RWJ Barnabas Health had a puzzle to solve when expanding its Clara Maass Medical Center in Belleville, N.J. First, the project team, including architect Francis Cauffman (New York), general contractor Torcon (Red Bank, N.J.), and developer Rendina Healthcare Real Estate (Jupiter, Fla.), needed to figure out where to build a new ICU and physician office space on a tight urban campus and connect it to the existing hospital.

The old ICU, which had opened in the 1956, was outdated, while office space in the building was inadequate for today’s larger, multispecialty, coordinated care groups. Then there was the matter of New Jersey building codes: Floor height regulations differed from the 1950s to today, requiring a clever solution when connecting the new building to the existing hospital.

The first piece to solve was location. Ten different options were considered, from adding new parking decks so the expansion could be built on an existing parking lot to demolishing existing campus buildings. Instead, the developer proposed tearing down the front façade of the existing hospital and constructing an 87,000-square-foot addition—a solution that involved relocating the hospital CEO’s office, rerouting a roadway, building a significant retaining wall to support the new structure, and tying in wiring and HVAC systems from the addition to the existing hospital.

“The selected location and design provided the best solution for the patient by placing them closest to other services within the hospital with a direct connection from the new facility to the existing hospital,” says Steve Barry, executive vice president of business development at Rendina Healthcare Real Estate. “An added benefit was that it created a new face for the hospital to communicate to the community that Clara Maass was embracing the future of healthcare.”

To deal with the differing floor heights, the team looked at several options, include long slanted walkways or short elevator rides to help transport people throughout the building. They ultimately decided to connect the ground and third floors at grade with the existing hospital; floors one and two are offset, creating a split floor plan. The first floor is a half floor, with 7 feet of hidden dead space.

The second floor, which has some hidden dead space as well, is a full floor that looks over a new atrium. This combination of split floor plan, atrium, and dead space ultimately allows the ground and third floors to correctly line up with the existing hospital.

The four-story expansion also features a new main entrance, lobby, patient registration area, and retail pharmacy on the ground floor. The first and second floors house physician office space. The new 27,000-square-foot, 32-bed ICU is located on the third floor and features private rooms with pull-out beds for visitors, family nutrition centers, and waiting areas.

On the exterior, Barry says the design tries to marry the past and the present. “We wanted to take the opportunity to not just replace or mimic what was there,” Barry says. “We wanted to borrow from it in certain aspects.” To that point, the brick elements on the new building were chosen to tie in to the hospital, while a curved glass wall on the front of the new addition creates a sleek, modern look.

Additional elements at the entry, including the three-level atrium in the lobby, help improve the patient experience. “The atrium produces a sense of arrival with soothing color tones and clear wayfinding signage to reduce stress for patients and visitors,” Barry says.