Construction across Nevada is on the rise, and healthcare facilities are no exception. Muliple projects are underway throughout the state to create and improve the points of access for healthcare.
What’s new?
“Part of our overall mission is to keep more Clark County residents in Clark County for their care,” said Matt Latuchie, vice president of strategic development at HCA Healthcare.
Northwest Las Vegas is a hot spot for HCA Healthcare developments. “The last 10 months have been really exciting,” Latuchie said. HCA Healthcare helped develop the stem cell therapy and bone marrow transplant program at Mountain View Hospital in northwest Las Vegas, “the first and only program in the state,” Latuchie said. A day hospital attached to this new clinic also makes patient care more accessible.
Sunrise Hospital expanded, too. “We added a new tower to Sunrise Hospital in late 2019,” Latuchie said. “It filled up on day one.”
Now, HCA is in the process of constructing a major parking tower at Sunrise. “I know a parking structure isn’t the sexiest project,” Latuchie said. “But it’s a huge testament to the overwhelming demand we have in that part of town.”
Additionally, HCA will break ground near the Strip, with the nearly 57 acres of land purchased from Station Casinos back in late 2022 set to be developed as the company’s next hospital in the valley.
On UNLV’s campus, Intermountain Healthcare is also designing what will be the state’s first children’s hospital.
“We start construction this fall, seeing patients near the end of 2030,” said Mike Wecker, assistant vice president of strategy and business development for children’s health at Intermountain Healthcare.
While the hospital and emergency facilities are important, Latuchie said urgent care is more immediately in demand.
“In March, we opened our 20th CareNow urgent care facility in the valley,” he said. “We’re very bullish about urgent care – we’re planning on opening another two by the end of 2026, and more next year.” The plan is to have at least 30 operating CareNow clinics across the valley by 2029.
In northern Nevada, Greg Gause, director of construction, facilities, and clinical engineering at Renown Health, said the priorities are similar.
The firm submitted permits for a new medical office building in Spanish Springs – 134 exam rooms, an imaging department, pharmacy, labs, and eventually, outpatient surgery care, are expected to be online in just under two years.
However, it’s also the ambulatory care network that’s taking priority.
“Our hospital is huge, but our clinics are not,” Gause said. “We’ve never invested capital like this in the outpatient side of care, but now, with the population growth, it’s something we need.”
Martin-Harris Construction has been in Las Vegas for decades building numerous commercial projects, including hospital and clinic renovations. The company launched a Reno office five years ago.
“We started doing small clinic work up there too in the last nine months,” Guy Martin, president of Martin-Harris Construction, said. “We expect that to continue as the need exists.”
Addressing Care Gaps
The focus of Renown’s strategic plan is accessibility of care. “Vegas has a lot more competition, bigger players,” Gause said. “We’re further behind when it comes to having care nearby.”
The Spanish Springs development, for example, is meant to be a one-stop shop to save residents the half-hour (or more) drive into Reno. “We’ve been opening up urgent and primary care centers left and right to be closer to community members,” Gause said.
The building process isn’t always as fast as firms (or communities) would like. Unlike other types of construction, healthcare facilities have longer lead times and delayed open dates.
“The permissioning process is unique to this industry,” Martin said. “If we finish a school on a Friday, students can walk in on Monday. In healthcare, we wait for all the controlled medications to be brought in, the equipment, everything – and that’s after we’re finished on our end.”
He has seen cases that take up to three months from building finalization to the first patient. “Delivering a healthcare project on schedule is imperative to the success of the end user,” Martin said.
While timing impacts all healthcare projects, in southern Nevada, specialty areas are the focus. “When you study the data about patients who leave Southern Nevada to receive care, overwhelmingly, the numbers point to a gap in specialty services,” Latuchie said.
Southern Hills Hospital is the latest recipient of HCA’s specialty focus with the opening of the newly constructed sixth and seventh floors in January. The seventh floor is only for inpatient rehab.
More and more Nevadans leave the state for oncology services. “Cancer treatment is the biggest hole,” Latuchie said. The HCA hospital planned for the former Station site will be oncology focused.
Other specialty hospitals, like the Intermountain Children’s Hospital, are trying to help keep Nevadans in Nevada.
“This was the third time I’d been asked to look at a children’s hospital in Vegas,” Wecker said. What changed this time was the “volume.”
“Volumes are an important metric to justify a financial investment in specialties like pediatrics,” he said. “A small portion of kids will ever need our services, and so you need to have more kids in the community to justify it.”
Medicaid has also been a boon in the funding process, with “somewhere between 50 and 60 percent of all patients expected to be covered,” Wecker said.
The Space and the Staff
None of this accessibility, expansion, or renovation work can be done without what healthcare construction teams consistently call the two more difficult parts of the job: the right land and the right staffing.
But what makes a plot of land “right”? “We want to bring services to Chinatown,” Latuchie said. “But it’s incredibly difficult to find even a one or two-acre plot of land.”
In the past, Latuchie said HCA would sit on an idea for months, even years, waiting for something to open. Sites had to check a certain number of boxes, and everyone had to be signed on. This, he said, slowed them down.
