The Elmhurst Care Center in Elmhurst, NY is a 410-bed nursing home in Queens named one of the best in the nation by US News & World Report.

Elder care is an ever-increasing area of growth for the businesses that serve it. This holds true for all segments of the market, from 55+ communities to hospice care facilities. America is aging, and there’s no place in the country not affected by the retirement of the Baby Boomer Generation.
This predicament is a boon to contractors. New elder care facilities are cropping up everywhere and existing buildings are being retrofitted at a blistering pace.
“Assisted living facilities and hospitals account for a lot of our work, both on the installation and service side,” said Dominick Fausto Sr., a third-generation master plumber and owner of Absolute HVAC in Farmingville, NY. “We’ve retrofitted two large systems in the past 10 months or so.”
However, the scope of work can be a far cry from residential work. These projects demand uncompromising quality and have compact timelines. Like most medical facilities, redundancy (back-up) in mechanical systems at a retirement facility is a must. The best components should be used and designs should be very carefully scrutinized.

Pictured (L-R) are Darnell Coleman
and Dominick Fausto Sr. outside of the Elmhurst Care Center.

Loyalty goes both ways
Much like finding good technicians, Fausto says that finding long-term customers in New York City can be problematic. In years past, doing great work at a good pace was enough to keep a customer for decades. However, the current fluidity in the health care industry—whether through employee turnover or mergers and acquisitions—means that long-term customers are scarce, regardless of how dependable the contractor has been. Despite the odds, Absolute HVAC still nurtures a relationship forged long ago.
Fausto’s most loyal customer owns retirement and medical facilities in numerous states and has trusted Absolute HVAC for 39 years. As the customer’s empire slowly changes hands to his children, he is insistent that the trust between the two companies remains intact.
“You wish all your customers were like this gentleman,” said Fausto. “We’ve given him our best for many years, and he appreciates it. No matter which one of his buildings we’re working on, he wants all of his systems to be built and maintained [by us] without compromise…and he means it.”
Recently, a team of Absolute HVAC technicians, led by Field Supervisor Darnell Coleman, retrofitted the boiler system at the Elmhurst Care Center in Elmhurst, NY. The 410-bed nursing home in Queens was named one of the best in the nation by US News & World Report, a reflection of great health inspections, nursing staff and medical care.
Redundancy and efficiency
The 11-story building was constructed in 1997, but before the walls went up, two massive, scotch-marine boilers were craned into the basement. The gas boilers were each rated at 6.28 million BTU/H. The boilers and everything else in the cavernous mechanical room, including a pair of 10-HP base-mounted pumps, were redundant (had ample back-up).
Absolute HVAC installed the original boilers 22 years ago and has serviced them. When the call came to replace one of the units, Fausto was intimately familiar with the system. He suggested using a high-efficiency alternative to replace one of the redundant units and leave the other big boiler in place as a back-up.
Over the course of a few weeks, Fausto worked with U.S. Boiler’s northeast regional director, Chris Massey, and some of the pros at Venco Sales Inc. to design a condensing boiler system for the building. Once completed, the design was approved by an engineer of record and a demo team was soon onsite to remove one of the big fire tube boilers. Venco also provided help onsite and with equipment specification.
Absolute HVAC technicians began the project by extending the concrete boiler pad and rolling six new Burnham Alpine modulating boilers into the mechanical room. At 95% Annual Fuel Utilization Efficiency (AFUE), Alpine’s onboard Sage control helped to simplify and integrate numerous boilers into one larger system.
“Six years ago we made the Alpine boiler our primary condensing unit,” said Fausto. “It’s extremely dependable, very easy to install and service, and comes in such a broad size range that it can be installed in a saltbox home or, as you see here, a massive commercial application.”

The new Alpine Boilers at 95% thermal efficiency will save
the facility more than 40% on natural gas expenses

The 800 MBH boilers were daisy-chained in a lead/lag configuration, effectively giving the facility a 30-to-1 turndown. The new condensing system now heats the entire structure as well as provides domestic hot water through the use of three, 120-gallon, high-recovery Techtanium instantaneous indirect-fired water heaters. The remaining scotch-marine boiler sits cold and will only be needed in the event of a catastrophic failure.
The height of the building demanded an extremely high system pressure, so the boilers were isolated from the building using two Alfa Laval plate-and-frame heat exchangers. The heat exchangers connected the four-inch boiler loop to the six-inch system loop.
Throughout the building, bedrooms are now heated by Packaged Terminal Air Conditioner (PTAC) units featuring a hydronic coil. Lobbies and various common spaces are conditioned with fin-tube baseboard and a few recreational areas feature hydronic air handlers.
Up and running
The installation progressed smoothly. The only challenge was running vent pipe. Two 18-inch thick walls required core drilling to terminate the six, 4-inch fresh air intakes and six, 6-inch exhaust pipes.
“Within four weeks we had half the new boilers up and running,” explained Fausto. “After another four weeks, the whole system was online. I think that 40% energy savings in winter is a conservative estimate. We did a similar installation with three Alpines in an assisted living facility for the same client and saw a 42% reduction in fuel use over the heating season.”
All six boilers run at 65% capacity when the outdoor temperature reaches 38°F. So far, evidence of Absolute’s high quality work has come from the passing of the inspection and the lack of domestic hot water complaints from building occupants.
The retrofit at the two retirement facilities is part of the owner’s transition of leadership to his children. He wants to update as much infrastructure as possible before leaving the buildings to them. And for the projects that don’t happen before he retires, Absolute HVAC will still be in business. ICM