Health care systems are in their building era

At some medical centers around Virginia, construction workers donning hard hats are nearly as prevalent this year as medical staff wearing scrubs.

From smaller-scale renovations to new hospitals with billion-dollar price tags, health care systems are undertaking a wide range of projects to respond to growing (and aging) populations and expand services at hospital campuses, among other goals.

Such projects show how health care systems can supplement services or augment physical spaces to adapt to changing patient needs, says Julian Walker, vice president of communications for the Virginia Hospital & Healthcare Association. “They’re reflective of hospital systems that are attentive of, and attuned to, the specific and unique needs of the communities they serve.”

At the forefront of the state’s health care projects are Inova Health System’s two new hospitals in Northern Virginia, projected to cost $2 billion and span more than 1.4 million square feet. The system broke ground in 2024 on its new Alexandria and Springfield hospitals, which are slated to be complete in 2028.

Inova Franconia-Springfield will include 110 beds and offer emergency care, surgery services and other inpatient treatment, but Inova Alexandria is the higher profile project. It’s located at the site of the former Landmark Mall and replaces the old Alexandria Hospital with a 192-bed facility that will include a cancer center and medical office building.

Meanwhile, in Halifax, Sentara Health is building a new acute care hospital with 42 beds that is scheduled to be completed in summer 2026.

Here are some other major projects on the horizon for Virginia’s health systems:

Growing statewide

Last year, VHC Health‘s board approved a strategic capital investment plan of roughly $500 million over the next five years to improve and enhance the Northern Virginia health system, says Christopher T. Lane, VHC’s president and CEO. In addition to projects at the main hospital campus in Arlington, the fast-growing provider is expanding into Fairfax County.

“We’re not growing for the sake of growing; we’re growing to provide great options for our community to receive great care right where they live and where they work,” Lane says.

In Falls Church, a 14,000-square-foot combined freestanding emergency department and urgent care center will open in late 2026, and VHC is negotiating with Arlington County to build a freestanding behavioral health hospital with inpatient rehab.

Construction began in January at VHC’s offices in Alexandria and McLean, as well as the addition of a third floor in Shirlington that started in November 2024.

Meanwhile, at VHC’s main campus, the health system is expanding its emergency department services by about 40%, increasing its comprehensive psychiatric emergency program by 50%, growing the ICU from 28 beds to 45 beds, and renovating its labor and delivery department to accommodate 50% more patients.

Roanoke-based Carilion Clinic conducts community assessments every three years, and transportation and access to care are always top priorities, says Carl Cline, vice president and administrator of Carilion Franklin Memorial Hospital in Rocky Mount.

Carilion has found success renovating and modernizing its 1952 building in Rocky Mount, including a $15 million project completed last year that doubled capacity for operating room services. “That’s where the community knows the hospital is and it’s very important to keep the hospital in the center of town,” Cline says.

A renovation project will begin this spring to create a pediatric clinic in Rocky Mount with three full-time pediatricians and a rotating group of specialists. It’s scheduled to be completed by fall.

Also, in Roanoke, construction is underway for the $100 million Carilion Taubman Cancer Center that will expand oncology services and bring advanced technology, clinical trials and more specialists to the location. The center is expected to open in 2027.

Nashville-based HCA Healthcare has several projects at various stages that will broaden its network in Virginia. The overarching theme is expanding access to care in growing communities, says Shaila Menees, chief development officer in the HCA Healthcare Capital Division in Richmond.

“How do we optimize, ensuring that folks that are already within our network can stay within our network for ease of care and continuity of care, which is critical,” Menees says.

HCA didn’t win approval for a medical center in Ashland, but it’s building an 18,000-square-foot ambulatory surgery center with two operating rooms there. The facility could open by late 2026.

Menees says HCA is exploring additional opportunities to expand in Hanover and Chesterfield, too.

Meanwhile, the health system plans to build more freestanding emergency departments, which typically have about 12 beds each. Construction will likely begin this year for two locations in the Richmond area and one in Leesburg, with all three opening sometime in 2026. HCA is also in the early stages of finalizing plans for freestanding emergency rooms in the Stafford and Chantilly areas.

In Central Virginia and Hampton Roads, Bon Secours Mercy Health has two major projects underway to bring more medical care to patients in fast-growing areas of Virginia.

The Bon Secours Health Center at Harbour View in Suffolk will expand to serve about 75,000 patients annually, which is important since the city’s population has doubled since 1990, says Andy Spicknall, the center’s president.

The three-story, 100,000-square-foot addition is scheduled to open in May with 18 private inpatient rooms and four operating rooms. The hospital is designed to support additional beds in the future.

“What has driven us to open this facility is the need to provide closer hospital care to this growing population,” Spicknall says.

Bon Secours also won approval for a freestanding 10-bed emergency department in Ashland that could relieve the “super busy” ER at Memorial Regional Medical Center in Mechanicsville, adds John Emery, president of that center and Bon Secours Rappahannock General Hospital.

Construction is underway, and the facility is set to open by January 2026.

The new emergency department, which will have outpatient imaging services, could save 10 to 15 minutes when EMS transports patients from nearby Caroline County. “That’s really a huge, huge thing,” Emery says.

Reducing the time it takes patients to access care during a medical emergency is likewise a goal for Riverside Health’s new hospital under construction in Isle of Wight County. Designated as a medically underserved area, the closest medical care for many residents is currently 30-plus minutes away, says Jessica Macalino, president of Riverside Smithfield Hospital.

While construction began in 2023, the idea dates back to 2008 when Riverside Health bought land in Smithfield. The need only increased with postpandemic population growth in Isle of Wight, and Macalino says tremendous community support helped make the new hospital possible. “We are very proud to be the provider expanding health care in this area that’s much needed.”

The three-story, 200,000-square-foot hospital will feature an emergency department, diagnostic imaging services, and 50 inpatient beds. It’s scheduled to open in early 2026.

On the same campus, construction is underway on a 20,000-square-foot medical office building with 40 exam rooms and physical therapy services. That is set to open around September.

In addition to projects in Charlottesville, UVA Health is undertaking a wide range of projects intended to better serve a “pretty broad swath” of Central Virginia and the Shenandoah Valley, says Eric Swensen, public information officer. Such plans will bring specialty care services to places like Culpeper, Warrenton, Manassas, Gainesville, Waynesboro and Staunton.

“We’re just seeing a demand for care that continues to grow, and we’re expanding to meet that need,” Swensen says.

An expansion to the UVA University Hospital’s south tower will add about 100 new beds, with dedicated floors for cancer care and NICU. It’s scheduled to be completed by 2028. Also in Charlottesville, the health system is building a 40,000-square-foot pharmacy center to streamline services and offer home delivery. It’s slated for 2026.