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If the prognosis for American shopping malls has been grim for decades, then the physicians at University of Rochester Medical Center (URMC) may have just resuscitated the building type. The Saunders Center for Orthopaedics & Physical Performance designed by Perkins&Will, working in collaboration with the S/L/A/M Collaborative (SLAM) as architect of record, fills an anchor-store-size hole left by Sears at the Marketplace Mall in Henrietta, New York—and possibly establishes a model by which healthcare development breathes new life into former retail wonderlands.

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Sears, opened in 1982 as one of four original anchor stores at Marketplace Mall, pictured prior to its transformation (1). Aerial view of the Saunders Center, which encompasses the footprint of the old Sears in addition to a new multi-story wing (2). Photos © Tim Wilkes (1), Halkin Mason (2)

Orthopedics and physical performance at URMC was previously located on the grounds of Strong Memorial Hospital. As caseload outstripped existing physical capacity, the department pictured the new Saunders Center as a one-stop satellite location. Perkins&Will design principal Rob Goodwin calls the brief unusual, explaining, “A lot of healthcare is centralized in dense campuses, which can be hard to access or feel intimidating for patients. This was an institutional decision to reach into the community.”

Interior circulation routes are flooded with daylight. Photo © Halkin Mason

Once selected by URMC in 2018 to create the facility, Perkins&Will and SLAM evaluated seven sites according to criteria that included proximity to multiple local and regional transportation modes. Located four miles south of Strong Memorial, Marketplace Mall checked those boxes and then some, according to SLAM principal Scott Hansche. He says that fashioning the Saunders Center from existing urban fabric “accounted for a year less time of construction, over $10 million in construction material and labor savings, and over $10 million in infrastructure cost not required,” with corresponding discounts in design and management. Sears closed shop in Henrietta the following spring, and within months URMC purchased the vacant 227,000-square-foot wing of Marketplace Mall and a portion of the adjoining parking lot to accommodate a ground-up, 145,400-square-foot outpatient clinical services building.

The new pavilion is connected to the single-story former Sears by a spacious concourse. There is also a connection to the existing mall at the north of the complex. Photo © Halkin Mason

The project was completed in phases, beginning with the conversion of the existing interiors. To the south, the single-level former department store is now dedicated to ambulatory surgery because, Goodwin notes, “there are things that work really well in a big pancake floor.” Perkins&Will and SLAM expanded the number of skylights here, a response to doctors observing that, at Strong Memorial, they could begin and conclude one of their long shifts without seeing sunlight.

From the east face of the building’s northern half, the design team removed a volume that it transformed into an exterior space featuring track-and-field lanes, half-court basketball, and football yard lines. As Goodwin says, “We organized rehabilitation functions around the courtyard, so you can basically conduct rehab outdoors, and at the same time bring daylight deep into the floor plate.” SLAM senior associate Gabriel Comstock adds that the configuration also makes healing visible to patients, giving them hope for their recoveries.

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Common spaces face a central courtyard (3); facilities, including a therapy pool (4) and sports rehab area (5) are illuminated by large skylights. Photos © Halkin Mason

The new multistory pavilion, completed in 2023, was the final finished component. Its siting immediately to the west of the outdoor rehabilitation area fully encloses the courtyard. The mid-rise building also defines the satellite campus architecturally, thanks to a sun-shaded envelope with curves that evoke human movement. The interior is programmed thickly for exam and therapy, to minimize walking for less ambulatory patients. These rooms could have been packed even more tightly into each floor, but Goodwin says he and his collaborators sacrificed some density to ring perimeters in circulation. “We made a deliberate effort to terminate every corridor in daylight, so it never feels like you’re internalized.” 

 His colleague, Perkins&Will interior design principal Carolyn BaRoss, says the Saunders Center concourse exemplifies human comfort as a priority. Erected along the Sears wing’s east elevation, the concourse is the primary connective tissue between former store and the pavilion. Perhaps more importantly, it also “multiplies dropoff and pickup points for people with compromised abilities,” especially compared to the few, bottleneck-like entries of the traditional shopping mall. Extending the pavilion’s undulating expression, a deep canopy snakily projects from the rectilinear circulation volume to shield visitors from rain and snow. Three cavernous vestibules slip beneath this canopy, too, to mitigate extreme weather for arriving and departing patients alike.

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An elite sports therapy facility (6) and clinical exam reception area (7) receive abundant daylight; a deep canopy protects arriving and departing patients from the elements (8). Photos © Halkin Mason

Whether sating caregivers’ desire for natural illumination or considering patients’ mobility demands, the design team emphasized well being to an extent that surprised even its individual members—for which Goodwin credits URMC’s empathetic doctors. “This project has become symbolic of how to bring healthcare into the community as opposed to the paradigm of community coming to healthcare,” Goodwin concludes.

Another truism challenged by the project? That dead shopping centers only have a second chance as fulfillment warehouses. Peripheral restaurants at Marketplace Mall are gaining traction since the Saunders Center opened, and URMC is considering a new investment at the site. Meanwhile, SLAM’s Hansche says the project, which deftly melds adaptive reuse with new construction, has spurred similar healthcare-focused redevelopments elsewhere. 

Click first-floor plan and elevations to enlarge