Western Pennsylvania’s top hospital systems are pushing ahead with major construction projects despite the economic downturn brought on by the coronavirus pandemic.

In Harmar, crews are working on the final touches of Allegheny Health Network’s newest neighborhood hospital. The 23,000-square-foot “mini-hospital” under construction at Freeport and Guys Run roads will offer a 24-hour emergency room, 10 beds for longer stays and lab and imaging services when it opens in September.

Also this fall, the emergency department at UPMC East hospital in Monroeville will expand from 24 to 36 beds, plus 10 more observation rooms. In Pittsburgh’s Uptown neighborhood, construction has been advancing for more than a year on a new, 445,000-square-foot, nine-floor tower for vision and rehabilitation services at the UPMC Mercy hospital campus.

“When this first hit, obviously there was great confusion everywhere, and the governor with really little notice said that all construction needed to stop,” said Dick Thompson, AHN’s vice president for facilities and real estate. “Then the health care organizations came back and said, ‘You really don’t want us to stop. We’re building things that will help us deal with the spikes that we’re facing.’ ”

The threat of covid-19 prompted delays and required extra precautions and rules for construction sites and workers when Gov. Tom Wolf declared a state of emergency in March. Within two days, Wolf amended the order to clarify that health care-related construction would be protected as an essential service and could go on as scheduled.

Despite revenue losses as nonurgent procedures were postponed, many projects already had been financed and either had broken ground or were in their final planning stages. As a result, the pandemic-spurred lockdown and related restrictions have not slowed the expansion momentum of UPMC and AHN, the region’s two largest hospital providers. Excela officials said they have no ongoing construction projects.

UPMC has not scaled back any of its construction plans since March or through the remainder of the year, according to executives.

“Our ongoing construction growth reflects our commitment to efficiently coordinate and place quality care where it is needed as we meet the increasing demand for UPMC’s clinical expertise,” Leslie C. Davis, chief operating officer of UPMC Health Services Division, said Friday by email.

Officials celebrated on Monday the grand opening of the AHN Cancer Institute attached to its flagship Allegheny General Hospital in Pittsburgh’s North Side. The 90,000-square-foot, $78 million facility is the focal point of AHN’s $300 million investment to expand cancer care.

“In general, we’re proceeding on the right schedule that we had anticipated, but things are being done differently,” Thompson said.

Among measures taken because of the pandemic: construction sites created more places to wash hands, ensured group meetings were held in open areas and spaced out workers to cover different shifts and hours — “so you didn’t have too many people working at any one place at any one point in time,” Thompson said. Workers get evaluated daily for symptoms and are urged to stay home for 14 days if feeling sick.

‘Triaging’ minor facility improvements

Some of AHN’s more minor projects, however, have been “triaged” — or postponed based on priority — as the broader industry copes with plunging revenue and braces for possible resurgences of covid-19. The system will spend about 25% less on construction work this year than it had planned, Thompson said.

“Everybody was worrying how we’re going to deal with this. You wanted to make the place safe for construction workers that needed to be on the job, and you also wanted it to be safe for the hospital workers,” he said.

AHN typically has about 85 active construction and renovation projects at any given time. Many are related not to new construction but rather improving the infrastructure of aging facilities, some of which date to 100 years ago. They include modernizing elevators, replacing air handling systems and upgrading IT systems.

Some hospital projects are confronting delays for nonpandemic reasons.

The planned UPMC South hospital in Jefferson Hills is on hold after the Jefferson Hills Zoning Hearing Board determined it was not a permitted hospital use. UPMC appealed the decision and expects an answer from the court in the coming weeks.

In the meantime, officials are planning to open an ambulatory outpatient center at a former Toys ’R Us store in the South Hills by November. It will offer outpatient surgery, cardiology, imaging, women’s imaging, obstetrics/gynecology, primary care and after-hours pediatrician visits.

AHN is expanding its emergency department at Jefferson Hospital.

Health giants’ reach expands with revenue

The number and reach of Western Pennsylvania health care facilities have been on the rise for years, particularly since Highmark purchased the then-financially struggling West Penn health system and renamed it AHN in 2013, becoming a direct competitor with UPMC’s hospitals.

As the network’s balance sheet improved, so did its investments in expanding its physical footprint and reach.

Since Thompson arrived at AHN six years ago, the system has spent more than $1 billion on construction and renovations.

“It’s been nonstop growth,” he said.

Three other AHN hospitals that are part of the health care network’s $1 billion expansion plans already are up and running. AHN Brentwood opened in March and AHN Hempfield was completed in January. AHN opened a mini-hospital in McCandless in December.

Price tags range from $20 million for the Harmar neighborhood hospital up to closer to $300 million for the 160-bed hospital under construction in the Wexford business district in Pine — AHN’s single largest investment ever. The 345,000-square-foot building, next to AHN’s Health & Wellness Pavilion on Perry Highway, is on track to open in fall 2021.

The new hospital will feature a full range of medical services, including comprehensive women and infant care: advanced cardiac, neurosurgical, orthopaedic and cancer treatment; 24-hour emergency department and short-stay observation unit with pediatric rooms; an adult intensive-care unit; and operating rooms equipped with minimally invasive robotic surgical capabilities.

Rival system UPMC also has been expanding its reach in the region’s northern suburbs as places such as Cranberry continue to grow and patients there demonstrate the need for more specialty services closer to home. UPMC claims a roughly 65% market share in the North Hills area.

“When we invest in facilities, supportive equipment and technology in Western Pennsylvania and throughout the state and beyond, we extend access to our primary care and, notably, UPMC’s high-end specialty services such as Magee (Womens Hospital), Hillman (Cancer Center) and heart and vascular services,” UPMC’s Davis said.

UPMC Heart and Vascular Institute will begin to offer advanced procedures at Passavant to lower the risk of stroke in certain patients, as well as transcatheter aortic valve replacement, or TAVR, as an option instead of open-heart surgery. Passavant’s McCandless campus is getting the Auris Health Monarch Platform, a new robotic bronchoscopy tool intended to help doctors detect lung cancer sooner.

The planning stages continue for two major hospital expansions at UPMC Presbyterian in Oakland and UPMC Shadyside — part of $2 billion in Pittsburgh hospital investments announced in 2017. Their groundbreaking dates have not yet been set.

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