R9E-Discuss What Rights City Has To Take Away Mt Sinai's Grant Of 15 Million Dog MIAMIBEACH
OFFICE OF THE MAYOR AND COMMISSION
To: Jimmy Moroles, City Monoger
From: Jonoh Wolfson, Commissioner
Dote: )uly 23, 2015
Re: Discussion ltem - Mount Sinoi
MEMORANDUM
Pleose ploce on the July 3 1 , 2Ol5 Commission Discussion Agendo:
A discussion regording whot rights we hove to toke owoy Mt. Sinoi's gront of l5 million
dollors due to their being bod corporote citizens. Specificolly, Mt. Sinoi hos continued to
oppose Boptist bringing good quolity heolthcore to the South Beoch oreo. They hove
submitted the ottoched items in o tronsporently orrogont ottempt to oct os if they core
obout troffic in south beoch. Rother, their desire to mointoin o monopoly on heolthcore
in Miomi Beoch borders on evil ond, if successful, will cost our residents deorly when it
comes to their heolth ond sofety.
It is cleor thot they put profits over people. Their gront must be rescinded. I osk the City
Attorney to outline whot grounds we moy hove.
Pleose feel free to contoct my Aide, Brett Cummins ot x6437, if you hove ony questions.
JW
We ore commifted to providing excellent public service ond sofety to oll who live, work, ond ploy in our vibront, tropicol, historic."ffi*."
nem RQ E _-
oate Ti__l_{396
1,. Operational Plan Review & Curriculum Vitae - National Healthcare Associates
2. State Building and Fire Code Review & Curriculum Vitae - Health Facility Consulting
3. Traffic Report Review - The Corradino Group
4. Parking Review Report - Walker Parl<ing Consultants
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397
ATIONAT
HEALTIICARE
A,SSOCI/\TES, lh!e.
The purpose of this memo is to compare the Baptist Health South Florlda (BHSF) Miami Beach Proiect
Operational Plan for 709 Alton Road to healthcare industry norms and standards to arrive at the
potentialcapacity of the facility based on the information given,
ln its OperationalPlan, BHSF confirms only some of the services it will offer in the building along with
hours patients can enter, arnbulance activity, estimated vlsitor throughput, high level schematics
(blocks) and other information. Much of the information provided in the Baptist Operational Plan is
talcen from suburban locations and is averaged to provide a volume estirnate, The patient volumes
represented do not coincide with the potential volume of the facility'
Urgent Cqre Center
The BHSF's Operational Plan places an Urgent Care Center on the buildlng's fourth floor adjacent to
physician offices in approximately 4,200 square feet of clinical space with a fully allocated space of
6,625squarefeet, ThehoursofoperatlonidentifiedirrtheOperationalPlanarel2hoursaday,Tdays
a weel< from ltam to 1lpm, The listed hours of operation appear to correspond to when the first and
last patients can enter the facility and not the business operation, Tradltionally, a walk-ln facility will
operate a few hours prior to and later than the listecJ hours with patients receiving services beyond
the,entrance hours.
Treotntent Rooms
At a facility of this size with 7 treatment rooms, there could be as many as 1LB trips perday' This
would result in 21,488 annual patient encounters or 42,896 trips generated, BHSF forecasts lt will
have 30 patients per day or 60 daily trips. This would be 51 percent of the actualvolume capacity of
the rooms.
Transfers from Urgent Care to Hospital
The Operational Plan indicates 0,6 percent of all patlents at its Brickell UCC were transferred to a
hospital during the last six months ol2Ot4. lf the new urgent care location reaches its full volume
potential, this 0,6 percent rate would result in 257 ambulance trips a year, or almost 1 trip per day just
from the urgent care center and not inciuciing tire"ambulaiory suige;y ceniei,
D i a g nosti c T re at m e nt Ce nte r
The Diagnostic Center as presented in the Operational Plan will be on the fifst floor in 6,000 net
square feet, and g,464 square feet on a fully allocated basis, BHSF indicates the average BHSF
rliagnostic center is 7,000 square feet. Other Baptist Diagnostic cenlers provide MRl, CT Scan, EKG,
ultrasound, dlgitalmammography, dlgitalx-ray, fluoroscopy and bone clensity, The OperationalPlan
"il,ii
'[-;
999 Ponce De Leon Boulevard o Suite 950 u Coral Gables, Florlda 33134 . TelePhone 305,444'5007 n Facsimile 305.444.5598
398
Review of BHSF Operational Plan
709 Alton Road
July 15, 2015
Page 2
doesnotindicatethenurnberof diagnostictreatmentmachines, Thetypeandnumberofmachlnesis
the driver of patient volume,
BHSF's Operational Plan suggests it will provide 37 procedures daily generating 74 trips, which
represents 19 percent of what could be the full capacity of the Diagnostic Center at this site,
Some Doy Surgery Center
The Ambulatory Surgery Center in BHSF's Operational Plart will be open 6am to 6pm lUonday thrcrugh
Friday, Our original analysis assumed 11 hours a day Monday through Friday and 5 hours on Saturday,
The Ambuiatory Surgery Center will be located on the first floor in 10,000 net square feet of space
with 4 operating roorns; fully allocated surgery center would include 15,773 gross square feet, The
Operational Plan states BHSF plans to focus on gastroenterology and colon-rectal procedures, These
procedures require less time than art average case at a surgery center,
The Operational Plan indicates the first surgery will begin at 7am and the last of the day to begin by
2pm, Of note, while the plan states the surgeries to be provided wtll be gastroenterology and colon'
rectal, the plan provides no detail as to the non-primary care physicians to have offlce space in the
building, Additionally, it is industry norm for a center with short cases of this nature to have the last
case at more like 4 PM when the center is open until 6PM for recovery, Therefore, it could have an
additional two hours of case time between 2 and 4 PM,
The BHSF Operatlonal Plan results in half of the forecasted daily trips than could be generated bythe
AmbulatorySurgeryCenter, Thedetailsoftheplanindicateitwillhave24surgeriesaday,or43trips
per day in contrast to full potentialof L08 daily trips (adjusted for not being open on Saturday) and
assumingghoursof directcasetime. Theestimateoffullvolumepotentialof l0Btripsisbasedon40
minute case/turn time, Shortening that duratiorr to 30 minutes results in maxirnum trips of 152; atZa
minutes,itwouldbe2l6trips. TlreshortertimeismoreconsistentwithGlandcolon-rectal cases,
BHSF proposes the Surgery Center will lrave 22 employees though we believe this is understated given
fcr,l' cpelaiirg roor'lrs and the neeC Jor p)'a-Dp, llcst-tc. scr'.r!: nurse, techs, anesthesia, phrTsicians,
admissions/discharge clerk, room cleaners, transporters and a manager(s), We believe that the 22
ernployees are reasonable if it excludes plrysicians (surgeons) and anesthesia physicians/personnel.
With the number of operating rooms and potential case load, we would anticipate an addiiional :1.2
surgeons/anesthesia per day.
Physicol Theropy
Physical Therapy will be located in 5,300 net square feet of sllace on the 3rd floor of the bullding;
gross allocated square footage is 9,937 square feet, Per the Operational Plan, it will be open for
399
Review of BHSF Operational Plan
709 Alton Road
July 15, 2015
Dean ?
patlents L2 hours a day, Monday through Friday, The Operational Plan assumes it will have 6
therapists, 10 employees, and patlents willbe scheduled in 30 minute [:locks,
The Operational Plan does not lndicate nurnber of rehab stations or types of equlpment, Like
diagnostic treatment centers, volume is driven by the type and number of statlons and equipment.
