Now’s the time to evaluate ability to convert hotel rooms to patient rooms

By Bob Winter  

As the COVID-19 pandemic rapidly progressed in the U.S. earlier this year, design teams began looking to hotels for potential relief if hospitals became overcrowded. The recent declining rate of infection and hospitalization tabled that discussion, but the possibility of a second wave – as well as future healthcare crises – must be consideredTo be prepared for either situation, hospitality owners should begin evaluating the process of converting hotel rooms to hospital rooms for low acuity patients and first responders.  

It’s important to realize that different types of properties can fulfill different needs – there is no one solution for all. Larger full-service hotels in urban environments often have more infrastructure than their suburban counterparts. These hotels have full-service kitchens and dining facilities to support staff, bigger lobbies for patient intake and assessment, ballrooms that can convert to separate wards for patients requiring increased observation, and they are closer to goods and service providers. 

But hotels in any location have one thing in common: their guestrooms. Though not identical from one property to another, their designs are similar in principal. When considering the possibility of converting hotel rooms to patient rooms in a surge event, consider the following systems and features that most rooms have in common and how they can be used:   

Recirculating HVAC units with individual control. These systems could include vertical or horizontal fan coil units, heat pump units, PTACs or VTACs. Standard filters are MERV 4, and only designed to capture the largest particles from the air. No practical changes are suggested beyond ensuring that the filter, coil, drain pan, and housing are clean. Portable HEPA filtration units can be provided in the room as required. 

Bathrooms. The bathroom exhaust operation and rooftop fan should be inspected and made to be continuous. Separation between the exhaust discharge and any outside air intake within 20 feet should be ensured. Otherwise, the private bathroom design in guestrooms is ideal for privacy and infection control. 

Dedicated outside air unit (DOAS). Supplying air to corridors and guestrooms should be controlled to operate continuously.  

Electrical. Verify design of the power supply and capacity to the guestroom. Backtoback headboard walls on a common circuit can result in nuisance tripping. 

Technology systems. Wi-Fi, phone, and TV are sufficient to serve patient requirements. Phones will be used as nurse-call devices. 

Emergency power. A portable generator will be required to serve the building, as the base building backup power system is typically designed to serve only life safety systems. 

Additionally, negative pressure for isolation must be considered for the conversion. Guestrooms are designed to be neutral or slightly positive compared to the corridor, with low volumes of outside (OA) and exhaust air (EA). Hotel OA and EA systems do not have the inherent capacity to be converted to achieve hospital room requirements for air exchange rates. If this is needed for the room, modifications including supplemental exhaust and outside air supply would be required at considerable cost. 

The conversion of a hotel room to a hospital room for low acuity patients and first responders is easiest to achieve when little modification is required of the MEP infrastructure. Going forward, hotels could be designed with the necessary infrastructure to enable conversion to more resilient buildings in a surge event.