Five Questions to Ask When Choosing a Healthcare Builder in Texas

Oct 8, 2026

Sarah Trocolli

Senior Communications Specialist

6-minute read

Healthcare owners and design teams need a builder who understands their facility’s operations and priorities. These five questions help guide that evaluation, with examples from RO’s work across Texas covering occupied renovations, reality capture, complex systems and early planning.

Healthcare construction decisions reach beyond the job site. They affect patient care, staff workflows, critical systems, and a facility’s ability to remain operational. The right construction partner understands the owner’s priorities, the facility’s operations, and the people who rely on it.

These five questions can help healthcare owners and design teams evaluate a builder’s approach before construction begins.

1. How do you build without interrupting patient care?

Healthcare construction often happens while the building continues to serve patients. That changes how the work must be planned. Noise, dust, access, infection control, and utility interruptions all become operational concerns.

At Harris Health Casa de Amigos in Houston, the community clinic remained open during a full interior renovation, a 3,000-square-foot addition, and construction of a new entrance. RO phased the work around clinic operations, controlled noise and dust, and coordinated utility shutdowns to maintain critical mechanical, electrical, and plumbing services.

Exterior of Harris Health with downtown Houston in the background

The team also worked through aging infrastructure, severe weather, and a six-month permitting delay while the clinic continued serving the community.

RO managed similar operational concerns at the Baylor Scott & White Specialty Treatment Center in Temple, serving the Greater Waco area. The project included 75 planned utility shutdowns and the replacement of five automatic transfer switches during the conversion of the first floor into a 20-bed Universal Care Unit. The work required careful sequencing and coordination with hospital staff to protect the power and utilities on which ongoing patient care depends.

The scopes may differ, but the responsibility is the same: understand how the facility operates and communicate before critical systems are touched.

2. How do you document existing conditions with less disruption?

Renovation teams frequently inherit drawings that are incomplete, outdated, or no longer match what is above the ceiling. Traditional field verification can take days and may require repeated access to sensitive clinical areas.

MirrorScape, an RO reality capture service, helps teams document existing conditions and turn that information into practical answers for design and construction.

The MirrorScape team completed the field capture in six hours, compared with an estimated five days using a traditional tripod-based approach.

RO MirrorScape team member scans above the ceiling in hospital.

At Dell Children’s Medical Center in Austin, the MirrorScape team used a NavVis MLX handheld scanner to document approximately 7,200 square feet above and below the ceiling in an active catheterization lab and connecting corridors. With access limited to nighttime hours, speed was critical.

RO’s in-house field engineers established approximately 24 control points, and the resulting 3D point cloud and 360-degree imagery gave design teams and trade partners browser-based access to existing conditions and the ability to create as-built models. Teams could verify clearances and investigate conditions without scheduling another visit to the clinical space.

“The MirrorScape team provides that peace of mind health care teams are looking for in the form of dimensionally accurate as-built models above and below the ceiling,” said Seth Anglin, MirrorScape | Business Development Manager.

3. How do you Protect Patient CARE and MAINTAIN Operations During Construction?

Protecting patient care means safeguarding people and the systems that keep a facility operating. Mechanical, electrical, plumbing, medical gas, technology, and specialized equipment systems must work together. A decision in one can affect several others, making coordination an ongoing responsibility.

RO’s commitment to Protect Life and Well-Being guides how that work is planned and performed. Site-specific safety plans, daily pre-task planning, and routine inspections help teams identify hazards and establish controls. In an active healthcare facility, planning must account for patients, staff, visitors, and construction teams.

RO employees compare BIM to installed MEP. — *MEP Coordinators and Managers use a 3D model in the*
*field to verify complex installation.*

To support that effort, RO’s in-house MEP team works with project teams, design teams, and trade partners to identify conflicts, clarify installation requirements, and coordinate equipment before work reaches the field. That coordination is especially important around imaging equipment, operating rooms, treatment spaces and utility shutdowns.

At the Texas Oncology Cancer Center in Fort Worth, the scope included four linear accelerator vaults, two CT scanners, and a PET/CT scanner. Each piece of equipment carried structural, shielding, electrical, cooling, and installation requirements that had to be coordinated with the surrounding building systems.

That coordination also applies in outpatient surgical environments. At USPI Woodforest Ambulatory Surgical Center in Montgomery, within the Houston region, RO delivered three operating rooms, one procedure room, five pre-operative bays, and 11 recovery beds. The facility is smaller than an acute-care hospital, but its surgical, life-safety, and backup-power systems still require close coordination from design through commissioning.

4. How do you use early planning to reduce healthcare construction risk?

Many project risks are established before crews mobilize. Incomplete scopes, late decisions, long-lead equipment, and unrealistic phasing assumptions become harder and more expensive to solve once construction begins.

RO’s Collaborative Project Planning process brings the owner, design team, trade partners, and builders together early to establish priorities, identify constraints, and create a plan that the full team can own. During planning for the Houston Methodist Cinco Ranch Comprehensive Care Center, the team reduced the original 13-month construction schedule to 10.5 months. Open communication and clear accountability helped align construction sequencing with the owner’s needs.

“WE BUILD TRUST BY UNDERSTANDING WHAT MATTERS TO OUR CLIENTS, BUILDING A PLAN AROUND THOSE PRIORITIES AND FOLLOWING THROUGH. THAT MEANS COMUNICATING HONESTLY, ADRESSING RISKS EARLY AND WORKING THROUGH CHALLENGES TOGETHER.”
Brad Henderson | Vice President of Healthcare Client Relations

5. What healthcare construction experience do you have across Texas?

Healthcare experience is most useful when it helps a builder ask better questions. A new acute-care hospital presents different risks than an occupied clinic renovation. Behavioral health facilities require careful attention to safety, privacy, and dignity. Ambulatory surgery centers combine a smaller footprint with highly coordinated surgical systems. Rural healthcare projects must respond to regional labor, logistics, and community needs.

RO’s work across Texas includes each of these environments.

Exterior of two story hospital at sunset. — *Trinity Regional Hospital Sachse*

Nurses and outpatient waiting area in medical facility. — *Trinity Regional Hospital Sachse*

In North Texas, Trinity Regional Hospital Sachse brought operating rooms, emergency care, advanced imaging, and inpatient beds together in a new acute-care hospital. At LifePath Systems in McKinney, the work supports behavioral health crisis care, extended observation, and respite services. These projects require different environments and different operating priorities, even within the same region.

In Austin, MirrorScape’s work at Dell Children’s helped the project team investigate concealed conditions in an active pediatric hospital. Central Health at Hancock took a different approach, adapting a former Sears building into a clinical and administrative campus while preserving much of the existing structure.

Across South Texas, the Frio Regional MOB and ER Renovation in Pearsall represents the San Antonio region and includes a new medical office building, emergency department expansion, and improvements across the existing hospital campus. In Temple and the Greater Waco area, Baylor Scott & White demonstrates the planning required to renovate active hospital space around critical utilities.

That range of experience helps RO ask the right questions, address project-specific risks, and bring the resources each facility needs.