The Operational Plan lndicates there will be an average of LL-12 patients per hour, which suggests 6
stations, However, its maximum capacity is stated to be 18 patients per hour, 'l-his suggests tlrere are
9 stations; it ls estimated that the full capacity of the 9 stations would be 1.44 patlents per day or288
daily trips,
P hysi ci on s / M e d i co I Offi ces
The BHSF Operational Plans states its intent to have prlmary care, gastroenterology and community
'physician offices. However, the plan only provides information surrounding the primary care ph\tsician
space and omits detail surrounding gastroenterology and community physician offices,
All of the physician office space will be on the 4th floor, adjacent to the urgent care center in
11,350netsquare feet, and 77,gOZ gross square feet, Less than half the space (5,200 of 11,350
square feet) will be dedicated to primary care physlclan space, BHSF Operational Plan lndicates 4
primary care physicians and 10 exam rooms,
Prlmary care will supposedly have 10 exarn rooms and 4 physicians, Hours of operatlon will be
MoncJay through Friday from 7am to 7pm and 4 hours on Saturdays, BHSF forecasted 81 patients a
day or L63 trips, Based on the full volume capacity of the space, parameters, primary care physicians
could see an average of 198 patients per day or 396 trips per day, Layering on community physicians
and gastroenterology would increase forecasted utilization as the space indicated on the floor could
accommodate another 10-12 physicians. Even just doubling the 163 trlps BHSF forecasts for
the 4 primary care physicians would be 325 daily trips, Primary care and other physicians servlces
appear 50 percent or more under capacity.
Employees
TheOperationalPlanstatesthetotalstaffwlllbeLL5. Lisestimatedbasedontheservicesandfacility
size there will more than likely be 145 employees.
For some {but not all) of the services proposed for the building, BHSF indicates the number of
employees it anticipates, ln some services it appears some staff has been omitted such as in in the
ambulatory surgery center there are not any anesthesia personnel or surgeons forecasted,
Additionally, io the extent commurrity physicians travelwith thelr own team, those personnelare not
included. In the medical office space, the physicians, physician extenders such as advanced nurse
400
iI,
Review of BHSF Operational Plan
709 Alton Road
July 15, 2015
Page 4
practitioners and physician assistants, and other personnel are all omitted in the community physician
a nd gastroenterology practices,
On top of servlce line specific employees, the Operational Plan indicates 3 security guards between
SAM and l.t:3OPM, or L8,5 hours per day, Ihis translates into 9.8 FullTime Equivalents (FTEs), The
Plan does not identify other building personnelsuch as maintenance and housekeeping which willalso
be incremental,
Parking
Parking remains understated based on industry standards relative to the functions occurring within
the bullding and industry metrics ln terms of parking spaces per square foot, With the number of
employees, plus more than one shift per day and parking needing to accommodate shift changeover,
the number of spaces is insufficient for employees let alone the patient volume.
Spoce Allocation
Table 1 below provides a space allocation by use for the building. lt is an allocation of common area
(program support) space to each ofthe medical uses to arrive at a total use square footage,
Use
Listed
Square
Footage
Percent Net
Space
Common
Area
Allocation
Total Area
Medical Office 11,350 3CI.0y 6,552 17,902
Diagnostic Center 6,000 ts.9%3,464 9,464
Surserv Center 1o,000 26.4%5,773 15,773
Physical Therapy 6,300 t6.6%3,637 9,937
Ureent Care 4,200 77,7%2,425 6,625
Medical Uses Total 37,850 1_00,0%21,850 59,700
Common Area 21,850
Retall/Caf6 3,900
)'^r ^ I <? qon
If
401
PATRICIA G REEN BERG, FACHE
N ATIO NAL H EALTHCARE AS SOCIATES, I N C,
999 Ponce De Leon Boulevard
Goral Gables, Florida 33134
305-444-5007
BUSINESS
EXPERIENCE:
1990- NATIONAL HEALTHGARE ASSOC|ATES, coral Gabtes, Florida
President
Established a healthcare and senior living consulting firm which specializes in expansion,
diversification, and acquisition analysis; strategic market positioning and market evaluation;
healthcare administration, planning and finance; compliance and regulatory support and
applications, including Certificate of Need applications; litigation support; financial modeling and
forecasting; workout services; market, financial and operational evaluations and assistance in
acquisitions or refinancings; determination and analysis of financing alternatives; securing
financing; and development. Clients include hospitals, nursing homes, senior living facilities,
physicians, other healthcare providers and related organizations and financing companies
serving the healthcare industry.
Experienced in preparing Certificate of Need applications for acute hospital services,
rehabilitation hospitals, long term acute care hospitals, hospices, psychiatric facilities,
home health agencies and nursing homes and providing related litigation support
services qualified in health planning, health finance, feasibility and operations
Skilled in needs assessments, markel studies and economic feasibility analyses for
healthcare services, hospitals, post-acute services, assisted living, skilled nursing and
retirement housing for new development, evaluation of existing operations and
acquisition opportunities
Provide on-going operational, regulatory and management support for healthcare
facilities including utilization evaluation and enhancement, regulatory reporting, financial
assessments and controls and administration support.
Conceptualized, structured and negotiated off-balance sheet transactions and physician
ventures.
Strategized and implemented business and service line opportunlties to enhance
revenues, increase market share and improve return on investment for hospital and
healthcare clients,
Evaluated properties for potential conversion to senior living facilities, including physical
plant and programmatic issues.
Planned and developed healthcare and senior living communities, including site
selection/analysis, project conceptualization, market and economic feasibility studies,
facility planning, campus master planning, medical equipmentation and development,
Formed NHA Management Services, lnc., a company specialized in the development
and operation of assisted living facilities, including those designed for lower income
population; serves as the company, s President.
402
PATRICIA GREENBERG
(coNTTNUED)
Partnered with clients in the planning, implementation, ownership and operation of
various types of healthcare related facilities, including congregate facilities, assisted
living facilities, nursing homes and medicaloffice buildings.
Qualified as an expert in judicial matters in the areas of health/hospital planning,
healthcare/hospital finance, financialfeasibility, long term acute care hospital planning
and operations, hospice planning and operations, staffing, budgeting and otherfinancial
operating criterion.
1984-1990 LAVENTHOL & HORWATH, Miami, Florida
Director, Southeast Healthcare Consultinq (1 990)
Assumed a new management position with broader responsibilities which was created as a
result of the Firm's reorganization. This one position replaced the roles of two positions - the
healthcare practice leader for Florida (previous position) and Georgia.
. Assumed professional staff responsibility for the healthcare consulting personnel in
Atlanta, in addition to responsibility for Florida personnel.
. Retained Florida clients and accepted responsibility for developing clients throughout the
Southeast region.
. lncreased utilization and chargeable time for the professional staff in Atlanta.
. Performed in this position untilthe Firm filed for bankruptcy. Have since retained client
base despite the bankruptcy filing.
Manaoer, Healthcare Consultinq (1986-1 990)
Managed lhe Firm's Florida Healthcare Consulting Practice, including client development,
seruice delivery and professional staff training and development.
Diversified practice from a predominantly retirement housing and long-term care base to
include substantial representation of hospitals.
Expanded practice to include strategic market positioning, Certificate of Need
preparation, rate optimization and hospital diversification strategy development.
Prc-r,ideC litigaticn suppor"t sen4ces relaied to Certiflcate cf I\.leed ad:,^rinls'lrat:ve hearlngs
and business interrupiion and damagdclaim cases.
ldentified product opportunities and market entry strategies forvendors to the healthcare
industry.
Supervised and directed the professional staff in the conduct of an engagement.