“We came to a crossroads about what type of site we were waiting on,” he said. “Do we hope for an A-plus site? Or are we comfortable moving forward with a B, or a B plus?”
Since the early 2020’s, HCA isn’t so much looking for a “slam dunk” as a “meets the needs” site. Ease of access and traffic patterns are two big factors in what separates the As and Bs.
“Is the site visible from the road?” Latuchie said. “Is there a median blocking the entrance that may require a U-turn?” Now, if a site doesn’t fit all the above, HCA will make concessions.
In Reno, Gause said power, light, and noise restrictions limit where Renown can build.
“Master developments can be roadblocks,” he said. “It’s not a question of if we can get the land, but if we can build what we want on it.”
For Intermountain, finding the right land for the hospital was more about size.
“Huge parking lots are unique to children’s hospitals,” Wecker said. “No patient comes alone – we have to have space in our lots for moms, dads, siblings, grandparents, friends.” That extends to waiting and even patient rooms.
“Everything has to be bigger,” he said. “Rooms must have beds for the parents, extra chairs, all the above.”
Additional rooms are required in the construction documents, too – family support services and other departments take up even more space.
But public interest isn’t enough: construction documents can’t even be drawn up without physicians’ sign-off.
“That may seem odd – shouldn’t we just build a hospital and then start filling it up?” Latuchie said. “But it really does not work that way. Physicians need to be interested in practicing there first.”
Wecker said physician buy-in was “a risk” for the children’s hospital. “There’s a shortage of specialists broadly across the nation, but even larger shortage for children’s health,” Wecker said.
Sometimes it’s as simple as physicians not wanting to move.
“The city of North Las Vegas has been really interested in building a hospital across from the VA,” Latuchie said. “Physicians look at other areas – they don’t live over there, or they don’t want to. That’s a difficult variable to contend with.”
For Intermountain, there’s no clear pipeline: there are two pediatric endocrinologists in Las Vegas, and no pediatric physical medicine or rehab doctors, Wecker said. “In Southern Nevada, we’re in a care desert,” he said. The only real, long-term solution is to bring more physicians to town.
Healthcare and Quality Compliance
Also involved in the conversation are the architects and construction teams, who all hold special certifications in healthcare construction.
“The credentials required to bid on healthcare jobs are vastly different than any other project,” Martin said.
In fact, the compliance requirements end up keeping many construction firms out of the healthcare sector. “It requires an investment not only from your company, but your people,” Martin said.
And once a firm gets a job, they must contend with the code. “Most sectors don’t have to deal with the code challenges that healthcare does,” Gause said.
Occupancy rules, fire protection, sprinkler overage, water and power usage, and exit accessibility are the tip of the iceberg when it comes to special considerations, he said.
“It’s very pricey to build clinics,” he said. “Healthcare facilities house people who are not capable of self-preservation, and so we have to be extremely particular in what and how we build.”
Because of the nature of the work, healthcare giants like Intermountain tend to work with firms with proven track records.
“We chose Shepley Bulfinch due to their nuanced experience with children’s hospitals,” Wecker said. “Their expertise is used in every consideration, throughout the entire design and development – making decisions down to the location of the operating room and the surrounding departments. It’s all critical.”
Martin said his company is often the first choice because of long-standing relationships. “All construction, but especially healthcare, is based on trust,” he said. “These jobs have to be done right the first time.”
Having Humanity
Working across various construction types showed Martin healthcare construction’s starkest difference: soft skills.
“Tearing apart the hallway in a hotel tower is different than a neonatal ICU’s hallway,” he said. “You must behave differently. Your attitude must be different – you have to lead with your heart first.”
Healthcare construction is also consistently high stakes, especially on active sites where only one portion or wing is being renovated or constructed.
“You make a mistake at a casino, what’s at risk is people’s comfort,” Martin said. “You make a mistake at a hospital, lives are on the line, every day, all the time.”
Playing Catch-Up
Despite the dozens of new builds, renovations, and plans on the docket, healthcare construction leaders say they’ll always be behind.
“The healthcare sector is always in catch-up mode,” Latuchie said. “We’ve got this dynamic, community, and in the healthcare space, we need to mirror that.”
It’s the same story in Northern Nevada. “Reno just does not yet have the services to meet demand,” Gause said. “Every day, we’re pushing to make that not the reality.”
Martin said the single biggest issue plaguing healthcare construction is funding. “Hospitals are still a business,” Martin said. “They still need to turn a profit to continue to exist.”
Reimbursables that go into their construction are negotiated over long periods of time, Martin said, and by the time a decision has been reached, the true cost has changed.
“Construction costs go up faster than hospitals can get the money,” he said. “Everyone wants hospitals to be built, but nobody wants to pay more for healthcare.”
Unraveling this “doom loop” is the big ask for all members of the healthcare industry, from construction teams to government leaders, he said.
“If the work is worth it to our clients, it’s worth it to us,” Martin said. “But until prices are controlled, we’re doing the absolute best we can to manage the volatility.”
