A hospital cannot close for a storm. When the May 3, 1999 tornado crossed Moore as an F5 on a 38-mile path, the Oklahoma State Department of Health recorded 583 injuries and 36 direct fatalities, and every emergency room within reach carried the load. That is the baseline for Oklahoma hospital design: the building must keep its power, water, medical gas and communications working in the hours when a whole region needs it most, and it must do that in a state that averages 59.4 tornadoes a year.
The same logic applies to river flooding, ice and heat. A new patient tower is not just a larger clinic. It is a building where an operating room, a pharmacy, a data room and an emergency generator all have to function through weather and through maintenance. Cost, schedule and regulatory review follow from that fact, and a general contractor who treats a hospital as a big commercial building will underestimate all three.
We build hospital additions, tower expansions, emergency departments, imaging wings and central plants across Oklahoma, often on active campuses. This page explains the work as we see it, from structure through commissioning.
Flood and storm history shapes where and how a hospital is built. In May 2019, river flooding at Muskogee rose more than 42 feet, the highest in more than seven decades and above the 39.6 feet reached in 1986. On April 23, 2026 the National Weather Service documented EF-4 damage from a long-track tornado that struck Vance Air Force Base and southern Enid, a 10-mile path with 10 injuries and no deaths. Both events are reminders that a medical campus has to plan for the worst day of the decade, not the average year.
For central plants, generator yards and fuel storage, the best practice is to site them above flood elevation and away from glass. Utility entries need duplicated routes. We work with design teams to place these systems early and to coordinate structural and mechanical components, so the plant does not end up in a floodplain corner because that was the last open space on the drawing.
Hospital structures are generally reinforced concrete or steel frames with heavier floor systems than ordinary offices. Vibration limits for imaging and operating rooms call for stiffer floors, and the weight of equipment such as MRI magnets and linear accelerators drives local slab thickness, shielding walls and rigging paths. Roofs carry rooftop air handlers and sometimes helipads, each with its own wind and structural requirements. In tornado country, designers consider enhanced glazing, protected mechanical rooms and shelter-in-place areas for patients and staff.
Our healthcare construction teams coordinate the structure with an extensive above-ceiling system. A patient floor has a dense layer of ducts, sprinkler lines, medical gas, electrical conduit and data cable above the corridor ceiling. Sequencing these trades is the main schedule challenge, and we use coordinated models and a physical walk-through before ceilings close to avoid clashes that would otherwise stop work.
Hospital projects are rarely built in a clean field. More often they are additions to a campus that is serving patients every hour. The main risks are infection control, noise, vibration, dust and utility interruptions. We work with the owner's infection control staff to build an Infection Control Risk Assessment into the plan, set up negative-pressure containment, schedule loud or vibrating work for low-census times and review every shutdown with the clinical team. Entrances, routes for patients and ambulance bays are protected throughout construction.
Parking and access are part of the same plan. Construction workers need parking and a route that does not mix with patient traffic, and deliveries are timed to avoid peak visiting hours. A well-run parking structure project on the same campus can be the first phase that frees space for the main building. We build temporary parking and wayfinding so patients do not get lost.
Public hospitals and county-owned facilities must follow Oklahoma's competitive bidding law. Under the Public Competitive Bidding Act of 1974, contracts over $100,000 go to the lowest responsible bidder by sealed bid, with 5% bid security, and a construction management route is allowed for trade contracts over $50,000. Many private nonprofit systems still use a negotiated or construction-management-at-risk model, which lets the contractor join the design team early. We explain the options in plain language, and where a project mixes public and private money, we check which rules apply to which part.
The statewide code picture also matters. The state sets minimum codes, but cities such as Oklahoma City and Tulsa adopt and enforce their own, and healthcare facilities have additional agency review. A construction manager at risk approach lets us price the building in stages as the design firms up the code basis.
Commissioning is where hospital projects either finish or stall. Every system must be tested, balanced and documented: emergency power transfer, nurse call, medical gas, pressure relationships between rooms, fire alarm and smoke control. Surveyors and the owner's clinical staff then walk the building before patients arrive. We plan that testing from the start and give the owner a punch list that is complete, rather than a stream of small items after opening.
For health systems that run several buildings, we also pay attention to the way a new wing connects to the old. Tie-ins to existing corridors and utilities are done in planned windows, often overnight, and we keep a written record of each. A new wing that looks perfect but disrupts the old one on tie-in day is not a success. A neighboring medical office building often shares the same campus utilities and parking, and we sequence work with that in mind. Owners also receive record drawings, equipment manuals and a training schedule, so the staff who keep the plant running learn each system from the installer rather than from a binder, and the first generator test under load is witnessed by the people who will depend on it.
Tell us the service line, the site and the occupied areas nearby. We will provide an approach to phasing, infection control and commissioning that your clinical team can review.
FAQ
Send the property, the building type and the schedule. We review the scope, the approvals and the trade packages and explain how the project would be sequenced.