Consulting Specifying Engineer Consulting-Specifying Engineer (November-CSE) : Page-12

MEP Roundtable tions are becoming more prevalent now. An operating room or procedure room needs to be equipped to perform more than just one type of case. Banse: More right-sizing of equip-ment, motors, and duct systems with more emphasis on tighter construction of systems and building envelope to avoid leakage, and more aggressive design to meet mandated energy codes and high-performance building systems. CSE: Due to the Affordable Care Act and other recent legislation, health care facilities are taking on new roles and ultimately will be designed differently. What new types of buildings, trends, or chal-lenges do you foresee? Orzewicz: It has been said that the Affordable Care Act will have an impact on the amount of care to be treated in outpatient facilities. We as engineers are starting to see an increase of new builds and renovation work for outpatient facili-ties, which means a typical outpatient facility like a medical office building is now performing increasingly extensive procedures that were typically performed in an inpatient or overnight stay facility. This transition in the way health care is provided is leaving the engineer to deter-mine if the mechanical and electrical sys-tems in these facilities now need to meet the standards and code requirements of an inpatient-type application. Smith: The Affordable Care Act has added a tremendous amount of uncer-tainty to the health care community due to the fact that the implementation of the law and the cost ramifications on Medi-care/Medicaid reimbursements are in flux. Facilities have a very difficult time determining a cost prospectus on building construction with income numbers as an unknown. That is why we have seen a downturn of hospital construction, espe-cially new facilities or major additions. Remodels and creative reuse of space is a present-day necessity. Kos: The Affordable Care Act forces accountable treatment of patients by restructuring the reimbursement policy. For example, hospital systems will no longer be reimbursed to treat patients who are re-admitted for the same illness or for treatment of patients with hospi-tal acquired infection. With the focus for reimbursements placed on quality of care, hospital systems have recognized that the cost of treating patients is the greatest inside the walls of the traditional hospi-tal. The growing trend is to move as many functions and clinical services to smaller outpatient health care facilities as systems adopt a hub-and-spoke delivery system in their effort to provide health care services more efficiently. With the hospital at the VRF is the perfect insulation for VRF ductless split systems condenser unit Comes Standard. No Extra Charge. Continuous 257° service temperature Exceeds VRF ductless split system temperature of 248° Win more VRF ductless split jobs with . Here’s why: Best size range available ID from ¹⁄₄ " up to 2 ¹⁄₈ " Wall thickness of ¹⁄₂ ", ³⁄₄ ", 1", 1 ¹⁄₂ ", 2" Non-corrosive Lowest VOC emissions Works in sustainable construction and areas where fumes are undesirable Use on copper, aluminum and stainless steel without corrosion Fastest installation on the market 1 2 Installs 300-400% faster with Cel-Link II with SSPT, our unique two-part sealing system Done once. Done fast. Done right. Call today for the name of your nearest distributor: 1-866-237-6235 | Or visit Aeroflex-InsOut_VRF_hp-ad.indd 1 input #7 at 7/23/14 5:20 PM

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