Authored and co-authored articles on annual basis focusing on topics of interest
including indigent care funding, long-term care joint ventures, hospital strategic planning
and converting a hotel to an assisted living facility, among others,
Presented numerous seminars related to the healthcare industry.
403
PATRIC]A GREENBERG
(coNTTNUED)
Assoclate, Healthcare Consultins (1984-1986)
Conducted healthcare market and financialfeasibility studies to support applications for
financing and for inclusion in public bond offering documents.
Evaluated sites for the development of retirement housing facilities and developed the
appropriate project conoept, including service focus, pricing and design, suitable forthe
site.
Cond ucted operational overviews of healthcare faci lities.
Supervised the staff and senior consultants in the execution of their responsibilities.
1983-1984 DELOITTE, HASKINS & SELLS, Miami, Florida
Healthcare Consultant
Conducted patient acoounting study that included management of a special receivables
reduction and cash flow improvement task force effort which resulted in the decrease in
accounts receivable days from in excess of '100 to below 50. Performed operational reviews of
hospital accounting, billing and collection functions, Managed automated thlrd-party
reimbursement programs for client hospitals in Florida and Puerto Rico.
1980-1982 WOMEN & INFANTS HOSPITAL, Providence, Rhode Island
Special Projects Coordinator
lnvolved in Certificate of Need application preparation for a $54 million replacement hospital
project. Assisted in writing a Request for Proposal for a computer system subsequent to
completing a Management lnformation System Study. Prepared preliminary operating budgets
and conducted capital asset planning and budgeting process.
EDUCATION:
Columbia University, Masters Degree in Health Administration
Boston University, BSBA, Finance and Operations Management
Board Certified in Healthcare Management
PROFESSIONAL
ACTIVITIES:
Fellow, American College of Healthcare Executives (ACHE)
Advanced Member, Healthcare Flnancial Management Association
Member, American Hospital Association
Member, Florida Hospital Association
Officer, Executive Committee, Treasurer - Board of Directors, South Florida Hospital/Healthcare
Association, Formerly Secretary (three years) and Treasurer (eight years) through 2010
Regents Advisory Council, ACHE (1991-1997)
Past RegionalVice President, NationalAssociation for Senior Living lndustries
Past Chairperson, Advisory Board, Florida Metropolitan University System
Past Board Member, The Healthcare Consortium
404
From: Skip Gregory
Date:fuly 20,2A75
Subject Code References for Project 0ceania
Please find some additional information concerning the project Oceania and
outpatient surgical services and outpatient clinical services in general.
The building and fire codes are determined by state rule and are applied to a project
as the rule of the reviewing agencies dictate as follows:
L. Unless the project received a Stage II approval from AHCA prior to December
31,,20!4, itwill be reviewed using the20LZ edition of the NFPA 10l" LSC and
all other NFPA codes as revised by the State Fire Marshal's Rule, Chapter
694-3,012 FAC.
2. Unless the project received a Stage II approval from AHCA prior to June 30,
2015, it will be reviewed using the 5u, edition of the Florida Buiiding Code
[FBC).
3, Unless the project has received construction document approval from the
]ocal authority having jurisdiction for fire codes review prior to December
3L,201-+, itwill be reviewed using the2012 edition of the NFPA 10L LSC and
all other NFPA codes as revised by the State Fire Marshal's Rule, Chapter
594-3,012 FAC.
4. Unless the project has received construction document approval from the
locai authority having jurisdiction for building codes review prior to June 30,
2075, it will be reviewed using the 5tt' edition of the FBC,
Although the Sfl, edition of the FBC still classifies an ambulatory health care
occupancy and an outpatient clinic as Business Occupancies, it has added a new
definition of an ambulatory surgical center that is aimost identical with the
definition of a hospital as follows:
AMBULAT0RY CARE FACILII'Y, Buildings or portions thereof used to provide medical,
surgical, psychiatric, nursing or sinrilar care on a less than Z4-hour basis to persons who are
rendered incapable ofself-preservation by the seryices provided.
HOSPITALS AliD FSYCIiIATRIC j-i0SPITi\LS. Faeili;.ies ;,rai prc;'ia; :ar; ri'creain:e;-ri for tlie
medical, psychiatric, obstetrical, or surgicai treatment of care recipients that
are incapable of self-preservation,
This similarity is carried into Chapter 4, Special Detailed Requirements Based on Use
and Occupancy,by the new section for ambulatory surgical centers, Section 422,
Because both types of facilities house patients "incapable of self-preservation", this
section has added new requirements that were not previously part of the FBC
including mandatory sprinklering requirements for all ner,v ambulatory surgical
centers.
405
Tlre Sth edition of the code also has added a new section to Chapter 4 for 7ffice
Surgery Suite, Section 469.Because outpatient clinics often perform surgical
procedures that are not covered by other design, building or fire codes, and because
these procedures can render the patient "incapable ofselfpreservation" section 4.69
was added,
This section now references the State Fire Marshal's rule, 694-3.0 j.2 FAC, the
Guidelines for the Design and Construction of Health Care Facilities, and just Iike
ASCs, it also references Chapter 20, Ambulatory Health Care occupancies in NFpA
101, Life Safety Code,
As can be seen from these revision taking place in the fire and building codes that
regulate ambulatory surgical centers and outpatient clinics, there is a growing
concern about the acuity and safety ofthe patient being treated in these settings,
Tlrerefore, the regulatory codes are moving more towards a rusk based assessment of
the services provided, whether they be inside of a hospital, an ambulatory surgical
center, or an outpatient clinic or doctor's office, As the commentary of the building
code states,
Complex outpatient surgeries outside of the hospital are now commonplace,
They are performed in facilities often called "day surgery centers" or
"ambulatory surgical centers" because patients are able to walk in and walk
out the same day. Procedures render patients temporqrily incapable of self-
preseryation by application of nerve blocks, sedation or anesthesia.
Patients in these facilities Spically recover quickly, A definition of "Ambulatory
care facili4t" is provided in Section 202. The code identlfies medical care Group
I occupancies as having Z4-hour stay. Without a Z4-hour stay, these surgery
centers are classified as Group B, Strictly regulating such occupancies as a
typical Group B accupancy is considered inappropriate, as this would allow the
rendering of an unlimited number of people incapable of self-preserttation with
no more protection than a business office. These types of facilities contain
distinctly dffirenthazards ta life and safety than other business occupancies,
such as:
1. Patients incapable of self-preservation require rescue by other occupants or
fire personnel.
2. iVledicctl stalJ must stabilize the patient priorto evacuation; therefore, staff
may require evacuation as well,
3, Use of oxidizing medical gases, such as oxygen and nitrous oxide.
4, Prevalence of surgical fires.
In the past, there wqs a. movement to classify ambulatory care facilities as
Group I-2 occupancies. Federal and statejurisdictions have recognized that
there is a middle ground between Groups B and I-2. These requirements
provide a scaled approach to protection. T'he occupancy classification is a
406
Group B, butwith some enhanced safety features focused on the concernwitlt
occupants being incapable of self-preservation on a temporary basis, The
enhanced requirements are based on the concepts in the regulation of the
Group I-2 occupancy requirements found in Section 4A7.
407
HEAIJTH FAC]IJTTY CONSULTING, L. IJ. C.
