New Hospital in Joplin Built to Weather Next Storm

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New hospital under construction in Joplin, Missouri, to replace the one destroyed by the tornado in 2011 has been designed to withstand a strong tornado and function in the aftermath.
June 10, 2014—The new hospital that is rapidly taking shape off of Interstate 44 at Hearnes Boulevard in Joplin, Missouri, will be far more than a state-of-the-art, tertiary-care center when it is complete in early 2015. The hospital will be a symbol of rebirth for a community hit hard by the single deadliest tornado in the United States since records were first kept in 1950. “Hopefully it will bring some closure to the community and a sense that Joplin is back,” said John R. Farnen, the executive director of Mercy Strategic Projects. “We survived, overcame the event, and have come out of it stronger.” Farnen replied in writing to questions posed byCivil Engineering online.
The 890,000 sq ft, nine-story facility is being developed by Mercy, a large Catholic health care system that operates 32 acute-care hospitals and 10 specialty hospitals in the Midwest. The new facility, designed for future expansion, will have approximately 200 beds, 15 operating rooms, and two helipads. It replaces St. John’s Regional Medical Center, which was in the direct path of the powerful EF5 tornado on May 22, 2011, a twister that was approximately 1 mi wide and traveled on the ground for a staggering 22 mi. The vast majority of the windows in the hospital where blown out by tornado-driven debris, and a helicopter was tossed off of a landing pad and destroyed. Utility service was cut and generators failed. The facility was quickly deemed irreparable.
The new hospital is located on an approximately 115-acre site, assembled from 20 separate properties, that provides ready access to major highways and has a high degree of visibility.
Bore testing at the site confirmed that the ground had neither the high water table nor the unmapped abandoned mines common to the Joplin area. “The city of Joplin and the surrounding community had historically been a mining community due to the region’s deposits of lead and zinc,” noted Jared Rasmussen, P.E., an engineer with Olsson Associates, the Lincoln, Nebraska, firm that performed the civil engineering for the project. “The previous ... hospital itself sat on top of one of these mines, which over the years created several structural issues for the facility. Due to these prior issues, Mercy went to great lengths to verify [the] existence of mines on the proposed site.” 
St John’s Medical Center took a direct hit from the powerful EF5 tornado in Joplin in May 2011
St John’s Medical Center took a direct hit from the powerful EF5
tornado in Joplin in May 2011. Nearly all of the windows were
destroyed and the generators failed. © Mercy
Although there turned out to be no mines, that doesn’t mean the site lacked geotechnical challenges. Workers blasted through 400 tons of rock and moved more than 1 million cubic yards of dirt to prepare the site. Those preparations included modifying two I-44 interchanges, adding signals, and relocating ramps. Two roundabout intersections were added, and both city and state roads were widened and modified, according to Rasmussen, who provided written answers to questions posed by Civil Engineering online.
The design is the work of architecture firm HKS, headquartered in Dallas. SSE Structural Engineers, of St. Louis, provided structural engineering on the project. The design team was charged with developing a structure that would not only withstand a direct hit by a tornado in the future, but remain operational in the aftermath. Another charge was to develop the project quickly.
“We knew, going into the project, that schedule was the primary challenge we had to overcome,” Rasmussen said. “The team started with not much more than a napkin sketch in late September [2011] and we were challenged to turn this concept in to a workable design by the first of December, while still providing a nearly balanced earthwork site.”
The new hospital is being built on an expedited schedule during which programming and design work were compressed and overlapped with early construction. “The biggest challenge was starting the design and construction at the same time and having design keep pace with the early construction progress,” Farnen said.
But the designers understood the need for speed; the community not only needed a new hospital, it needed to heal emotionally from the devastation that the tornado wrought. In the days following the twister, images of the hospital became a symbol of what had been lost—161 dead, more than 1,000 injured, more than 8,000 homes and nonresidential structures destroyed. It was especially hard on the community to lose a hospital at a time when it was needed most. “That was the problem. It was hit with a tornado, [and] shortly thereafter it was completely out of service. It couldn’t stay in operation. They had to transport everyone to adjacent facilities,” says Ryan Felton, LEED-GA, a project director for McCarthy Building Companies, Inc., in St. Louis. McCarthy is the builder on the project.
Exterior rendering of a temporary hospital which was built in Joplin in late 2011, assembled from modular units built in California
A temporary hospital was built in Joplin in late 2011, assembled
from modular units built in California. The hospital is functioning in
this temporary facility until the new hospital is complete in 2015.
© Mercy
The new hospital’s design incorporates several lessons learned from the former structure. For instance, the new facility has a remote energy plant. “The energy plant is 450 ft away from the facility ... strategically located on the east side,” Felton says. “It is recessed into a hillside. From there, the utilities go to the main facility through a utility tunnel that’s about 20 ft below grade.” At the former facility, the utilities were aboveground, exposed to the tornado.
Another key focus of the team was the facade. The few windows in the former hospital that weren’t destroyed were made of laminated safety glass. The new facility makes much greater use of safety glass. Particularly sensitive units have windows designed to withstand 250 mph winds, and other areas have windows designed to withstand 140 mph winds. “The specialized glass took about nine months to design and pass the required testing,” noted Farnen.
And that testing was intense. “On the 250 [mph] windows, we had to shoot a 15-pound 2x4 out of the system at 100 miles an hour. And then on the 140 [mph] windows, we had to shoot a 9-pound 2x4 at 55 miles per hour,” Felton says.
The structure’s facade features large precast panels, approximately 6 in. to 8 in. thick, 14 ft tall, and ranging from 12 to 20 ft wide. Bricks were cast into the panels to provide aesthetic appeal. The panels weigh between 35,000 and 45,000 lb, requiring special steel members to secure them to the building’s steel frame, which bears the load.
The new structure’s roof was also secured against high winds by eliminating the rock ballast that had weighted down the roof of the former hospital—and that became airborne during the tornado—in favor of a lightweight concrete topping slab.
“There really [are] no standards yet for what needs to be incorporated into a facility that is in the tornado zone,” Felton says. “Our team... took quite a few of the different standards that are out there and tried to take a common-sense approach.” He notes that the design incorporates elements of the Federal Emergency Management Agency’s FEMA 577 (Design Guide for Improving Hospital Safety in Earthquakes, Floods, and High Winds: Providing Protection to People and Buildings), the International Code Council’s ICC 500 (a standard for design and construction of storm shelters that is currently being updated), and the Miami-Dade, Florida, building code for high winds.
Felton notes that the facility under construction now is actually the fourth replacement for St. John’s. The first was a tent hospital developed in the immediate aftermath of the storm in conjunction with emergency responders. That was followed soon after by portable units brought in to better withstand the winter. In April 2012, a 167,000 sq ft interim hospital opened. It was constructed from modular units built in California and assembled on the site, Felton says.
Finding the space for staff and supplies has been a challenge in these temporary facilities, Farnen said. “The temporary facilities had limited ... capacity of 30 beds in the field hospital and 60 in the portable hospital,” he said. “Most of the other facilities [such as] imaging, lab, pharmacy, restrooms, and support space were separate facilities brought in to support the main hospital facility.”
The $500-million project is on target to obtain a temporary certificate of occupancy by the end of 2014 and open in March 2015.
“Hopefully it will represent a sense of pride for the Joplin community for what the entire community has accomplished,” Farnen said. “I know, personally, I am amazed [at] how resilient the community of Joplin has been.”

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