Case study: Using a hotel as an alternate care site

According to this study, there are both challenges and solutions when converting hotel rooms to hospitals

By William E. Koffel, PE, FSFPE, Koffel Associates, Columbia, Md. February 3, 2021

A concept study was published by HKS Architects in March 2020 titled COVID-19 Conversions: Hotels to Hospitals. With a similar configuration to many hospitals and with the reduced demand for hotel rooms, hotels have been considered to be a viable option as an alternate care site for health care providers. In fact, the Center for Health Design created a website tool that attempted to link health care organizations with hotels that were available for use as an alternate care site.

The HKS study advised that using a hotel as an alternate care site is not appropriate for certain populations including pediatric and geriatric patients, patients requiring a ventilator or relying on machine-assisted breathing or those that require monitoring due to risk of progression to a severe condition. The study identified space use scenarios that could be employed during a public health emergency. Certain challenges and potential solutions were identified in the study.

The study indicated that converting a hotel to an alternate care site creates obstacles to efficient and effective delivery of care. However, a hotel may be an acceptable solution in public health emergency situations that are expected to be short-term and without a transmissible element (e.g., extreme heat or cold conditions). Features already in a typical guest room (TV, telephone, Wi-Fi) can be useful in a health care environment as well.


  • Hotel beds are not optimal for health care use.
  • Individual room heating, ventilation and air conditioning units may not have the necessary outside air changes for health care occupancies, particularly during an event such as the COVID-19 pandemic.
  • Infection control within the room must be addressed (e.g., surfaces)
  • Corridor widths, door openings and elevators may not be sized to accommodate needed care equipment.
  • Hotel rooms may not have adequate clearances to support patient monitoring equipment.


  • Hotel mattresses can be fully covered with a waterproof protective wrap.
  • Increase air exchange rates, upgrade HVAC cleaning protocols and install high-efficiency particulate air filters.
  • Carpets can be removed or a “carpet protection tape” can be used to create a barrier between the carpet and the patient.
  • Limit occupancy to ambulatory, low-acuity patients. Nonambulatory patients should be routed to the nearest hospital.
  • Remove all extraneous hotel items to increase clearances around the bed.

Author Bio: William E. Koffel is president of Koffel Associates. He is chair of the NFPA Correlating Committee on Life Safety and a member of several NFPA technical committees. He is a member of the Consulting-Specifying Engineer editorial advisory board.