TAIJIJAHASSEE, FLORIDA
funans R. (Srcr) Gnncony, NCARB
HpaIrH FACILITY CoNsuI.rNc
TarlauassEn, FloruoA
WWW.I.IEALTHFACILITYCONSUT,TING. COM
E>CBruBNCBD IN THE REVIEW oF THE DESIGN AND CoNSTRUCTIoN oF HoSPITALs,
NURSING HOMES, AMBULATORY STIRGICAL CENTERS, AND OTHBR SIMILAR HEALTH
CARE FACILITIES To MEET VARIoUS CoDES AND STANDARDS. SERVES oN MANY
NATIONAL CODE WRITING COMMITTEES AND ADVOCACY GROTIPS FOR THE
ADvANCEMENT oF HEALTH cARE FACILITy DESIGN. OursporeN ADVocAt'E rroR
RESIDENT DIRECTED CARE AND HOUSEHOLD DESIGNS IN NTIRSING HOMES AND
PATIENT CENTERED CARE IN HOSPITALS.
EDUCATIoN
UrvtvpRsrry op TBxas - B. A. DscREB
fucp Uuvensu'v-MesrERS oF ARcnrrpcruRn DEcnpB
Pnornssrontal RpcIstrurrox nxo Apru,urroNs
R.ucrsrpRro AncsrrBcr - SrarB or FroRna Q.{o. 11759)
NCARB CnRrrrmo (No, 32824)
CsRrm'tso Sppcml FIRB Sarsry INspecron - Srarr oF FLONDA
CBRTMIPO FTNU SAFPTY INSPECTOR _ CPITITBR rON MTOTCANB/MEDICAID SNNVTCPS
CBRtm'mo FtnI Sarsry EvaruarroN SvsrBu luspncroR (FSES NFPA 101 A)
ExBcurrvn BoARD IUEIvtsER oF THE HBaLrs Caru SncuoN, NFPA
VoitNc rVovmnn t-t't Coons ttuo Stu;vortRDs REt'tEW Cotntrrrr, Hpalrg CaRn
SECTIoN, NFPA
Cuan op tur, Lnn Stwtry Coot Suacoutrutrrnt, HBalru CaRs SpcrtoN, NFPA
VoTING MnMsEn op NFPA 110/1ll TBcrucal Covnarrrpp, SrtuoAno tron
Eueacmtcy lxo Srlt ro pr P owon Srvmts,NFPA
VorNc MSMBBn or UL CoruurrrBr, Sr,q.ttoAnos Tocat'ncu PANEL 1069
Sravo,ano ron Hosptrlt StcutttNc ,qNo Nunsr, Cut EgunuoNr
4L28 ZefilaLt Drive,Tallahassee, FL 32303-2252 T 850-567-3303 Fu/Home850-514-
2495
unuwww.heaLthfacilltyconsuLtinq.com Emair@
408
Resume- James R. Gregory
Page2 of7
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CoNrsNr AUTHoR pov lwrnooucrroN ro B.estc Lru Slpzrv CzDE, NFPA 101,
2000 portoN, coNTRACTED By CTNTBR roR Mpucans/MrotcaIo SBnvIcrs
(cMs)
EottoR FoR A coMMENTARy/HaNngoor poR 7na GwoauNas FoR THE Dtstctrt
It'to Cot'tsrnucrtot't or HuLra Cmz Fa)ILITIES, CoNTRACTED BY TIII Guiopt tNBs
4128 Zermatt Drive, Tallahassee, FL 32303-2252 T 850-567-3303 Fu/Home850-514-
2495
uRt www. heal-thfacil ttyconeultinq, com Emall qreqory6klp@qmal I ' com
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Page 3 of7
4128 zerrnaLt Drive, Tallahassee, FL 32303-2252
2495
URL
Facntrv INsururB AND AMERICAN SocIETy oF FIEALTHCARE ENcnrtppRnqc.
WOnx IS INPROGRESS.
Awnnos aNn Rncocxrrrous
CBRuprcere oF ArrRecmttoN, AvrpntcaN CoLt pcB oF }lparrg Canr
ARCHrrECTS,2010
ENcTNJapzuNG AwARD oF EXCELLENCE, FLORIDA HEALTHCARE ENGINEERING
AssocnnoN,2010
Cpnrmlcnrr Eor AppnscIATIoN FoR rnn AoveNcplvmNr or Crnrunr Cuaucr nq
NURSTNG HoMES, Flozuoa Healru Cap.BAssocnuou, 2009
Purr,rc SpRvaNr AwARD, FLoRIoR AssocnrtoN or Holrass AND Ssnvtcss roR
rss AcrNc,2009
CpRrlrIc,q.rE oF ArrRECTATIoN, AcpNcv FoR HEALTU Carul AoutNtstRauoN,
2009
EmcnrrBpp.rNc Awanp or Excplr,nuce, FLonIDA HEALTHcanB ENoINSERING
AssocmnoN,2007
CpRrmIcarr or AppRBcIATIoN, Facu,trv Gutoplnrms INstttute, 2006 aNo 2010
2012. 2013 ano 2014 PnrsrNrnrroNs
2014
o ,, 2OI4 FaCu,ITy GUmpmrms INSTITUTE UPDATES,,, ACE SUIvTIvtT AND RgVgItSIi
Expo,NEw Oru.raNs, LoursIaNA, FEB. 03-05,2014
o "SAGE PLACE", ENvtRonrr,mNTS FoR AcrNc, ANAHEIIvI, CalmoRue, Mav 3-
6,2014
o..LIFE SaTgTy Cons PaNEL OF EXPERTS,,, TELS SUMMIT, MIIWAUTEE,
wrscoNsrN, Mw 14-15, 2014. ..BUILDING AND FIRE SATSTY COOSS: NO LONCEN ITWPUUSInS T,O CHANGE,,
Snnnqc INTo tIE FuruRE, Ft-oruoa LEADING Acp, JecrsoNVILLE, SrrtevsnR 8,
20t4
o'oNEw ASHE auo AIA Srauoanos: Crurtcal IssuBs pon HSaTTHCARE
MAINTENANcp, ReNoverioN, AND CoNsrRucrIoN, FLoRIDa PRopssstoNAL IN
INrpcrroN CoNrRor 39t' Axlrual EoucauoNAl CoNrTRBNCB, ORtaNlo
FLoRTDA, SpprBMsnR 17 -19, 201 4
o "Allllut,AToRy Sur.clcei Cexirns Cope Upp.\rES", NEW Coots .\)'iD
sraNoeRps" 30" ANNUAL AHCA srumaR ANo 52*'At'INuaL FHEA Tnaps
SHow, Oru.ANno, FLozuDA, SBpreI\Gnn 22-24, 2014.
o OOFGI GurnsI,TNBs UPDATE, 2014,'WEBINAR, AMEzuCAN SOCMTY }IEALTHCARE
ExcrxrnnruNc AssocnnoN, OcroBER 7 4, 201 4
oOONEW ASHE auo AIA S.I.ANDARDS: CruTTCAL LSSUES TOR FIIAITHCARE
MaTNTBNaNCE, RTNOVATIoN, AND CONSTRUCTION,,
r "THE DestcN aNo CoNsTRUCTIoN or OurpartuNr SuRcrcal, FACILITIES" AIA
FoRr LauoERDALE CHArrrR, FoRr I-auoBRDALE, FLoRIDA, NovnMspR L5,2014
T 850-557-3303 Fax/Home 850-514-
Ematl qreqorvskio@qmal1 . com
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Resume- James R. Gregory
Page 4 of7
2013. "'WHAT Wrr-t, AHCA Appnovn? DsvnloptNc Successrul ICRA AND ILSM
PRoGRAtr,ts", MIAMI, FLoRIDA, MARCH 2013. ..SAGE P.L.A.C,E, PRocnaiTavTNG FoR LIvTNC AND ACHIEVING CULTURE-
CuaNcp ENvrRoNtvmNTs", ENVIRoNMENTS pon Acnqc AxNuat- CoNFERENCE,
NEWORLEANS,ATTI 2013. ..CoDE IMPACT! How Culrunn CrraNcE INSPIRED RSvTSIoNS wILL AFFECT
YouR HoN,G" LEADTNG Acr FloruoA, DISNEy Onr-aNoo ResoRT, lut-v,2013. "CULTURE CriaNcr IN 2013", Flozupe Hsat-ru CARE AssocIATIoN 2013
ANNUAL CoNpBnBNcE AND TRaos SFIow, Hou-vwooD FLoRIDA, Aucusr 2013. "FIRE/Lmr Saprtv Upparcs roR NuRsnqc HotvGS, FHCA RectoNal
