Controversial Laguna Hospital project underway

$480 million modernization and seismic retrofit effort expected to be completed in 2009

By David Silva

Workers will soon finish laying the structural foundation of the controversial Laguna Honda Hospital reconstruction project, a $480 million effort to seismically retrofit and modernize the historic facility.

Turner Construction Co. of Oakland is construction manager at risk for the project, which includes tearing down the 138-year-old main building and replacing it with three new buildings totaling more than 700,000 sq. ft. An additional 150,000 sq. ft. of portions of the hospital site deemed historic will be remodeled. The facility's original 1,200 beds will be replaced with 780 new ones.

"The original program was intended to build 1,200 beds," said hospital Administrator John Kanaley. "But when the project was originally billed out in 2004, we had seen significant escalation in costs that were more than the city was prepared to pay. The construction industry has seen very high inflation rates over the past few years, in the neighborhood of 8, 10, and even 12 percent. So there was a whole repackaging and reconfiguration of the project. We expect a decision in the next year by the health department and the mayor to revisit the number of beds."

The city-run Laguna Honda is the nation's largest public skilled nursing facility, and serves indigent seniors and the disabled in the Bay Area.

San Francisco voters passed a $299 million bond in 1999 to partially pay for the reconstruction, with tobacco settlement money and federal loans expected to pay for the rest. The high cost prompted fierce opposition by area activists, who said the money would be better spent promoting smaller community health-care programs.
Organizations such as the American Assn. of Retired Persons charged that the city's decision to reinvigorate Laguna Honda flew in the face of a national trend away from large public nursing facilities to more intimate, in-home care.

Kanaley said the project was necessary to fulfill a state mandate that all public hospitals be brought up to current seismic safety standards by 2013 or face losing their licenses to operate.

Construction on the facility began in 2003, and final build-out is slated for summer 2009. Anshen + Allen Architects and Gordon H. Chong and Partners, both based in San Francisco, are the project's primary architects.

Anshen + Allen Principal Zigmund Rubel said the project was necessary not only to bring the facility up to code, but also to provide patients with a less "institutional" setting for long-term occupancy.

"Current conditions at the facility are not desirable in terms of patient care," Rubel said. "The original design was what we'd call the 'Florence Nightingale ward solution," large open wards which at the time was state-of-the-art. So modernization was as much a driver of this project as code compliance."

Anshen + Allen's design calls for steel and concrete as the primary materials, with glass and plaster exterior finishes and patches of limestone in the entry area used to "soften" the look of the facility. Aluminum, stainless steel and glazing are employed to counter the stone elements.

"On the interiors, we tried as much as possible to go with sustainable products that would reduce 'off-gases' that may be harmful for the patients, while taking into consideration durability," Rubel said.

Other architectural firms that participated in the design of the reconstruction project include Fougeron Architecture, Tsang Architecture and Aviva Klapper Litman Architects - all of San Francisco.

Laguna Honda, located at 375 Laguna Honda Blvd., has a history almost as colorful as the city it serves. The institution began as an almshouse in 1866, and a 40-bed infirmary was added two years later to deal with small pox outbreaks. In 1906, it was used as a distribution center and emergency housing venue in the aftermath of the San Francisco earthquake and fire. The hospital was earmarked in the 1930s to minister solely to the city's elderly and poor.


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