Sector Capability · Healthcare

Healthcare Construction Scheduling

Primavera P6 construction scheduling for hospital general contractors, mechanical and electrical contractors, and owners: contract-required baselines, monthly updates with a narrative report, and independent schedule reviews. ICRA zones, utility shutdowns and state agency reviews are activities in the logic, not notes.

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30+
Years hospital & healthcare scheduling
50
Years total complex construction
100%
Pure-play scheduling focus
All Phases
Pre-con through close-out
Why Choose CPM Pros

Why healthcare programs
need specialized scheduling

Infection control sequencing — ICRA & PCRA
ICRA and PCRA zones must be logically sequenced and maintained throughout construction. We build and monitor these constraints into every baseline — not as activity notes, but as real P6 logic that drives sequencing decisions and protects patient safety compliance throughout the project.
Phased occupancy planning — hospitals rarely go dark
We schedule around live hospital operations — coordinating swing space, interim utility outages, and department relocations without disrupting patient care. Our schedules account for the reality that a hospital bed is never empty for long, and construction has to work around clinical priorities.
Owner's rep schedule review
We independently review GC-submitted schedules for logic errors, missing scope, and unrealistic float before your milestone dates are compromised. Monthly narrative reports give the owner's team and board a clear written account of contractor performance and schedule risk.
Regulatory milestone tracking — OSHPD, HCAI, Joint Commission
OSHPD, HCAI, Joint Commission, and CMS inspection milestones require careful sequencing and lead time. We keep these on the critical path where they belong — with logic predecessors so regulatory submissions and inspections sit in the critical path, not as an afterthought that delays occupancy.
Delay analysis and TIA review
When contractors submit time impact analyses on healthcare projects, the stakes are high — delayed occupancy affects patient care and revenue. We verify the methodology and protect your contingency against inflated delay claims, with forensic analysis experience on acute care hospital and medical center programs.
Scheduling Services

Scheduling services for
healthcare programs

From ICRA zone sequencing to forensic expert witness testimony for hospital construction claims, our services are built around the complexity of healthcare construction.

Baseline CPM schedule development (Primavera P6)
ICRA / PCRA phased construction sequencing
Independent schedule peer review
Monthly owner schedule narrative reports
Swing space and interim occupancy planning
Time impact analysis and delay quantification
State agency review integration (HCAI, AHCA, HHSC, NYS DOH, IDPH, GA DCH, WA DOH, LA OSFM, CMS)
Forensic schedule analysis for claims and litigation

Project Sub-Sectors

HospitalsMedical CentersSurgery CentersMedical Office BuildingsBehavioral HealthCancer CentersLife SciencecGMP Facilities
What the Schedule Has to Carry

Hospital schedules are built from
approvals, shutdowns, and equipment

Healthcare CPM scheduling services differ from general building work in what the Primavera P6 model has to hold: every AHJ review cycle, every utility shutdown in an occupied building, and every piece of owner-furnished equipment with a vendor date attached. CPM Pros builds those into the logic so the owner sees the effect of a slip in the next update, not at the licensing survey.

Utility shutdowns and tie-ins as scheduled events
Tying new work into live medical gas, normal and emergency power, steam, and air handling takes a written shutdown procedure, facilities approval, clinical notification, and usually a night or weekend window. Each shutdown is its own activity with the approval as a predecessor and a window calendar on the work, because a missed window on an occupied floor slips the tie-in by a week or more, not a day.
Owner-furnished equipment and the activation chain
Imaging suites, sterile processing, pneumatic tube, nurse call, and lab systems are usually owner-furnished and contractor-installed (OFCI), with vendor lead times that run longer than the rooms built to hold them. The schedule carries vendor-confirmed delivery dates, the rigging path, shielding and structural prerequisites, vendor installation and calibration windows, and acceptance testing. Activation runs in parallel with construction close-out so that licensing survey readiness is a planned date instead of a scramble.
Inspections and licensing are the finish line
A hospital is not open when the contractor finishes. Occupancy waits on the AHJ sequence: fire and life-safety inspections, medical gas certification, elevator inspection, the state licensing survey, and, where new services are added, CMS certification and Joint Commission survey readiness. In California, HCAI plan review and inspector-of-record field reviews add their own cycles. Each inspection sits on the critical path with its review duration and the responsible party named, because an inspection that is not in the logic cannot move the forecast until it has already moved the opening.
Phased work in an occupied building
Renovation in a working hospital means swing space moves, temporary partitions and negative-air zones, interim life safety measures (ILSM) while exits and alarms are affected, and elevator and corridor routes that cannot be shared between patients and construction traffic. The schedule sequences departments through swing space, ties each ICRA zone’s barrier setup and sign-off to the start of work in that zone, and gives each partial turnover its own inspection chain. The result is a phasing plan the facilities director can hold the contractor to, not a Gantt chart with notes in the margin.
State Requirements