EDUCATION SEMINARS, TALLAHASSEE, TAMPA, ORIANDO, DAVM, OCTONER 1-4,
2013. CoDE CnaNcus ron CulrunB CHANGE, 65'" ANttual FnB PRsvBNroI!
CoNrpRpNcn, FLonne Fnp M,q.nsIrALS AND INspncroRs AssocIATIoN, KEY
WBST, FLoRIDA, NOVEMBER 20 1 3
2012. 'NEW Coors AND SraNoanos Rrvpw Fon Flotuoa Htalru Cans
FACILITIES", OFntce or PI-aNs aNp CoNSTRUCTIoN, TallagassEE, ORLANDo,
ANDMIAMI, FLORIDA, FaenuARv 2012. ..FGI GUToBLINBS AND IIVPACT ON FIRE SAFETY,,, NAUONAI- TRENDS IN
DBuvpRy oE HBeLts AND LoNG TBnu CanB: IuplrcattoNs roR Sargrv Copps
axo StaNoARDs", BaLfitvtoRE, MARyLAND, Mencn 2012. "SAGE P.L.A.C.E, PRocnAiul,nNG FoR LtvtNc eNo AcmBvNc CuLruRE-
CIIANcE ENVIRoNT\.GNTS", RoTHScHILD FoLrNoauoi.l AND AclNc AND
ENvIRoNMENT, ORLANDo,FLoRIDA, Aprul 2012
. O.THIRD AuNuar AIAS/SAGE SruopNr DPSICT.I COIpBTITTON, ENVTRONMENTS
EonAcntc 2012, OnraNoo, FLoNoA, ArNL 2012. "SAGE SruorNrDrstcN Colalnrll'roN aNo RsvtstoNs ro Copes pon CulruRB
CHANGE", AHCA/FHEA AN.nrrual CoNrBrcNcE AND Tnaop SHow, ORLANDo,
Fr,oruoa,2012
PnornssroN.q.L ExpnMENcp
Hnalru Facrlruv CoNsulrnc, LLC
TALLAHAssnu, l'lonloa
Pnr,sros,Nr
2010 ro PnEspNr
Du-nus .ltr,o R.r-spo\TSIBILITIE s :
PROvTopS CODE AND DESIGN CONSULTING SERVICES FOR NEW AND EXISTING
IIEALTH CARE FACILITIES INCLUDING HOSPITALS, NURSING HOMES, AMBULATORY
STJRGICAL CENTERS, AND OTHER LICENSED AND CERTIFIED HEALTI-I CARE
FACILITIES.
IRoDUCES rHE ANNUAL AceNcv non HeaLrn CRns AourNtsrnnrtou (AHCA)
TRAINTNG sEMTNAR THRoucH coNTRACT To rHE Flonroa Hpalru Cans
ENcnvBpruNc AssocnrIoN, (FHEA),
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Resume- James R. Gregory
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PROVDES CODE AND DESIGN TRATI\ING SEMINARS AND PRESENTATIoNS FOR
HEALTH CARB PROFESSIONALS AND ASSOCIATIONS, ARCHITECTS, AND ENGINEERS.
AcnNcv FoR HEALTH CARE AorumrsturroN
Office of Plans and Construction
Tallahassee, Florida
BuRBau CuIpr
1993 -2010
DUTIES AND RESPoNSIBILITIES :
MANAGED THE ACTIVITIES oF 46 ancTuTBCTS, ENGINEERS, FIRE PRoTECTIoN
SPECIALISTS AND ADMINISTRATIVE STAFF LOCATED IN THREE SEPARATE OFFICES IN
THE REVIEW AND APPROVAL OF ALL NEW CONSTRUCTION AND RENOVATION
PROJECTS IN AtL HOSPITALS, NURSING HOMES, AMBULATORY SURGICAL CENTERS,
AND INTERMEDIATE CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED.
MANACco THE ARCI-UTECTURAL REvIEw oF ALL CERTIFICATE oF NEED
SUBMISSIONS AND ALL ANNUAL LICENSURE SURVEYS LOCATED IN THE STATE OF
FLonroa.
PLENupn AND CooRDINATED THE TRAINING FoR 10 T.InE SA-FETY INSPECToRS IN
T'I]E FIELD OFFICES OF TIIE I]IVISION OF HEALIH QUALITY ASSURANCE.
PIEMTNo AND COoRDINATED THE AGENCY,S RESPoNSIBILITIES IN TFIE EMERGENCY
OPERATIONS CENTER AND OF THE DEPLOYMENT OF DAMAGE ASSESSMENT STAFF
PERSONNEL IN EVENT oF EMERGENCY AS PART oF THE ESF-8 REspoNsp PLAN.
PT.AMTTPO AND CONDUCTED THE STATE wIDE ANNUAI SEMINAR PRESENTED To ALL
DESIGN PROFESSIONALS, CONTRACTORS, OWNERS AND PROVIDERS OF HEALTH CARE
PRACTICING IN THE STATB oF FLoRIDA.
SECUREo, PLANNED AND BUDGETED TECHNICAL TRAINING SEMINARS AND SCHooLS
FOR ALL SI'AFF PEITSONNEL.
RBwRoTe AND UPDATED TTIE STATE RULES AND CoDES GovERNING HEALTH CARE
CoNSTRUCTIoN IN THE SrarB op FLozuoI..
MawramBD LTAISoN wrrH oT'ltER oFFrcES IN THE AcsNcv p'oR HEaLru CanB
AomNrsrRaTroN, Flozuoa Hosprtal Assocmttol, Fr,oRIoa HBar,rH CeRs
AssoclrrroN, FLo?,iD.\ \{r,olc.tr- Assoct.tuox, cFllcES oF TI-IE St,rtp Frc.
MARSHAL AND oT}IER INTERESTED PRoFESSIoNAL ASSoCIATIoNS AND oFFICIAL
AND VOLUNTARY AGENCIES CONCERNING THE FACILITY DESIGN, STRUCTURE AND
FTINCTION OF }IEALTH CARE FACILITIES.
DBTTnumpD WHICH PRoJECTS PRoPoSED BY THE HEALTH CARE FACILITIES MUST
BE SUBIECT To REVTEw By rIrE OrprcB or Plalls auo CoNSTRUCTIoN.
RBPRBSPNTBD TTIE AGENCY To THE STATE LEGISLATURE CoNCERNING ALL FIEALTH
CARE CONSTRUCTION ISSTIDS.
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Resume- James R, Gregory
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REPRESENTED THE STATE ON VARIOUS NATIONAL CODE COIVMITTEES INCLUDING
THE FLORIDA BUILDING COMMISSION AND THE NFPA.
