more floors, it was never feasible to add them.

The building at 55 Wall Street was originally built in 1836 as a two-story Merchants’ Exchange, which also served as the U.S. Customs House. McKim, Mead & White enlarged it in 1908 for bank headquarters by adding four floors and a second tier of colonnade frontage to what must have been a massively over-structured base. It is now landmarked and functions as a Cipriani restaurant and a condo.

Here in the West Village, St. Luke’s School is adding two floors to its original 1945 two-story school building. During the summer recess, massive steel supports were threaded through the floors down to the foundation. Then, more steel framework was added for the top floors. When school commenced this fall, scaffolding protected children from the work continuing above, with materials loaded from the street side. A new condo tower was built to help pay for this expensive school expansion.

Spending extra now for an uncertain future is a gamble, and a questionable one at that.

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