A medical office building looks like an ordinary two- or three-story office building until you count what the floor must carry: imaging suites with lead-lined walls, a sterile processing room with floor drains, procedure rooms with strict level requirements and a mechanical yard sized for continuous air handling. Because the owner is usually a physician group, a health system or a developer leasing to both, the concrete package has to leave room for tenants who have not been named yet.
The Fort Collins and Loveland hospital campuses set the pattern for this work. Poudre Valley Hospital on South Lemay Avenue has 270 beds, 11 surgical suites and a Level III trauma designation, while Medical Center of the Rockies in Loveland has 187 private rooms and a Level I trauma designation. Clinics, specialty offices and ambulatory surgery buildings gather around such campuses, and each needs a foundation, slab, site utilities and an accessible route from the parking lot to the front door.
We build that scope for developers and general contractors who want a structure ready for tenant improvement without surprises in the slab.
The best predictor of a clean medical office build is how early the tenant's equipment is known. MRI and CT rooms may need a depressed slab, a thickened section or an embedded copper shield; a linear accelerator vault is a separate structure with thick walls and a dedicated foundation. We ask for the equipment schedule at the foundation stage and mark each room on the pour plan, because moving a floor drain or sleeve after the slab is placed means saw-cutting, which a medical tenant will not accept.
Plumbing under the slab is the other item. Medical suites typically have more floor drains, sinks and gas and vacuum lines than a conventional office. The slab on grade trade crews coordinate with the plumber so that the rough-in is inspected, bedded and backfilled before the vapor barrier goes down, and the building's slab is placed in one continuous sequence rather than in patches.
Fort Collins requires commercial air leakage testing and provides a commissioning fact sheet and checklist as part of its 2024 International Building Code set, which the city treats as current for permits submitted on or after April 1, 2026. A medical office building is one of the more demanding envelopes under that rule, because it holds pressure relationships between rooms and has a high ratio of mechanical equipment to floor area. We seal foundation wall penetrations and slab edges in a documented order so the testing contractor can sign off.
Accessibility is inspected closely. Entrance ramps, curb ramps, accessible parking stalls with their access aisles and sloped sidewalks must meet slope, cross-slope and landing criteria, and a patient arriving by wheelchair or walker tests them every day. Our ADA ramps and accessible routes work is laid out with string lines and a digital level before forms are set, then checked again before the pour so corrections cost minutes, not days.
Medical office sites are often tight infill parcels next to a hospital, which means shared driveways, existing utilities and neighbors who cannot lose power or water. We pothole every buried line first, communicate shutdown windows to the owner in writing, and stage excavation to keep emergency routes open. Fire access, hydrants and a looped fire line are standard requirements, and the fire line and hydrant installation trade crews can set hydrants and valves during the same mobilization as the building's service lines.
The same site discipline applies near the hospital districts. Where a hospital is leased land owned by a health service district, as at Poudre Valley, easements and boundary agreements shape what a neighboring clinic may build and where its utilities may cross. We sort those out with the owner's civil engineer before trenching begins, and we align our scope with the larger hospital work that may be going on next door.
Healthcare owners buy with a different calendar. A clinic that opens late loses revenue each week, and a delay in the foundation package ripples directly into licensing and staffing dates. We tell project teams the weather-dependent portions of the work up front and plan winter protection so footings and slab are not hostage to a cold snap. Work near an occupied hospital campus adds access limits, noise windows and sometimes infection-control requirements for dust, which we plan with the owner's representative.
Because health systems, developers and group practices all buy medical office space, our work crosses schools and healthcare owners and commercial developers. We tailor the schedule accordingly: a developer wants a shell ready for several tenants, while a health system wants a finished suite on a hard date.
Our approach to a medical office project is to start every meeting with the calendar. The pour windows, the winter limits and the inspections tied to each activity go on a one-page schedule that the owner, architect and general contractor all see. Footings and the slab are scheduled so mechanical, plumbing and electrical trades arrive when the floor is ready for them, not when it is only close.
That schedule is backed by testing. Cylinders are cast from each placement, slump and air content are checked at the truck, and subgrade compaction is verified before steel is placed. A medical owner needs documents as much as concrete, so we keep a pour log that records mix, temperature, location and test results for each placement.
Send the tenant equipment schedule, the site plan and your opening date, and we will return a pour plan and a price that accounts for drains, imaging rooms and accessible routes.
Exam rooms, labs and sterile processing areas need drains, sinks, gas lines and conduit, often in locations that depend on the final tenant plan. We map each penetration on the pour plan, inspect rough-in before the vapor barrier, and keep sleeves in a tight location tolerance so equipment can be set without core drilling later.
Yes, but with caution. A shell slab can be placed with provisions for future drains and thickened areas in likely imaging rooms, but changing a layout after the pour means cutting. Some developers place the slab after signing the first major tenant; we can price both approaches.
The equipment manufacturer specifies flatness, thickness and sometimes isolation. We place those rooms in a defined area with the required reinforcing, finish them to the stated tolerance, and cure them carefully. Measurements are taken before the vendor installs, so any remedial grinding is done while the room is empty.
The testing agent needs access to foundation penetrations and slab edge details before they are covered. We hold inspections for those items, document sealing, and coordinate with the envelope contractor so the whole assembly can be tested on the date the schedule shows.
We agree on access routes, work hours, noise, dust and utility shutdown notices with the owner before mobilizing. Silica dust from sawing is controlled with wet methods, and trucks are scheduled so that deliveries do not block patient or emergency routes.