Safety Net Hospital Strengthens Services

In Chattanooga, TN, Erlanger Health System transforms facility into first lifestyle hospital in the region.

By Anne Cosgrove
From the June 2017 Issue

In the fall of 2016, Chattanooga, TN-based Erlanger Health System dedicated the expansion and renovation of one of its healthcare facilities in the city—Erlanger East Hospital. Completed one month ahead of schedule, this $50 million, 112,000 square foot construction project set out to transform the Erlanger East facility into the region’s first lifestyle hospital.

(Photo: © Garrett Rowland Photography)

Pursuit of the lifestyle concept means that the transformation of Erlanger East put high priority on having the facility resemble a hospitality setting wherever possible. A new 58-bed patient tower, which includes a six-bed intensive care unit, reflects that focus with generously sized patient rooms. Meanwhile, a renovated lobby and reception area modernized hospital aesthetics. And, outside, a new campus-wide walking trail, putting green, and playground add to the offerings.

Bruce Komiske, vice president of new hospital design and construction for Erlanger Health System, which operates five hospitals, oversaw the project and explains, “Erlanger is the only safety net hospital and academic medical center for a 50,000 square mile area of southeast Tennessee. In order to continue to provide over $100 million in uncompensated care it is critical that the hospital also provide care for those who have insurance and can pay for the services. Erlanger East is located in a growing area and has always had a great reputation as a place to receive care. But it was somewhat limited in the services provided.”

Joining Erlanger Health System in 2013, Komiske’s current project is a new Children’s Hospital at Erlanger. Planned to replace the health system’s existing facility, this new hospital is scheduled for a groundbreaking on June 6, 2017.

Komiske’s career as a hospital administrator has included senior management roles, including at Yale-New Haven Hospital in New Haven, CT. In the early 1990s, he branched out into children’s hospital construction, overseeing the construction of Hasbro Children’s Hospital in Providence, RI. From there, he has worked on several notable children’s hospital projects—an area for which he has a decided passion.

Komiske’s work in this arena includes the Maria Fareri Children’s Hospital in Valhalla, NY, Lurie Children’s Hospital in downtown Chicago, and early planning for the Benioff Children’s Hospital at University of California San Francisco, as well as the Children’s & Women’s Hospital—Sidra Medical Center in Doha, Qatar.

In Chattanooga, the new Children’s Hospital at Erlanger will significantly improve service to one million children across a four state area—offering 22 pediatric subspecialties affiliated with the University of Tennessee College of Medicine. The first phase, beginning in June, consists of a 90,000 square foot Children’s Hospital Outpatient Center.

Bruce A. Komiske, Vice President, New Hospital Design and Construction, Erlanger Health System

A Chat With Bruce Komiske

What are your responsibilities with Erlanger Health System?

My current responsibilities include leading the team to plan and build the new Children’s Hospital at Erlanger.

During your career, what is a significant change in the industry that’s impacted how you do your work?

What impacts my work is continuously improving the process to create innovative healing environments by recruiting the best talent and engaging all constituents, including staff, patients, families, and the entire community in the process. Also important is creating a “vision and guiding principles” statement and visiting the “best of breed” facilities and documenting those visits. Make no small plans. If you are creating a new project, do it better and different than the others. Lastly, have fun and celebrate your successes.

Stringent Budget And Timeline

While the expansion and renovation of Erlanger East significantly improved the scope of services and experience for both patient and caregiver, the project also provided an opportunity for the children’s hospital project team to establish a working relationship. HKS, Inc. was the primary architect, and McCarthy Building Companies was the construction manager.

Explains Komiske, “HKS and McCarthy competed as one of two teams to create the new children’s hospital. Both firms were brought on at the same time under a construction management contract with McCarthy. When the decision was made to move forward on the Erlanger East project we decided this would be a great way to gain experience as a team. The results exceeded all expectations. This was done on time, on budget, with zero lost time incidents. And, approximately 70% of all the construction dollars stayed local.”