Eight hospital markets,
eight state review chains

Texas, California, Florida, New York, Illinois, Georgia, Washington, and Louisiana each put a state agency between the drawings and the opening, from New York City and Chicago to Houston, Los Angeles, Miami, Atlanta, Seattle, and New Orleans. The schedule names that agency, its submittal stages, and its inspections as activities with durations and owners, so a review cycle that runs long shows up in the forecast the month it happens, not at the licensing survey.

Texas: HHSC Architectural Review Unit and TDLR
Texas carries more hospital construction than any other state, about a fifth of the national square footage under way in mid-2026 (Revista counted 14.8 million square feet across 41 projects in July 2026). Hospital plans go through the Texas Health and Human Services Commission’s Architectural Review Unit (ARU): an application package, plan review comments or self-certification, architectural inspections during construction, and a final architectural inspection before the Health Facility Licensing Unit issues the license. Accessibility runs on a separate track, Texas Accessibility Standards (TAS) plan review and inspection by a Registered Accessibility Specialist through TDLR, with its own fees and timing. Texas has no certificate-of-need process, so the schedule starts at design rather than at a state approval to build.
California: HCAI (formerly OSHPD), CDPH, and the 2030 seismic deadline
California hospital buildings (OSHPD 1 occupancies) are reviewed, inspected, and signed off by the Department of Health Care Access and Information, HCAI, which took over OSHPD in 2021 and still uses the OSHPD name in its building standards. HCAI’s Facilities Development Division reviews the drawings, approves Amended Construction Documents (ACDs) during construction, and works through an HCAI-certified Inspector of Record (IOR) on site; the California Department of Public Health (CDPH) then licenses the beds. The seismic program adds a calendar of its own: SB 1953 requires general acute care hospitals to meet the 2030 structural and nonstructural standards by January 1, 2030, and AB 869 (2024) lets HCAI grant eligible hospitals up to three more years. On a California job the schedule carries HCAI review cycles, ACD turnaround, IOR hold points, and the seismic deadline as fixed dates, because none of them move for a contractor’s recovery plan.
Florida: AHCA Office of Plans and Construction
The Agency for Health Care Administration’s Office of Plans and Construction reviews hospital projects in three stages under Rule 59A-3.080: Stage I schematic plans, Stage II design development, and Stage III construction documents, the only mandatory stage and the one that lets construction start. The Agency acts within 60 days of a complete Stage III submittal and returns deficiencies in writing, so each resubmittal is a review cycle the schedule has to show. It also makes onsite construction inspections as needed, and new facilities and substantial additions must show compliance with hospital disaster preparedness site standards, which pushes wind-rated envelope, emergency power, and flood elevation decisions onto the critical path early. Florida repealed certificate of need for hospitals in 2019, one reason it has added nearly fifty new hospitals since 2020.
New York: DOH Bureau of Architecture and Engineering Review and Article 28 CON
New York hospitals are Article 28 facilities, and a project of any size runs on two Department of Health tracks at once. The Certificate of Need track sorts projects by cost under the August 2025 rules: limited review up to $30 million, administrative review to $60 million, and full review above that, which needs a Public Health and Health Planning Council recommendation and the Commissioner’s approval. The construction track runs through the Bureau of Architecture and Engineering Review (BAER): schematic and design development submissions, final construction drawings, self-certification allowed below $30 million, approval to proceed once the CON documents are accepted, and a pre-opening survey by the regional office when the work is substantially complete. In New York City, Department of Buildings permits and inspections sit on top of both. The schedule carries the CON decision, each BAER submission, and the pre-opening survey as owner-controlled activities with real durations, because no contractor can accelerate them.
Illinois: IDPH Design Standards Unit and the HFSRB permit
