What we build · Ambulatory Surgery
A Licensed Facility Is a Different Project
An ambulatory surgery center is a licensed facility. State plan review, code requirements for operating rooms, medical gas and air handling all apply, and each has a real schedule consequence.
Tell us the space, the specialty, and whether the facility will be licensed. Those three answers decide almost everything else.
Licensed?
The first question, because it changes the whole project
ICRA
Containment built and monitored, not just described
Occupied
Clinics keep seeing patients while we work
Licensed
General contractor, licensed in the state of Florida
The schedule is set by review, not by construction
Owners plan surgery center projects around construction duration and are then surprised by plan review, inspections and commissioning. Building it is frequently the shorter half. A program that does not have realistic review and approval durations written into it is not a program, it is a hope.
Review duration is also outside anybody's control, which is what makes it different from construction risk. A contractor can add crews to recover a construction delay. Nobody can accelerate a review, which is why it belongs in the program as a real activity with realistic float rather than as an optimistic placeholder.
What applies
- State agency plan review before construction begins.
- Operating room requirements: air changes, pressure relationships, finishes.
- Medical gas systems, installed and certified by qualified parties.
- Emergency power and its own commissioning requirements.
- Inspections through the build, not only at the end.
Why commissioning takes longer than expected
A surgical suite has to demonstrate that its air changes, pressure relationships, temperature and humidity control, medical gas and emergency power all perform as designed. That is testing and documentation, and it happens after construction is finished.
Compressing it is not an option on a licensed facility, and it is the phase most often left out of a program drawn around construction duration. Allow for it explicitly or the opening date moves.
How we handle it
- 01Build the program around review durations, honestly stated.
- 02Coordinate with your design team through the review process.
- 03Install to the reviewed and approved documents, not to a variation.
- 04Sequence medical gas and its certification properly.
- 05Support commissioning and the licensure inspection.
Put the review duration in the program as a real activity with a real duration. Every surgery center that opened late had a program where review appeared as a two-week placeholder somebody hoped would be generous.
Said plainly
Where we stop
We build to the approved documents. If something on site would be better done differently, it goes back through the process rather than being changed and explained afterwards — that is not flexibility, it is a licensure problem.
FAQ
Common questions
- Does an ASC need state plan review?
- Yes. It is a licensed facility and review is part of the program, not a formality.
- How long does review take?
- Long enough that it belongs in the schedule as a real activity. Your design team will advise the current position.
- Who certifies medical gas?
- Qualified installers and independent verifiers. It is not general plumbing work.
- Can we change something on site?
- Not without going back through the process. Building off the approved documents creates a licensure problem.
The requirements
Licensure & Plan Review
Some healthcare spaces are licensed facilities reviewed by the state. Some are commercial tenant buildouts. The difference decides the cost, the schedule and the standard.
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Infection Control & ICRA
Construction in or near a healthcare space releases dust, and dust carries organisms that matter to people who are already unwell. Containment is a built assembly with a measurable performance.
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Medical Gas
Medical gas piping looks like plumbing and is governed by an entirely separate regime of qualification, installation and independent verification.
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Life Safety & ILSM
Building work interrupts alarms, sprinklers, exits and smoke compartments. In an occupied healthcare facility every one of those interruptions has to be planned and compensated for.
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Working in a Live Facility
Most healthcare construction happens in a building that is still seeing patients, which makes coordination the largest part of the job.
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More what we build
Medical Office
A private physician practice doing examinations and consultation. Usually a commercial tenant buildout with clinical requirements layered on top.
Read more →
Dental
A dental practice is defined by what runs underneath it — water, air, vacuum, drainage and data, all arriving at fixed points in each operatory.
Read more →
Imaging & Radiology
X-ray, CT and MRI each impose physical requirements that a normal building does not anticipate — shielding, floor loading, power and, for MRI, a magnetic field that never turns off.
Read more →
Next step
Find out what is actually wrong with it.
An inspection, photographs of what we found, and a written scope. If the honest answer is that it can wait another season, that is the answer you will get.