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Repurposing residence halls as Alternate Care Facilities (ACFs)

As hospitals face COVID-19-related bed shortages, university residence halls may hold the key to expanding access

By Elissa Kellett, AIA, LEED AP BD+C, and Josh Theodore, ACHE, EDAC 

Hospital beds are at a premium and will grow scarcer as the U.S. wrestles with the COVID-19 pandemic. Healthcare leaders agree that in allocating beds the priority should go to the most acute patients – COVID-19 or notCreative solutions are needed to house and care for patients that do not require acute care, such as non-COVID-19 patients and medical staff and first responders who are routinely exposed to coronavirus and need to be housed in quarantine. 

With college and university residence halls across the country sitting emptyleaders in healthcare and higher education are beginning to consider the possibility of temporarily converting residence halls as Alternate Care Facilities (ACF). To aid in this effort, thought leaders from LEO A DALY’s healthcare and higher-education teams recently participated in a design charette, resulting in the report, “Repurposing Residence Halls for Healthcare Use”. You can view that document here: 

What kind of residence hall is a good candidate?  

The U.S. Army Corps of Engineers has identified residence halls as a potentially good fit for temporary refitting as ACFs. College and university administrators may be wondering if theifacilities are good candidates for conversion. The less that must be done to refit a residence hall, the more quickly it can be used for healthcare use, and the more quickly it can be returned to its original use when the crisis passes. 

To be rapidly converted, residence halls need key features common with hospitals, such as: 

  • private or semi-private rooms (semi-private rooms are likely to house one patient but provide more space than private rooms) 
  • In-suite private or shared toilet 
  • dedicated HVAC system for each suite or room (and the possibility to upgrade filtration) 
  • Controlled access 
  • Shared facilities that can be used with minimal adaption for nursing stations, break rooms, storage of clean and soiled linen, storage for medical equipment, pharmacy, and nourishment 
  • Critical support service and/or facilities for food service, cleaning, waste removal, laundry and receiving/loading 

Proximity to a hospital could also be a deciding factor. Universities that double as academic medical centers are best positioned to offer their residence halls as ACFs 

What modifications might be needed? 

One a residence hall has been evaluated as a good fit for conversion, modifications can be minimal.  

Modifications to common spaces on each floor would be made to enable healthcare staff operations. Public and shared spaces would be adapted for nursing stations, storage, break rooms, and nourishment.  

Modifications to student rooms would be made to enable patient care. Electronic patient surveillance, window shades, mobile headwall units and mobile medical gasses would be brought in. Beds would be replaced (door size permitting) or modified. Porous finishes would be covered or replaced as needed. 

Modifications to the Lobby level would be made to facilitate intake and operations. These would include the repurposing of any front desk for reception and check-in, the addition of administrative space, labs, clean and dirty linen, pharmacy, supplies and storage spaces for portable devices such as x-rays, IVs and patient monitors.  

Infrastructure modifications will likely include the addition of a generator and fuel storage outside the main electrical room, and a new transfer switch to tie the emergency system into the existing one. Air filtration may be upgraded depending on existing system capabilities.  

What hurdles must be overcome? 

The design and construction work necessary to retrofit a residence hall to a healthcare facility is only one part of the picture. Staffing will also be a challenge throughout this crisis. Legal and code requirements will have to be looked at quickly and creatively if these projects are to be executed with due haste. 

This will take expertise in healthcare design, residence hall design and engineering. It will also take vision, the ability to work successfully with a wide range of stakeholders, and the ability to act quickly and decisively, allocating talent and resources to respond to this crisis.  

For help evaluating a residence hall, contact the authors:

Elissa L. Kellett, AIA, LEED AP BD+C  is vice president, global higher education practice leader with LEO A DALY. She has devoted a 36-year career to helping colleges and universities envision and realize capital projects that further their mission and reflect the unique character of their institutions. Email Elissa at

Joshua A. Theodore

Joshua A. Theodore, B. Arch, ACHE, EDAC, is vice president, global health practice leader with LEO A DALY. In this role, he guides strategy, business development and overall design excellence for our health practice worldwide. Approaching 30 years in the industry, he has gained a broad perspective from the planning and implementation of all types of health facilities in more than 15 states, the United Kingdom, Middle East and Caribbean. Contact Josh at