Illinois reviews hospital construction in two steps that cannot be reordered. The Health Facilities and Services Review Board issues the certificate-of-need permit for projects over its thresholds and for any change in licensed beds, and the Illinois Department of Public Health’s Design Standards Unit will not begin plan review until that permit, or the documentation that none is needed, is in hand. The Design Standards submission is substantial: design development and construction drawings, a functional program narrative, a systems program narrative covering fire alarm, electrical, HVAC, medical gas, and fire protection, a code analysis, and, for phased projects, an occupancy schedule with a graphic plan, all under Section 250.2430 of the Hospital Licensing Requirements. On a Chicago project the city’s building permits and inspections run alongside. The schedule shows the HFSRB decision, the IDPH review, and each phase’s occupancy approval as separate activities, so a permit that waits for the next board meeting shows up in the forecast at once.
Washington: DOH Construction Review Services and Certificate of Need
Hospital projects in Washington are reviewed by the Department of Health’s Construction Review Services (CRS), which holds technical assistance conferences at preliminary design, design development, and construction documents and aims to finish plan review within 40 days of a complete submittal. CRS issues its construction authorization as a recommendation to the licensing authority, and it can hold that authorization until the Certificate of Need program approves the project, so for a new hospital, added beds, or a tertiary service the CON decision belongs on the critical path next to design. The local building official still controls occupancy, and electrical and elevator inspections run on calendars of their own, through Labor and Industries in most of the state and through the city in Seattle and Spokane.
Georgia: DCH Plans Review Unit and a reformed Certificate of Need
Georgia’s Department of Community Health reviews hospital construction through the Plans Review Unit in its Office of Health Planning: a preliminary floor-plan review, then final construction documents submitted at least 45 days before construction starts, after which DCH issues a construction permit letter that lapses if work has not begun within six months. Addenda and change orders go back through the same unit, and DCH makes a single final inspection, requested at least 28 days before substantial completion, alongside the State Fire Marshal’s and the local building authority’s inspections. Georgia still has Certificate of Need, administered by the same department; HB 1339, effective July 1, 2024, removed the capital-expenditure and imaging-equipment thresholds for existing hospitals and exempted qualifying new rural hospitals, so more projects now start at design rather than at a CON hearing.
Louisiana: State Fire Marshal plan review and LDH Health Standards
Louisiana splits the work differently. The Office of State Fire Marshal performs the plan review for every facility licensed or certified by the Louisiana Department of Health, under Act 745 of 2012, and LDH’s Health Standards Section licenses the hospital once the Fire Marshal’s review, the Office of Public Health’s reviews, and the local permits are satisfied. There is no certificate of need for general hospitals; Louisiana’s Facility Need Review covers other facility types. What the schedule has to respect instead is the Gulf Coast: flood elevation, wind-rated envelope, and emergency power requirements shape the early critical path, and hurricane season from June through November is a calendar constraint on exterior work in New Orleans and Baton Rouge. The Fire Marshal’s plan review and inspections and the Health Standards licensing survey appear as named activities with durations, the same as in any other state.
Questions GCs and Owners Ask
How does the schedule handle inspections, permits, and access limits in an operating hospital?

Each one becomes logic rather than a note. Permit and submittal reviews are activities with the agency’s review duration and the party responsible. Inspections are predecessors to the cover-up or turnover they gate. Access limits, such as night-only work above occupied floors, no corridor deliveries during shift change, or one elevator for construction, are calendars applied to the activities they restrict. Utility shutdowns are discrete activities with approval lead time. When any of them slips, the next monthly update shows the effect on the occupancy date instead of hiding it.

