Humber River Regional Hospital Toronto, Ontario, Canada

Humber River Regional Hospital is one of Canada's largest regional acute care hospitals, serving a catchment area of more than 850,000 people in the northwest GTA. Affiliated with the University of Toronto, the hospital is home to Ontario's first Centre of Excellence for laparoscopic bariatric surgery; Canada's first home nocturnal dialysis program and a major cancer program.

The new, fully digital hospital project will provide, both in-patient and out-patient care, including cancer, cardiac and critical care, emergency services, dialysis, bariatric surgical services, women's and children services, diabetes and mental health programs.

The project encompasses a 14-story tower, a separate central utility plant and 2,000 parking spaces in two parking structures and some surface parking. The new Facility, which will be approximately 1.7 million ft² gross, will operate 656 beds in 2015/2016, with capacity to expand to 722 beds by 2025/2026. Construction of the hospital is scheduled to take approximately 43.5 months. In addition to construction of the new facility, key risks associated with the maintenance responsibility of the hospital over the 30-year service period have been transferred to Plenary Health Care Partnerships.

Project Facts

Plenary Group is the project sponsor, equity investor and financial arranger for the project.

Location: Toronto, Ontario
Client: Humber River Regional Hospital
Size: 1.7 million ft²
Value (NPV): $1.75 billion
Builder: PCL Constructors Canada
Architect: HDR Architecture Associates, Inc
Services: Johnson Controls
Financial Close: September 2011
Completion Date: Spring 2015
Contract Terms: 33.5 years, Design-Build-Finance-Maintain

Design Features

First Fully Digital Hospital

The hospital's vision for Information, Communication and Automation Technology had a strong impact on the design of the Facility by influencing a New Model of Care, as well as the management and operation of the facility. The Information, Communication and Automation Technology strategy is intended to directly support Humber River Regional Hospital's key project objectives:

Achieve a fully digital and paper light hospital
Integrate all aspects of the hospital into a seamless and efficient operation
Leverage technology wherever possible to improve efficiency, reliability and safety
Simplify information flow and access to care providers and patients and community partners
Provide simple access to system and information.

Green Design

In addition to being digital, the hospital incorporates lean and "green" sustainable design principles. The lean approach to planning emphasizes the use of on-stage/off-stage areas inside the facility, as well as consistent floor layouts, standardized rooms and clinics, and centralized support spaces.

Green design is realized by maximizing daylighting opportunities, orienting the building to minimize heat gain, using sustainable materials and high-performance building systems, and incorporating green roofs on 50% of the roofs throughout the campus. The facility adheres to the Leadership in Energy and Environmental Design (LEED®) rating system guidelines with a goal of achieving LEED® Silver certification.

Innovations

As financial arranger, Plenary Group continues to innovate and achieve great value by leveraging attractive bond market pricing through the use of all bond financing solutions. This project incorporated a short bond, paid out at substantial completion, as well as a long amortizing bond and a long bullet bond.

The combination of short and long bonds is an innovation that is unique to Plenary Group deals in the Canadian PPP market and, indeed, the bullet bond structure is a Canadian PPP market first that has yet to be matched in Canada (or globally, to the best of our knowledge).

Combining the amortizing bond with the bullet bond helped produce the lowest average long-term PPP bond coupons since the financial crisis. 100% of the savings were passed through to the Client.

Through the financing of this project, savings of approximately $50 million were achieved for the hospital; first, the bullet bond structure reduced long-term debt costs for the project; and second, the spread and base rate movement between bid stage and financial close generated significant savings.

Local Economic Impacts

The project will help provide economic stimulus by creating and supporting thousands of jobs. Labour will largely be drawn from the Greater Toronto Area. At the peak of construction, it is estimated that 1200 workers will be on site daily.

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