Fit as a Fiddle

by Annie Block, Laura Girmscheid, and Candice Lee -- Interior Design, 11/1/2006

They may not be able to name all 206 bones in the human body, but Interior Design's 40 health-care Giants are experts when it comes to hospitals, outpatient facilities, and medical offices. The results from our second annual ranking show that these firms, including six newcomers, have had their fair share of practice-overall health-care design fees have nearly doubled since last year, from $197,266,769 to $345,201,531. And these designers are helping not only to save lives but also to save the planet: Sustainability has become integral to this category, 95 percent of the firms say. Today's picture of good health appears to be tinted green.

2006 Rank	Firm Headquarters, Web Site	Health-Care Fees (millions)	Work Installed
			Value (millions)	Sq. Ft. (millions)
01	Perkins + Will Chicago perkinswill.com	40.810	175.60	5.65
02	HDR Omaha hdrinc.com	36.683	3607.03	4.29
03	Granary Associates Philadelphia granaryassoc.com	28.278	NR	1.90
04	Anshen + Allen Architects San Francisco anshen.com	19.318	391.30	1.24
05	Perkins Eastman New York perkinseastman.com	19.119	273.13	2.90
06	Cannon Design Boston cannondesign.com	16.493	NR	NR
07	PageSoutherlandPage Houston pspaec.com	15.656	336.00	2.84
08	NBBJ Seattle nbbj.com	15.400	NR	1.29
09	SmithGroup San Francisco smithgroup.com	12.625	NR	8.09
10	Shepley Bulfinch Richardson and Abbott Boston sbra.com	10.900	NR	3.00
11	Zimmer Gunsul Frasca Partnership Portland, Oregon zgf.com	10.200	220.00	0.55
12	Ellerbe Becket Minneapolis ellerbebecket.com	10.081	NR	5.75
13	HOK Saint Louis hok.com	9.919	59.38	15.30
14	Karlsberger Columbus, Ohio karlsberger.com	9.155	398.15	1.50
15	WHR Architects Houston whrarchitects.com	6.480	16.50	2.20
16	Array Healthcare Facilities Solutions King of Prussia, Pennsylvania arrayhfs.com	6.286	335.00	1.90
17	EwingCole Philadelphia ewingcole.com	6.050	285.00	2.14
18	Ballinger Philadelphia ballinger-ae.com	5.850	130.00	1.50
19	TRO Jung/Brannen Newton, Massachusetts troarch.com	5.769	423.00	1.85
20	Gresham, Smith & Partners Nashville gspnet.com	5.594	95.00	3.60
21	Anderson Mikos Architects Oak Brook, Illinois	5.185	19.76	2.62
22	Leo A Daly Omaha leodaly.com	4.928	103.40	0.30
23	Francis Cauffman Foley Hoffmann Philadelphia fcfh-did.com	4.800	500.00	2.50
24	Loebl Schlossman & Hackl Chicago lshdesign.com	4.645	80.00	0.45
25	Harley Ellis Devereaux Southfield, Michigan hedev.com	4.568	228.00	1.34
26	Flad & Associates Madison, Wisconsin flad.com	4.275	94.60	1.76
27	Tsoi/Kobus & Associates Cambridge, Massachusetts tka-architects.com	3.800	19.00	1.70
28	OWP/P Chicago owpp.com	2.738	NR	0.28
29	Lawrence Group Saint Louis thelawrencegroup.com	2.510	50.20	2.15
30	Maregatti Interiors Indianapolis maregattiinteriors.com	2.207	90.00	4.42
31	JRS Architect Mineola, New York jrsarchitect.com	2.050	50.00	0.13
32	NTDStichler San Diego ntdstichler.com	2.000	43.33	0.21
33	Ronald Schmidt & Associates Englewood, New Jersey rsaaia.com	1.925	115.00	0.28
34	Hillier Architecture Princeton, New Jersey hillier.com	1.880	44.00	0.31
35	RLF Winter Park, Florida rlfae.com	1.604	459.93	1.53
36	VOA Associates Chicago voa.com	1.500	10.00	4.97
37	Plunkett Raysich Architects Milwaukee prarch.com	1.101	186.70	1.11
38	Wilmot Sanz Gaithersburg, Maryland wilmotsanz.com	0.970	268.41	1.05
39	Mojo Stumer Associates Greenvale, New York mojostumer.com	0.950	8.00	0.10
40	Carson Design Associates Carmel, Indiana carsondesign.com	0.900	11.02	0.58
NR=Not Reported

	Health-Care Fee Income	% of Fee Income
Hospital	$215,405,755	62.4%
Outpatient facility	$49,018,617	14.2%
Medical office	$25,544,913	7.4%
Clinic	$22,438,100	6.5%
Senior living	$8,630,038	2.5%
Skilled nursing facility	$7,594,434	2.2%
Rehabilitation facility	$7,594,434	2.2%
Assisted living	$3,797,217	1.1%
Mental health facility	$2,071,209	0.6%
Hospice	$345,202	0.1%
Other	$2,761,612	0.8%
Total	$345,201,531	100%

California	31%	Texas	21%
New York	26%	Florida	15%
Illinois	23%	Arizona	13%
New Jersey	21%	China	13%

New construction	57%
Renovation	43%
Domestic	96%
International	4%

1. Perkins + Will
2. NBBJ
3. HOK

	Agree	Somewhat Disagree	Strongly Disagree
Today's health-care clients understand that design is a healing tool	100%	0%	0%
Health-care clients are more willing to invest in design than before	97%	3%	0%
Sustainability is becoming a more important part of designing health-care facilities	95%	5%	0%
More clients are interested in integrating "green" products into health-care facilities	95%	5%	0%
There is now more crossover between hospitality and health care	87%	8%	5%

Methodology

The annual business survey of health-care Interior Design Giants ranks the largest firms by health-care design fees for the 12-month period from July 2005 to June 2006. (In the event of a tie, the firm with the larger dollar value of installed work is listed first.) Health-care design fees include fees attributed to:

All health-care interiors work.
All aspects of a firm's health-care design practice, from strategic planning/programming to design/project management.
Fees paid to a firm for work performed by employees and independent contractors who are "full-time staff" equivalent.

Health-care design fees do not include revenues paid to a firm and remitted to subcontractors that are not considered full-time staff equivalent. For example, certain firms attract work that is subcontracted to a local firm. The originating firm may collect all the fees and retain a management or generation fee, paying the remainder to the performing firm. The amounts paid to the latter are not included in the fees of the collecting firm in determining its ranking. The data was compiled and analyzed by the Interior Design market research staff in New York: Laura Girmscheid, research manager, and Candice Lee, research director.