The Executive Guide to Medical Office Construction in NYC

1. Pre-Construction: The Regulatory Labyrinth

Before architectural drawings begin, the viability of a medical site relies on two critical factors: Zoning and The Certificate of Occupancy (C of O).

Use Group 4 (Community Facility)

In NYC, medical offices generally fall under Use Group 4. If you lease a ground-floor retail space designated as Use Group 6, you must file an Alt-1 Application with the Department of Buildings to change the use. This process involves amended C of O issuance and can delay project timelines by 6 to 9 months. An Alt-2 (Directive 14) application is preferred, used when the existing C of O already supports medical use, allowing for faster self-certification.

Asbestos & Environmental (ACP-5)

No permit is issued without an ACP-5 Certificate (Asbestos Assessment Report). In older Manhattan buildings, disturbing pipe insulation or floor tiles without this assessment triggers immediate Stop Work Orders.

2. Infrastructure: The Hidden “Hard Costs”

While aesthetic finishes are visible, 50% of a clinic’s construction budget lies behind the walls in Mechanical, Electrical, and Plumbing (MEP) systems.

3. Radiology & Shielding Physics

Integrating X-Ray, CT, or Fluoroscopy suites requires a Medical Physicist’s Shielding Report prior to wall construction. This report dictates the lead equivalence required.

• Lead-Lined Drywall: Typically 1/32″ to 1/8″ lead sheet bonded to 5/8″ fire-rated gypsum.
• Lead Glass: Control booth windows must match the wall’s shielding value.
• Door Frames: Standard hollow metal frames will leak radiation. You must specify lead-lined frames and solid core doors.

4. Financial Management & Project Tracking

Managing the interplay between “Soft Costs” (Expediters, Architects, Physicists) and “Hard Costs” (GC, Electricians, Plumbers) requires robust tracking. We have developed a proprietary tool for NYC medical developers:

5. FGI Guidelines & Accreditation

For facilities seeking Article 28 status or OBS (Office-Based Surgery) accreditation (AAAASF/JCAHO), adherence to the Facility Guidelines Institute (FGI) is mandatory.

This affects “clear floor area” in exam rooms (min 80 sq ft), corridor widths (min 5 feet for stretcher access), and distinct separation of clean vs. soiled utility rooms. Failure to meet these dimensions during framing will result in a failed DOH inspection.