AcsNcy FoR HEALTH CARE AouINrsrnauoN
Oprrcn oF PLANs AND CoNsrRUCTroN
Tu,lanassEE, FLoRIDA
ARcurrpcr SuppnvrsoR
1989 - 1993
DurrBs AND RESPoNSIBILTUES :
SupEnvtsro 11 rucrsrrnpD ARCHTTECTS rN THE REVTEW AND TNSpECTToN oF ALL
NEW CONSTRUCTION AT ALL LICBNSED AND CERTIFIED HEALTH CARE FACILITIES IN
rns Srare or FLoRma, REGULATED UNDER Cnapron 395 alrn 400, F.S.
INCLUDING HOSPITALS, NLIRSING HOMES AND AMBULATORY SURGERY CENTERS.
RPVMWTO AND APPROVED ALL WoRK PERFoRMED BY THE ARCI{ITECTURAL STAFF
INCLTIDING STAND-UP REVIEWS, PLAN REVIEWS AND CONSTRUCTION SURVEYS.
IUTTNvmWPD, H]RED, EVALUATED, TRAINED AND DISCIPLINED ALL MEMBERS oF
THE ARCHITECTT'RAL STAFF.
PA TTCTpITED IN THE SUPERVISIoN oF TWo REGISTERED ARCHITECTS wHo
REVIEwED THE ARCHTTECTTTRAL sEcTroN oF THE Crnrmrcatp oF Nspo
AppLICATIoNS. CooRorNarBD THIS REVIEW pRocEss wITH THE CpRnrrcttB op
Npno Orprcn ro ENSURE coMpLtANCE wrrH ALL Srars RULES AND REGULATIoNS.
PARTICIPATED IN THE SUPERvISIoN oF EIGHT INTERDISCPLINARY REvIEw TEAMS
COMPOSED OF A REGISTERED ARCHITECT, MECHANICAL ENGINEERAND ELECTRICAL
ENGINEER IN THE RXVIEW AND INSPECTION OF ALL LICENSED AND CERTIFIED
HEALTH CARE FACILITIES.
PlaxNno woRKLoADS, woRK FI,ows, DEADLINES, woRK oBJECTIVES AND TIME
UTILIZATION OF THE ARCHITECTS AND THE SURVEY TEAMS.
PIANUPo AND CoNDUCTED WEEKLY STAFF MEETINGS AND QUARTERLY
WORKSHOPS FOR ALL STAFF PERSONNEL SO THAT CONTINTIITY OF CODE
ENFORCEMENT AND INTERPRETATION IS MAINTAINED,
WAS TIIE DELEGATED AUTHORITY FOR ALL TECHNICAL STIPERVISION DLrRING THE
ABSENCE oF THE Bun-aru CiiigI.
AcnNcy roR IInar,rH CARE AonumsrnarroN
Orucr or PLANs a.Nn CoNSTRUCTIoN
T.lr,urussEo, FLoRroA
AncmrBcrII
Prau Rrvrpwsn/CoNsrRucTroN SuRveyoR
1986- 1989
4L28 ZermaEt Drive, Tallahassee, FL 32303-2252 T 850-567-3303 Fu,/Homo850-5L4-
2495
unl- www. healthf acilitvconeultino. com Emall@
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Durtps AND RESPoNS rB n,rrrEs :
Srarr ARCHTTECT wrrH THE OrprcB oF LrcpmsuRe AND CERTTFTcATIoN.
RPSpoNSISLE FoR THE REVIEW AND APPRoVAL orTHE PLANS AND CoNSTRUCTIoN
OF ALL }IEALTH CARE FACILITIES IN THE STATE OF FLORIDA REGULATED TINDER
CuaprBR 395 AND 400, F.S., TNCLUDTNc HospITAI-s, NURSTNG HoMEs,
AMBULATORY CENTERS AND OTHBRS. REVIEWED PLANS AND SPECIFICATIONS (3
STAGES: SCHEMATIC, PRELIMINARY AND CONSTRUCTION DOCUMENTS) TO UUTT
TIIE STATE ADMINISTRATIVE CODES, BUILDING CODES, FIRE SAFETY CODES AND
HANDICAPPED ACCESSIBLE CODES.
ACTSo AS TI-IE TEAM LEADER FoRAN INTER-DISCIPLINARY TEAM CoMPoSED oF AN
ARCHITECT, MECHANICAL ENGINEER AND ELECTRICAL ENGINEER. Coonon,IaIso
THESE FINDINGS AND ALL DEFICIENCIES WITH l'HTi TEAM MBMBERS AND PREPARED
wRrrrEN REpoRTS FoR TrrE AppRovAL oF THEARCHITECT SupBRvrsoR. Sunvpvuo
EXISTING FACILITIES FOR COMPLIANCE TO THE MINIMUM REQUIREMENTS OF
CuanrR 13, NFPA 101. CoNouctBo oN-srrE TNSIECTToNS DURTNG
CONSTRUCTION TO ASSUIIL COMPLIANCE WITH THE APPROVED PLANS AND
SI'ECIFICATIONS, REVIEWED ALL CONSTRUCTION CI-IANGE ORDERS AND FIELD
CHANGES AND RECoMMENDED To THE OFFICE oF LICENSURE aNo CSRTIpICATIoN
THAT THE PHYSICAL PLANT WAS READY FOR OCCUPANCY.
RnnnnnNcns OxRuoursr:
4L28 zermatt Drive, Tallahassee, Fl 32303-2252
2495
unL www. heal!hf acl 1 i tvcgneulting . com
T 850-557-3303 Fu/Home850'514-
Emall qreqorvskip@qmail . com
414
TF{H C$RRAMINO ffiffiffiUP INffi"
ENGINEIFG' PIANNERS . PROGMMI\4ANAGERS . ENVIRONMEIITALSCIENTISI"SoZ
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Project #:
Subject:
Iuly 20,2015
Stephen I(, Bryan, PE, PTOE
TCG# 42't6-01
Proposed 709 Alton Road Project
Updated Traffic Impact Study Review (Dated June 9,2015)
Trip Generation Study Review (Dated April20, 2015)
MEMOR.ANDT]M
To whom it may concern:
This memorandum documents the findings of the detailed review of the proposed'709 Alton Road
Froject Traffic hnpact Study prepared by Traf Tech Engineering, Inc., dated June 9, 2015, The
review also iucludes the accompanying Trip Generation Study prepared by David Piurnmer &
Associates dated April 20,2015. The review comments have been divided into the following tluee
sections:
UPMEU @ATED JUNE i,2015)
Data Collection
i. The traffic study lvas noted as "Upilated June 9, 2AI5", horvever traffic data coliection
deficiencies frorrr the original traific study (conducted during October 2013) were not
updated. kr particular, the signalized intersection of Alton Road and 86 Street was not
updated, As noted on Page 6 and in Figure 3, the northbound and southbound movements at
this intersection were blocked off during the Alton Road construction project and
assumptions were made for these movements in the future traffic analyses, However, the
4055 NW 97th AVENUE o MIAMI, FL 33178
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,)
Alton Road northbound and southbound left turn movement restrictions were removed in
.lanuary 2015 and the updated traffic study did not reflect this change, The collection of new
traffic counts reflecting actual operating conditions will remove the previous assunptions
that were made in the original trafftc study. Update the traffrc volumes for this intersectiorr
to reflect current traffic conditions.
2. The traffic study only contained traffic couirts collected during the PM peak period, but the
trip generation data collected reflected both the AM and PM peak periods. Therefore, the
traffic analyses contained in the traffic study can only reflect PM peak period operating
conditions, The AM peak period cannot be considered in the traffic analyses ra,ithout traffic
counts collected during the AM peak period.
