In 45 seconds it came and went. Ballast from atop the roof rained down, shattering windows, sending glass shards flying. Wind peeled back the underlying deck. In it rushed, ripping doors from hinges, Sheetrock from studs, IVs from patients' arms. Up it barreled, blowing out ceiling tiles, light fixtures, wiring. On the roof, an air-handler lifted off, then slammed into a back-up generator. The building lost power. Patients on respirators lost their lives.

Then, it was over.

However, that wasn't the end of St. John's Regional Medical Center. On May 23, 2011, a day after the EF-5 tornado struck Joplin, Mo., packing 200-mph winds and claiming 162 lives, Lynn Britton, president of the Sisters of Mercy Health System, indicated he wanted St. John's—or some semblance of the 750,000-sq-ft facility Mercy operated—functioning within a week.

By then, John Farnen, executive director of planning, design and construction with Chesterfield, Mo.-based Mercy was on the ground. The devastation, he says, "was surreal." Two days later, as members of Missouri's Disaster Medical Assistance Team were testing tents to house a makeshift 60-bed field hospital, Stephen Meuschke, project manager with St. Louis-based contractor McCarthy Building Cos., arrived on site—a parking lot.

‘Hook It Up’

"All these mobile units started showing up," recalls Meuschke. "We had two ORs, an MRI, a CT, labs, pharmacies—we never knew what was coming next. Something would arrive and someone would say, 'Hook it up.' Everything was running off generators for two months. I've been here ever since."

Mercy hasn't stopped rebuilding. Its most recent step to renewal involves the construction of a $335-million, 875,000-sq-ft, steel-framed replacement hospital, a facility that broke ground in January 2012, just seven months after the tornado struck.

"From the outset, Mercy made the commitment to fast-track," says Scott Wittkop, McCarthy central division president. "A facility of this size typically requires 18 months of planning. Here, we broke ground after seven."

"As late as November 2011, we hadn't seen a single drawing," adds Meuschke. "When we broke ground, all we had were civil drawings. We didn't even know what the foundation looked like. By the time the foundation was in, we still hadn't seen the exterior skin. So it became a matter of, 'Well, that's what the foundation looks like, so we'll take its dimensions and match the skin to it."

Interior work on the facility, renamed Mercy Hospital Joplin, began in December. If all proceeds as planned, exterior work will be completed in November, the central utility plant in January 2014, with punch list, MEP commissioning and move-in scheduled for early 2015.