Hospital Construction in Aurora and the East Metro
Hospital and health campus construction in Aurora and the south and east metro, with infection control, life-safety continuity and licensing sequencing.
Hospitals are organized around systems that cannot stop: power, medical gas, air handling, water and the fire alarm and sprinkler network that protect patients who cannot walk out. Construction has to respect that from day one, whether the project is a new tower, an addition to an operating campus or a freestanding emergency department. We approach hospital work as a general contractor that plans infection control, utility shutdowns and inspection sequences as carefully as it plans steel and concrete.
The south and east metro has become one of the more active hospital markets in the state. The Anschutz Medical Campus continues to expand, AdventHealth Parker has begun a seven-story tower, HCA HealthONE Sky Ridge sits at the heart of Lone Tree's RidgeGate district, and the Aurora Highlands master plan reserves a 50-acre hospital site. Each of those facilities draws medical offices, parking and utility upgrades, and each brings its own process for design review and owner standards.
Owners come to us at different stages: some with a campus master plan, some with a parcel and a financing plan, others with a tower already designed and a budget that does not match. In each case the first step is a candid look at the program, the site and the approvals, and a schedule that includes the inspections and licensing steps that decide when patients can enter.
Codes, licensing and who inspects what
Hospital buildings fall under institutional occupancy rules, and the review is layered. The local building department reviews under its adopted code, which is the 2021 IBC with city amendments in Aurora and the 2021 I-codes in Lone Tree, while state health authorities review licensing-related items and the owner's own insurers and accreditors apply standards on top. Energy and electrical editions differ as well; electrical and plumbing editions are set at the state level while building codes are adopted locally.
Because the layers are separate, the schedule has to carry them separately. We map which agency reviews which discipline, when each review is needed and what inspection or certification is required before patients are moved. For campuses with multiple owners, such as a university hospital next to a children's hospital and a veterans medical center, shared infrastructure often means shared approvals, which we coordinate through the owner's facilities group.
The campuses we are building around
On the Anschutz Medical Campus, the UCHealth University of Colorado Hospital opened an 820,000 square foot, $644 million facility in 2007, and its main inpatient pavilion has more than 400 beds. Children's Hospital Colorado, at 1,400,000 square feet, opened the same year south of the campus, and the Rocky Mountain Regional VA Medical Center opened in July 2018. That cluster of very large facilities, with two RTD R Line stations, sets the expectation for what an urban medical campus requires.
Suburban hospitals operate on a different scale. AdventHealth Parker has 179 beds and started a $300 million, 186,000 square foot tower adding sixty beds in January 2025. AdventHealth Castle Rock has 90 beds listed and opened a cancer center in February 2026. Sky Ridge is a Level II trauma center with more than 300 beds. These are mid-size campuses where a new wing or tower must be built beside operating departments, which defines the whole approach.
Building next to patients
The most important decisions are made before construction. Where do the new utilities tie in, and can they be switched without interrupting care? Where does construction traffic enter relative to ambulance routes, helipads and the parking structure that visitors use? We map each of these with the facilities team, build a logistics plan and test it against the clinical calendar. A tower crane, a utility tie-in or a crane pick over an entrance each get their own plan.
Infection control and noise are managed through a written risk assessment, and the plan is reviewed with infection-prevention staff before work begins. We build containment, negative air and sticky mats where required, and we monitor dust and vibration while work is underway. Where an addition touches existing space, our phased work on occupied campuses planning sets exact tie-in dates with the nurse managers.
Safety and life-safety system continuity
Hospital projects require more than standard site safety. Fire watch, interim life-safety measures and impairment notices are mandatory when sprinkler, alarm or egress systems are shut down for tie-ins. We track every impairment, notify the hospital's safety officer and document each restoration. That discipline lets inspectors and accreditors see a clean record.
On the trade side, medical gas installers, controls specialists and high-voltage electricians need verified qualifications and testing procedures. We collect their credentials, run pressure and purity tests with an independent party and document the results in the closeout package. For smaller work that is not a full hospital, our medical office buildings practice applies a lighter version of the same discipline.
Cost, escalation and the owner standards
Hospital budgets are driven by mechanical, electrical and plumbing systems, which can be the largest share of the total, along with medical equipment coordination and the number of beds served. A $644 million, 820,000 square foot facility and a $300 million, 186,000 square foot tower point to the scale of capital involved, but unit costs differ widely with the mix of acute care, imaging and surgical space.
We build a budget with the owner in layers: base building, equipment-ready rough-ins, owner-furnished equipment allowances, and contingencies for unforeseen conditions in existing buildings. Each of those is tracked separately, which makes it easier for boards and lenders to see what is changing. Healthcare systems that fund projects in tranches especially value that transparency.
Preconstruction that finds the problems first
We start preconstruction with a site investigation of the existing campus: record drawings checked against field conditions, utilities located and surveyed, and structural conditions probed where new construction meets old. Surprises in an existing hospital are costly, so we try to find them while a change is still a drawing revision.
Next, the team develops a logistics plan, a phasing plan and a long-lead plan, and these are reviewed with the owner's clinical and facilities leaders. Education institutions with teaching hospitals add a research and teaching layer, and we incorporate their requirements as well. When a parcel in a master plan is ready for a first hospital, our Aurora Highlands planning focuses on the infrastructure the hospital will need.
Start with the campus plan
Send us the master plan, the program and the licensing timeline, and we will return a phasing plan and a budget range with the approvals and tie-ins on the schedule.
Questions Owners Ask
How do you keep a hospital operating during construction?
We write a logistics, infection-control and utility-shutdown plan with the owner's facilities and clinical leaders. Tie-ins happen in scheduled windows, with interim life-safety measures in place and fire watch where needed. Construction traffic is separated from patient, ambulance and visitor routes.
What approvals decide when patients can move in?
The local building department's certificate of occupancy, state licensing steps, and the owner's own commissioning and accreditation requirements. We build a map of each, with dates and responsible parties, so nothing is discovered at the end.
Are there hospital sites planned in the east metro?
The Aurora Highlands master plan reserves a 50-acre hospital site, and existing campuses in Aurora, Parker, Lone Tree and Castle Rock have expanded or are expanding. We help owners decide how utilities and roads should be phased to support a hospital when the timing is right.
Why do existing-building surprises matter so much?
Because hospitals have dense utilities and old records. An unexpected duct, pipe or structural condition can shut down a department while the team works out a fix. We investigate before pricing and carry contingency for what remains unknown.
What is the difference between hospital and medical office work?
Hospitals house inpatient care and carry institutional occupancy rules, licensing and life-safety systems that are far more demanding. Medical office buildings are lighter and quicker to permit. Many campuses have both, and we coordinate them under one logistics plan.