Lindsay Corotis
Climate change is having a growing impact on the healthcare construction industry. Beyond physical risks to building occupants, extreme weather events such as floods and wildfires introduce scheduling delays, increased costs, evolving building codes and shifting insurance requirements, particularly in high-risk regions.
These challenges underscore the need for proactive planning to protect healthcare facilities, staff and patients while ensuring continuity of care during emergencies and extreme weather events.
At the same time, the industry is navigating broader market pressures. Operating margins are tightening and uncertainty around federal policy and tariffs, especially for materials like steel and aluminum, continues to drive cost volatility. Ongoing supply chain disruptions further complicate scheduling and budgeting, often requiring healthcare owners to reassess timelines, procurement strategies, contingency planning and risk allocation throughout the project lifecycle.
At Skanska, we are committed to preparing the built environment to adapt to a rapidly changing climate. This responsibility brings a unique set of considerations, from how healthcare facilities are designed and built to how they support occupants and surrounding communities over time, particularly as climate risks become more frequent, severe and unpredictable.
Regional Trends Shape Strategies
As healthcare systems face these pressures, regional trends are shaping construction strategies. In the South, population growth in states like Texas and Florida is driving new facility expansions designed with resilience and sustainability in mind. Dense urban markets in the Northeast are focused on renovations and infrastructure upgrades that meet decarbonization goals while addressing space constraints, aging systems and evolving regulatory requirements. On the West Coast, increased patient demand is driving renewed investment in energy-efficient and climate-resilient healthcare facilities.
Healthcare projects also present added complexity. Construction often occurs within active, operating facilities, requiring careful coordination to avoid disrupting essential services. With billions of dollars in healthcare projects underway nationwide and a rise in specialized facilities, construction teams are expected to meet tight deadlines, adhere to rigorous safety standards and align closely with medical and research staff. In response, firms across the sector have developed tailored approaches that prioritize safety, sustainability and uninterrupted operations.
Having the right project partners has become a critical factor in delivering durable, sustainable healthcare facilities. Industry collaborations, including initiatives such as the Centering Health Equity in Climate Action (CHEC), are helping embed public health considerations into sustainability strategies. These partnerships provide access to research and cross-industry expertise, supporting solutions that address challenges like urban heat mitigation, energy efficiency and thermal comfort while protecting patient health and advancing long-term resilience goals.
Commitment to National Climate Resilience and Adaption
Contractors have long worked closely with healthcare clients during design and preconstruction to incorporate region-specific resilience strategies. In Florida, facilities are adopting flood protections such as water pumps, inflatable shields, roof upgrades and wind tunnel testing to strengthen structures against storm surge and high winds.
Skanska is applying these lessons at the Lee Health Fort Myers Hospital campus, a new 52-acre medical destination featuring a 5-story hospital, medical office building, patient tower and childcare center. Informed by Hurricane Ian, the project includes an emergency makeup water supply, redundant power systems and enhanced building envelopes to support storm readiness, recovery, and operational continuity.
In earthquake- and tsunami-prone regions like the Pacific Northwest, hospitals are integrating rooftop infrastructure and vertical evacuation strategies. Skanska’s expansion of Columbia Memorial Hospital in Astoria, Oregon includes a tsunami-safe refuge area with roof access developed in collaboration with regional emergency management and technical experts.
In California, healthcare projects increasingly incorporate full generator backup systems, expanded water storage, and upgraded storm drainage to address wildfire-related power shutoffs and flooding risks. Together, these efforts reflect a growing emphasis on resilience that supports physical safety, operational continuity and long-term financial stability.
Balancing Energy Efficiency with Patient Safety
As building codes evolve and aging facilities undergo modernization, energy efficiency has become central to healthcare sustainability efforts. However, standards such as minimum outdoor air exchange requirements can increase energy use. Project teams are addressing this challenge through advanced HVAC controls, energy modeling and high-performance building envelopes that reduce consumption while meeting clinical needs.
One example is Skanska’s work on the Cordilleras Mental Health Center Replacement in Redwood City, California, set for completion in early 2026. The 77,000-square-foot campus includes multiple mental health recovery centers and co-housing, with design decisions shaped by patient safety requirements such as anti-ligature measures, controlled access, and specialized commissioning.
Climate resilience and sustainability are no longer optional in healthcare construction, they are essential. Through region-specific design, strong partnerships, energy-efficient technologies and flexible capital strategies, the industry is evolving to protect patients and communities today while building resilient care environments for decades to come.
Lindsay Corotis is a vice president and account manager at Skanska USA Building.
