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I've stated many times that the hospital isn't going away. And I still believe that.

But the number of hospitals and their size will most definitely shrink. Recent statistics compiled by Modern Healthcare Metrics are hard to ignore:

  • Total number of days patients spent in hospitals peaked in 2007 and 2008 at 163 million; in 2017 it had dropped to 152 million.
  • The length of a hospital stay has basically remained the same, at 4.8 days in 2017 from 4.7 days in 2007.
  • The number of days Medicare-eligible patients spend each year in the hospital has dropped 22.7%, despite a 36.7% increase in the number of Medicare-eligible patients.
  • About one in four hospital beds currently in use will become surplus in 2027.

48,000 Hospital Beds Will Disappear

Modern Healthcare predicts that in the next decade, nearly 48,000 hospital beds will need to be eliminated -- or roughly 191 hospitals with 250 beds each.

Rural hospitals, whose utilization rates are falling faster than those in urban areas, stand to lose the most.

Design Challenge

This poses a unique design challenge/opportunity. Architects and designers who work with hospital owners may be asked to help come up with creative solutions to help repurpose unused patient units.

Developers who buy closed hospital properties will be looking for design professionals to help them convert these buildings into something else.

This is not new.  Many older hospital buildings have already been turned into housing or hotels -- like Columbia Hospital in Washington, D.C., which closed in 2002 and reopened in 2006 as a condominium community.

Or the Linda Vista Community Hospital in Los Angeles, which shut its doors in the 1990s and came back to life in the 2010s as low-income housing apartments for seniors under the name Hollenbeck Terrace.

Cordia at Grand Traverse City is another example. This upscale senior living community in Traverse City, Mich. is built on the campus of a former insane asylum, repurposing the historic main building into residential apartments.

What is to Become of Shuttered Hospitals?

My guess is that most of the hospitals that will close in the next 10 years won't be older or necessarily iconic buildings. They will be more modern buildings, built or renovated to accommodate the latest technology.

So what is to become of them?

To address this question, a few years ago, Gensler Research conducted interviews with hospital executives and other healthcare professionals. They also looked at secondary research and case studies.

From this research, Gensler's researchers developed an 8-step process for project teams to identify the "highest and best use for any given building." They also concluded that the vast numbers of hospital buildings that are abandoned are not historic or iconic.

Which is okay, because in many instances, the researchers felt that "un-iconic" buildings might be the best candidates for repurposing into workplaces, residences, hotels, or other healthcare uses. (Their brief but informative report, "New Life for Hospital Buildings," can be downloaded free from the Gensler website.)

What Do You Think?

What ideas do you have or have you heard about for repurposing hospitals or patient units within hospitals?  Share them in the comment box below!

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Kurt Neubek, FAIA

5 years ago

Sara, I think the most obvious need in many markets will be to convert inpatient space to outpatient functions. In other situations, some units can be downgraded from acute care to rehab, other post-acute care, or senior living. The adjacency to the hospital would be beneficial and demand for these is predicted to grow.
If the hospital was designed with good retail frontage, then whatever the local market needs can probably be accommodated, from retail to hospitality and housing.
Page (Page Southerland Page) has many examples of former inpatient spaces that were converted to other creative uses.

Sara Marberry

5 years ago

Thanks, Kurt! It will be interesting to see what happens. Technology will most certainly also play a role.

Majd Ebwini

5 years ago

Interesting topic!
Adaptive reuse presents an option for more economically addressing spatial requirements, fostering opportunities to expand the delivery of health and medical services.
Ideas for healthcare uses:
• Some hospitals are attempting to convert lower-acuity beds, such as medical-surgical beds, into higher-acuity space.
• Repurpose unused patient units to improve workflow and increase patient comfort and convenience in the hospitals.
• Outpatient facilities and Ambulatory surgery Centers
• Fitness and wellness centers
• New medical offices in response to the business growth strategy.

Joseph Sprague FAIA FACHA FHFI

4 years ago

Hi Sara excellent article. I think it underscores the total movement to ambulatory care side from several standpoints. Reducing inconvenience, network planning, acceptance of alternative caregivers, and reduce healthcare costs across the network. Health Facilities Management Magazine is doing a feature on this whole idea and it should be out soon. Those of us in the planning and design field need to incorporate this thinking for all of our clients!

Sara Marberry_013-Retouched-New copy

What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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