In 2005, St. Bernard Parish was all but destroyed when a massive storm surge triggered by Hurricane Katrina’s driving rains breached the parish levees. At the heart of the tight-knit community, Chalmette Medical Center weathered Katrina’s violent winds only to succumb to the flooding that occurred the following day. Damaged beyond repair, the acute-care facility was ultimately demolished.

After several years, St. Bernard Parish secured both the funding and community support necessary to build a new hospital. Ready to bring healthcare back to its residents, the St. Bernard Parish Hospital Service District charged Gresham Smith with designing a three-story, 40-bed replacement facility that would not only withstand future disasters, but also reflect the community’s history and re-establish the parish’s identity.

Situated 3 feet below sea level and 4 feet below Katrina’s high-water marks, the hospital’s new site was also subject to flooding. To bring the location above the floodplain, Gresham Smith added 75,000 cubic yards of sand fill, raising the existing grade by 4 feet, and placing the site 1 foot above sea level. By berming the entire site by 4 feet, the dangers of annual flood intrusion were mitigated. In addition, our design places all engineering items—from air handlers to switchgear to the hospital’s fuel tank—16 feet above the base flood elevation on the second level of the building.

Although the parish would require the hospital to close under extreme flooding conditions, Gresham Smith designed the new facility to be up and running as soon as floodwaters receded. Our team carefully analyzed each department for its programmatic flexibility and degree of public access, the cost and mobility of its related equipment, and the types of wall and floor finishes required. Of primary importance were the hospital’s OR and patient rooms, which were placed on the second and third floors respectively.

Due to access concerns, the emergency department had to remain on the building’s first level. However, Gresham Smith’s design concept of raising surgery to the second floor allows the associated prep and PACU bays to serve as a makeshift ED should the hospital’s first level become unusable. In addition to custom space planning to maximize the building’s safety and efficiency, the entire facility was designed to be impact resistant.

Tasked with reflecting the community while celebrating the history and culture of the parish, our design team used images of the regional landscape and local historic figures throughout the hospital’s interiors. The color and form of the interiors were also rooted in the natural environment of the region. In keeping with the conceptual relationship of the bayou, wood was used in the ceilings and main lobby spaces, and a two-story wall graphic of the parish featuring Lake Borgne and the surrounding bayous was also incorporated.

A catalyst for enticing former residents back to the parish as well as attracting top-tier medical staff, St. Bernard Parish Hospital opened its doors seven years after the colossal storm surge severely damaged the previous facility. The 109,000-square-foot hospital’s ability to withstand extreme weather and water conditions was soon put to the test when Hurricane Isaac hit Louisiana’s Gulf Coast. The robust new building sustained no significant damage and remained fully functional during major power outages, high winds and flooding.


St. Bernard Parish Hospital District


Chalmette, Louisiana

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S. Robert Hamby AIA, EDAC, LEED AP
S. Robert Hamby AIA, EDAC, LEED AP
Senior Architect