Trip Generation and Distribution
3. The foilowing ate comments regarding Table 1 on Page B:
a, The ITE Land Use Code 826 (Specialty Relail) contained 10 total trips that were
calculated from the rate equation. Since the ITE I* value was 0,98, the equation
fbrmula should be used to determine the total nunber of trips (31 total trips). Update
the land use to reflect the equation formula,
b. The Same Day Surgery Land Use is listed as 9,900 SF in size, however the
independent vaiable that the trip generation rate was based on was Procedure Rooms
(riot SF size area). The number of procedure rooms for this land use is not listed in
Table 1 or in the proposed land uses on Page 3. Explain how Procedure Rooms
correlate with the SF size area.
c. For the Common Areas, the weighted average of all other iand uses was used to
determine its trip generation rate (2.49). However, the weighted average of all other
land uses was not used to determine the inbound/outbound percentages (34% and 66%,
respectively), in addition, the 2.49 trip generation weighted average rate included the
published average rates for the ITE land use codes (LUC "120 and 826). The trip
ge;r:;eti...'. l:i:;';s:.1 :::'"1:e ri:l;l:::J i..':.:'lg; :.::: cal:,:l1'.ici.S f,.r t1::*.3 11ya h:id L:s-.
codes should be quantified from the equation fomula results. ln oflrer words,
LUC 720 should be 3.60 (instead of 3,57) and LUC 826 should be 8.16 (instead of
2.71).Update the land use to reflect the equation formula results.
d. Daily trips were calculated and provided in the originai traffic study, but has been
removed from the updated traffic study. This information could not be checked.
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4,
5.
3
In Figure 4 on Page 1 0, the intersection of Alton Road and 8s Sheet depicts 25 inbound trips
traveling southbound on Alton Avenue. FIow do fliese 25 inbound trips become part of the
55 inbound trips entering the site during the PM peak hour?
ln Appendix E, the cornmitted deveiopment trips shown for each intersection should be
further detailed to show how these committed developments trips for the proposed
development were derived from the committed development trips contained in Appendix D.
Provide more details on the committed development trips, especially how they relate to the
proposed development.
ln Appendix E, the intersections of Alton Road and 7e Street along with Alton Road and the
project driveway depicts 36 northbound through trips for the 600 Alton committed
development instead of 72 trips shown in Appendix D. Which is correct?
Fuh:re Conditions Traffic Volumes
7 . On Page I 1 and contained in Appendix C, a 1.01 peak season factor was used to convert the
existing traffic counts to peak season conditions based on the factors provided for Category
8700 Miarni-Dade North in2012. Subsequently, the Florida DOT has published 2014 peak
season factors and due to its proximity to the proposed development, Category 8739 Miami-
Dade I-395 is the most appropriate category of peak season factors to use for this traffic
study (1.06 peak season factor). Update the future traffrc volunes,
8, On Page 11, the study notes that "minimal traffic growth has occured during the past 5
yeaxs" and that a conservative approach of 1o/o was used for the arurual glowth rate.
However, using the information contained in Appendix C, the past 5 years (2A08 b 2012)
reflected a2.87% compounded anrrual growth rate for Site 2527 and a 1.61.Yo compounded
arurual growth rate for Site 6059. The average growth rate of these two sites would equal a
2.24% compounded annual growthrate instead of the 1% used inthe traffrc study. Update
the future traffic volumes,
9. On Page 11 and in Appendix D, at least frve of the nine committed developments presented
Saiurday peak hour trips. This report did noi noie thai at assuiriptioll was made io iquaie the
Saturday peak hour trips to weekday peak hour trips. Note this assumption along with any
other assumptions in this study.
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4
Trafflrc Analyses
10, i1 Table 3 on Page i5, the 2013 existing analysis was not updated to include the current
traffic conditions noted previously in Comment 1,
1 1. In Appendix E, the intersection of Alton Road and 86 Street was not updated to include the
current traffic conditions noted previously in Comrnent l.
12. Il Appendix F, the report summary for the intersection of Alton Road and 8s Street does not
reflect the signal timings provided in Appendix B, Verify with the Miami-Dade Conty
Siglals and Signs Division that these signal timings are still the same or if not, obtain the
latest signal timings and update the traffrc alalyses accordingiy. In addition, the current
traffic conditions were not updated as noted previously in Comment 1. The peak hour factors
(PHF) for the approach to this intersection were not provided and could not be checked.
13 . I1 Appendix F, the repofi summary for the intersection of Alton Road and 7e Street depicts a
PHF for the northbound and southbound approaches of 0.95 and A.92, respectively. The PHF
for both of these approaches should equal 0.98 to match the traffic count data contained in
Appendix B,
14. Ip Appendix F, the report summary for the intersection of Lenox Court and 7ft Street depicts
a PEIF for the southbound approach of0.92. The PHF for this approach should equal 0'58 to
match the traffic count data contained in Appendix B.
Miscellaneous Comments
15. On Page 72, "(HCS) should read "(HCM)",
16. For Tables 3 and 4 on Page 15, the source information sliould also include SYNCHRO.
1 7. In Appendix E, the intersection of Lenox Court and 7tr Street header ilrfonnation should read
7e Street instead of 8e Street.
18. The Appendix G comments are detailed in the Trip Generation Study review comments
provided in the next section.
TRIP G_ENERATXON SllUUv R.EVTEW (p. ATED AFB,rL 20" ?015)
Data Collection
19. At BHSF sites, the in-office surveys were conducted for each visitor and employee, Were
the employee in-office surveys conducted to include all physicians performing services at
each BHSF site?
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5
20, The traffic data for the trip generation study was not collected consistently. On Page 3 and
Exhibit 2 onPage 4, the traffic data was collected three different ways (i,e. In-offtce surveys,
windshield surveys, and driveway counts). These data collection procedures varied within
each larrd use and these dissimilar ways of data oollection could lead to some data being less
accurate than other data that was collected,
Trip Generation
21. On Page 1, the Community Center land use should be revised as the Commons Area land use
to match the traffic study (e.g. Page 3 and Table 1 on Page B). This change sliould also
eliminate any possible confusion with ITE LUC 495 (Recreational Community Center).
22.InBxhibit 3 on Page 5, the Sane Day Surgery Land Use independent variable that the trip
generation rate was based on was Procedure Rooms (not SF size area). The number of
procedure rooms for this iand use is not listed in Table I of the traffic study report. Remove
the SF size area and replace with the number of procedure rooms that are encompassed in
the proposed development.
Trip Generation Sunmary Tables (.Attachment A)
23, In Attachment A, rounding errors are contained in the spreadsheets and needs to be checlced,
24. In Attachment A, the in/ouVtotal trips for each land use were developed by averaging the
counted trips during the 3-day data collection period. These averages were then diluted by
averaging them with the tluee different locations where data was collected, Since the trip
data was collected during the peak periods for three days and to be conservative, the highest
peak hour during the data collection period for each of the three different locations should
have been used ancl averaged together to determine a trip generation rate for each lald use,
In addition, the in/out percentages should have been based on these same peak hours.
25. In Attachment A for the Physical Therapy Land Use, the Doctors Hospital Sports Medicine
& Rehab trip generation summary survey stated that data was collected from April 14,2015
tcr April 16,2015. Horvevei, the trip generation indlvidr-ral sr-rrveys reflect April 7,2015 to
April 9, 2015. Wirich 3-day data collection period is correct?
26. In Attaclment A, the following trip generation resuits provide a brief calculation sumnary
using the methodology noted in Comment 23 (i.e. the highest peak hour in lieu of the
average peak hour). A comparison of trip generation rates to the Trip Genetation Study is
also noted. Update the trip generation analyses used for both studies accordingly.
