Six years ago, Presbyterian Healthcare Services included a plug-n-play chassis when it built its five-story Presbyterian Rust Medical Center Hospital in Rio Rancho, N.M. The state’s second-largest health care provider adopted the strategy so that, during anticipated expansions, crews could easily link new structural and mechanical systems to existing ones.

The plug-n-play method is facing its biggest test yet with the center’s 200,000-sq-ft fast-tracked addition. Construction of the $80-million facility began in May 2014.

“One of the primary reasons to choose plug-n-play is to avoid construction over an existing, occupied and fully operational acute-care facility,” says Lucas Ford, project director with McCarthy Building Cos.

The construction manager-at-risk built the original hospital six years ago, and is constructing the current expansion under an accelerated 18-month schedule. The strategy “has played out well,” he adds.

Designed to connect with minimal disruption to the original hospital, the expansion includes a six-story, cast-in-place reinforced concrete patient tower with 120 private beds and a penthouse suite. Sitting on 240-plus auger-cast piles 55 ft to 75 ft deep, the tower’s partial basement connects to the one in the existing tower.

The hospital’s original two-level diagnostic-and- treatment (D&T) center is also under expansion to add a pre-op room, four operating suites and a post-anesthesia care unit on the second floor and space for a future emergency department expansion on the first. The new D&T space also houses the addition’s air-handling equipment.

Further, the McCarthy team is adding elevators and parking, and expanding both the central sterile processing room and the central plant for new equipment. Total cost of the project, including furniture, fixtures and equipment, is $100 million.

The project was on schedule through early August for a November completion. Then, on Aug. 18, a 21-linear-ft section of a six-story exterior access scaffold collapsed on a building on the north side of the campus. One worker died and seven others were injured. The scaffold, erected by a subcontractor, was for window work and other items, says Patty Johnson, a McCarthy spokesperson.

The site was immediately closed pending an investigation by the New Mexico Occupational Health and Safety Administration office in Santa Fe, which declined to comment on the collapse. Rio Rancho authorities and McCarthy are also conducting independent investigations, Johnson says.

A portion of the site unaffected by the incident reopened to workers on Aug. 24. The remainder is still shut down.


The design team, led by architect Dekker/Perich/Sabatini, selected cast-in-place structural concrete for the new tower and the D&T center because the material is adaptable for expansion modules. Concrete also needs no fireproofing and resists vibrations.

The project sits within a seismic zone rivaling those in California, Ford says. “The structure itself with the new 2012 building codes has changed the way we had to approach this project early on,” compared with the original hospital, he says.

The primary difference is the reinforcing steel requirement, Ford says. The expansion has approximately 40% more rebar than the original structure.

The rebar diameter is greater and there is more rebar congestion in the beams, decks and walls to meet the 2012 requirements, he adds.

An enclosed pedestrian bridge connects the two towers at levels two, three, four and five. It was designed to create better circulation from the old to the new towers.

“It’s a free-standing structural steel bridge set between two concrete patient tower structures,” says John Laur, Dekker/Perich/Sabatini’s principal. “Instead of putting columns into the existing patient tower, we created a separate structure with cantilevered ends.”