What is the difference between ICRA and PCRA, and where do they show up in the schedule?

ICRA, the infection control risk assessment, sets the precautions for a work area based on the patients nearby and the type of work, from a walk-off mat at the door to a sealed zone under negative air. PCRA, the pre-construction risk assessment required by Joint Commission environment of care standards, covers the wider hazards: air quality, utilities, noise and vibration, emergency procedures, fire and life safety. In the Primavera P6 model, barrier installation, negative-air setup, and the infection prevention sign-off are activities that precede the first work in each zone, and the ICRA class of one zone constrains when the neighboring zone can start. Treating them as logic is what keeps a barrier from going up the day after demolition.

Which approvals belong on the critical path of a hospital project?

The ones that gate occupancy, and they differ by state. Common to most projects: building and fire marshal inspections, medical gas verification under NFPA 99, elevator inspection, the state licensing survey, and CMS certification or a Joint Commission survey where new services or beds are added. On top of those, the eight markets CPM Pros sees most each add a state review chain: in Texas, the HHSC Architectural Review Unit’s plan review and architectural inspections plus TDLR accessibility inspections; in California, HCAI (formerly OSHPD) plan review, Amended Construction Documents, and inspector-of-record field reviews, then CDPH licensing; in Florida, AHCA’s Stage III approval before construction and its onsite inspections during it; in New York, the DOH Bureau of Architecture and Engineering Review and the Article 28 certificate of need; in Illinois, the HFSRB permit before the IDPH Design Standards Unit will open a plan review; in Washington, DOH Construction Review Services plan review, which can wait on Certificate of Need; in Georgia, DCH’s Plans Review Unit permit letter and its final inspection; in Louisiana, the State Fire Marshal’s plan review ahead of LDH Health Standards licensing. CPM Pros puts each approval in the schedule with the agency, the submittal it depends on, the expected review duration, and the owner or contractor action that starts the clock.

How are owner-furnished medical equipment and activation handled?

As two chains that meet at the licensing survey. Equipment: vendor-confirmed manufacturing and delivery dates, site-readiness predecessors (shielding, structural pads, power and cooling, data), rigging path, vendor installation, calibration, and acceptance testing, each as its own activity. Activation: staff orientation, stocking, equipment training, IT and clinical systems go-live, and day-in-the-life simulations, scheduled in parallel with construction close-out under the owner’s responsibility. The model shows whether a late MRI delivery moves the opening date or only the imaging suite, which is the question the executive team asks first.

Can CPM Pros review the general contractor’s schedule instead of building one?

Yes, and for most owners that is the right engagement. A third-party review of the contractor’s baseline checks logic, calendars, ICRA zone sequence, regulatory milestones, and float before the schedule is accepted. Monthly review of each P6 update tracks logic changes, float consumption, out-of-sequence progress, and drift in inspection and activation milestones, and reports it in a monthly schedule narrative report written for the facilities director and the board. Problems surface while there is still time for a recovery schedule, not after the opening date has moved.

Who prepares the monthly schedule narrative for a hospital general contractor?

CPM Pros does, for GCs who do not carry a scheduler. Send the progress for the period and the pay application dates; the updated Primavera P6 schedule and a written narrative come back within 3 business days, ready to go in with the pay app.

Related Reading
Related Pages

Reach the licensing survey
on the planned date.

Every inspection and activation step is in the logic, so the opening date moves in the update, not at the survey.

Schedule a Conversation info@cpmpros.com
Get in Touch

Let’s talk about
your schedule

Whether you need a baseline developed, a delay analyzed, or an independent schedule review, we’re ready to engage. Scheduling is the only thing on our calendar.

ReachNationwide — fully remote across all U.S. markets
SoftwarePrimavera P6, Microsoft Project, Excel — all delivery formats
ResponseWritten quote typically within 3 business days