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419
a, Urgent Care Center Land Use (2,83 vs. L86 in the Trip Generation Study)
b, Diagiostic Center Land Use (1.47 vs, 0.69 in the Trip Generation Study)
c. Physical Therapy Land Use (8,25 vs. 4.80 in the Trip Generation Study)
d. Same Day Surgery Center Land Use (2,17 vs" 0,89 in the Trip Generation Study)
40ssNW9TthAVENUE r MAMIFL 33178
TEL 305.594.0735 o 800.887.5551
FAX 305.s94.075s
WWW.CORMDNO,COM
Location
Highest PM Peak Hour Independent
Variable
Trip Gen. (PM Peak I{our)
In Out Total Rate In Out
BMPCG 7 9 t6 s664 SF 2.82 44%56%
BMPT 9 9 18 7217 SF 2.49 s0%s0%
BMPB 5 10 15 47OB SF 3.19 33%67%
Overatrtr.dvg,2t 2E 49 2.E3 43Y"51o/"
Location
Highest PM Peak lfour lndependent
Variable
Trip Oen, (PM Peak Hour)
In Out Total Rate In Out
BMPT J 10 13 6689 SF 1.94 23%770
BMPCG J oo 11 80s7 sF 1.37 27%73%
BESC 2 6 8 72s1 SF 1.10 25y,75%
0veralX Avg.I 24 32 \.47 250h 750/o
Locatiotr
Highest PM Peak Hour lndependent
Variable
Trip Gen, (PM Peak IJour)
In Out Total Rate In Out
PPT 14 22 36 1962 SF 18.35 39%61%
SCG 5 9 t4 3s00 sF 4.00 36%64%
DHSMR 11 13 24 10000 sF 2.40 46%s4%
Overall Avg.30 44 74 8,25 41|}59Yo
Location
Highest PIt4 Peak Hour lndependent
Variable*
Trip Gen. (PM Peak Hour)
hr Cut Total Rate In Out
BHGEC 3 12 l5 6PR 2.50 20%80%
BI.IECCS ))4 4PR 1.00 s0%s0%
BESC .,15 1B 6PR 3,00 17%83%
Overall Avg.B 29 31 2.77 220 780/o
*Procedure Rooms (PR) do not correlate with the SF independent variable.
420
7
'IRAFEIEST@IEE R$YXEW EUMMARY
27. The Trafflc Study should be revised and updated to reflect the comments contained in this
rnemorandum, in particular, but not limited to, the following items:
a, Update and provide a new traffrc count at the intersection of Alton Road and 86 Sheet
to reflect the cunent traffic patterns.
b, Update the trips generated by the site and distributed on the roadway network based on
these review comments including those provided for the Trip Generation Study,
c. If the AM peak hour needs to be analyzed, then AM pealc period trafflc needs to be
counted to be collected and analyzed in the traffic study.
d. Update the future total traffic volumes based on these review comments,
e, Update the traffic analyses based on these review comments,
28, The Trip Generation Study should be revised and updated to reflect the comments contained
in this memorandum, in particular, but not limited to, the following items:
a. Update the trip generation to provide information on the Procedure Room independent
variable for the Same Day Surgery Center Land Use. If not available, then the trip
generation rate needs to be revised and determined by the SF independent variable,
b. Update the trip generation rate analyses for each ofthe four land uses based on these
review comments.
After your review, if you have any questions, please feel free to contact me or Salman Rathore to
discuss.
Sincerely,
Ttr{E CORR.ADINO GROUP, rNC.@
Stephen K. Bryan, P,E,, PTOE
sbryan@comadino,com
(61s)982-6204
CC: Salman Rathore, The Corradino Group
40s5NW97thAVENUE o MIAMI,FL 33178
TEL 30s.594.0735 o 800.887.5551
FAX 305.594.075s
WWW.CORRADINO.COM
421
MEMCRAI{D['4,1
SUBJECT: PARKING IMPACT REVIEW
!,UALKffiM
PAIII(NO CONSUTTANTS
DATE:
FROM:
SUBJECT:
July 20, 2015
Jon Mortens
Review of Proposed 709 Alton Rood Porking
4904 Eisenhower Boulevord, Suite I50
Tompo, F133534
Office: B 13.888.5800
www,wolkerporking.com
Wolker Porking Consultonis (Wolker) provides the following points to consider regording the
plonned porking for the proposed medicol outpotient heolthcore focility locoted ot 709 Alton
Rood, Miorni Beoch. Our review indicotes 278 spoces ore recommended before ony locol
odjusiments ore mode to meet the projected peok hour demond. Considering potentiol
odjustments, we recommen<1 providing no less thon the 212 spoces required by City code.
Recomnnended, Requined omd Froposed Forking
The Zoning Doto Summory sheei for the project proposes to provide 175 porking spoces (2'76
spoces per 1.000 sf).
This equotes to o 17.5% reduction io the City requir,ements bosed on providing 1 spoce per 300
sf (3.33 spoces per 1,000 sf).
Wolker recommends using o bose rotio of 4.5 to 5.0 spoces per 1,000 sf depending on the
specific medicol lond use. A slightly lower bose rotio for retoil ond cof6 lond uses is
recommended, which reflects the cof6 will be primorily used by on-site potrons. Wolker's
roiios ore bosed on the previous internol reseorclr on medicol office use porking demond ond
dolo from the lnstitute of Tronsportotion Engineers (lTE) Porking Generotion, 4th Edition, ITF-
publicotion. The resuliing bose demond moy be odjusted to occount for locol conditions, but
is designed to ensure sufficient porking during the peok hour of demond. A comporison of the
recommended, required, ond proposed porking is provided below'
The required porking is considerobly less ihon the typicol recommended bose rotio' When
odjustments to the bose rotio ore opplied to occount for drive rotio reductions {most likely for
employees) the recommended bosed rotio con be odjusted downword, but likely not to o
level below the required porking by City code.
ffiJ00
Colculoted
Rotio
Wolker Reseorch
MedicolOfflce
Diognosiic Center
Surgery
PhysicolTheropy
18,444 GSF
8,089 GSF
'!6,01 7 GSF
10,03r GSF
7,',r '19 GSF
4,50 /k GSF
4,50 /k GSF
4,50 /k GSF
4.50 /k GSF
5,00 /k GSF
B3
36
72
45
36
Sub-Totol Medicol Uses 59,700 GSF 272 4,s6 /k GSF
422
IUEft/loRAE\lDIJM
SUBJECT: PARKING IMPACT REVIEW w mfm:;i$ffim
Impoct of Disploced Forking
This site wos included in ihe overoll observotions of Souih Beoch porking study conducled
during o weekdqy ond weekend in November 2013 (report issued in 2014), During the
observotions 57 spoces were inven'toried on the poved surfoce lot locoted on the site. This
porking lot oppeors to hove exponded since the originol observotions were mode.
Occuponcy levels on lhe surfoce lot during the weekdoy ofternoon reoched 4?%; weekend
occuponcy reoched 98%, The proposed development Wll disploce this porking demond
which will most likely need to be qbsorbed within the surrounding oreo.
While the redevelopment of the siie does not require ihe existing demond be occounied for in
the new development, the loss of the porking will likely hove o negotive lmpoct to the
surrounding oreo,
Othen lterns
Considering ihe Iond uses ond intended funciions, peok demond would be during o weekdoy
doy period with limited to no shoring due io ihe commonolity of the lond uses (medicol).
Reductions in porking demond for odding bicycle porking should be limited to employee
porking, os potrons (medicol poiients) ore unlikely or unoble to utilize o bicycle to visit the site
for treotment. The totol number of bicycle spoces provided on fhe site is not cleor ond only
stotes one porking spoce per 12 short-term bike spoces.
423