Challenges to the project included a tight budget and schedule. McCarthy’s Will Gaither, a senior project manager, says, “Our main two goals were finishing on time and under budget. That is the goal of every project, but we really had no other option to extend the [schedule], or to add money to the overall budget. These two goals drove every decision, and the time it took to make decisions. One of the ways we kept everyone focused was a ‘hot list’ on display in the job site office for everyone to see. We used this to show important items that had fast-approaching deadlines, or critical decisions that needed to be made in short order.”



Completed in late 2016, a $50 million expansion transformed Erlanger East Hospital in Chattanooga, TN into the region’s first lifestyle hospital. The project includes four new operating rooms, a post-anesthesia care unit expansion, a pre- and post-op expansion, a new cardiovascular interventional radiology suite, and renovations to the reception and administrative areas. (Photos: © Garrett Rowland Photography)

Collaboration and teamwork are essential for working on any active hospital campus, and Gaither explains that weekly OAC (Owner, Architect, Contractor) meetings served to keep Erlanger East stakeholders apprised of project updates. “While OAC Meetings are usually held with a small leadership group, McCarthy and HKS made sure to include all entities involved in the project,” explains Gaither.

“Important items that had to be discussed during those meetings were potential risks that the construction and renovations posed to the existing building and their operations,” he continues. “To overcome these issues, McCarthy had to coordinate closely with Erlanger about different logistical items, including the flow of patients and staff to schedule tie-ins to the existing building.”

Says Komiske, “It all comes down to the quality of the team brought together and their commitment to the project. The construction/design team became part of the community and demonstrated the same passion for the project as the internal team did.”

Erlanger East Reaches New Heights

Komiske says, “Thanks to the incredible design from HKS, the exterior of the new patient care tower looks more like an upscale hotel than a hospital. Instead of traditional landscaping, there is a putting green and playground surrounding a beautifully landscaped courtyard facing the main road. A mile long walking trail around the campus was built with donations from the community.”

Project Information

Name of Facility: Erlanger East Campus (New patient tower and surgical center expansion), part of Erlanger Health System. Location: Chattanooga, TN. Square Footage: 112,189 square feet (Renovation and addition). Budget: $50 million. Project Timetable: December 2015 (preconstruction start) to November 30, 2016 (dedication). Cost Per Square Foot: $445 (renovation and addition). Facility Owner: Erlanger Health System. In-House Project Manager: Bruce Komiske, vice president, new hospital design and construction. Architect: HKS, Inc.. General Contractor/Construction Manager: McCarthy Building Companies, Inc. Electrical/Mechanical Engineer: CCRD/WSP. Structural Engineer: Walter P. Moore. Other Firms: March Adams (Civil), CRJA (Landscaping).

Product Information

Carpet/Flooring: Shaw Industries. Paint/Coatings: Sherwin-Williams. Restroom Fixtures and Supplies: American Standard; Kohler. Building Management System: Siemens. Fire System Components: Tyco. HVAC Equipment: Daikin. Power Supply/Backup Power Equipment: Caterpillar. Roofing: Firestone Building Products. Doors: VT Industries. Elevators/Escalators: Kone.

Inside, those who enter the lobby are welcomed with music from a grand piano (donated by a former patient), while artwork from local photographers is displayed throughout the facility.

Gaither notes, “More than just an expansion to key medical services, Erlanger East was the opportunity to enhance the Erlanger brand identity through the creation of a holistic lifestyle campus with an emphasis on integrated care, connections to community, and the natural elements unique to Chattanooga.”

And now looking ahead, Komiske says, “We are very excited that the same team that created the success at Erlanger East is now ready to start the new Children’s Hospital Project.”

hospitalLearn more about Erlanger Health System here. For more about McCarthy Building Companies, visit Facility executives are invited to share their construction, renovation, and improvement stories. Please send an e-mail with an overview to the Editor at

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