HOW TO START AN OBL IN TEXAS
Twelve questions physicians ask before they build, answered.
PROJECT PHASES & BUDGETING
01 INITIAL BUDGET ESTIMATION
Antero Medical Construction provides detailed cost breakdowns for specialized medical suites. Our Texas-based project estimates typically range from $75 to $90 per square foot for specialized medical fit-outs, ensuring competitive pricing compared to the industry average of $125.
02 SPACE REQUIREMENTS & SELECTION
We assist in identifying the ideal square footage for your clinical needs. Our designs optimize 600–700 square foot procedure rooms to ensure peak efficiency for equipment and staff safety, maximizing your medical facility's ROI through smart space planning.
03 FACILITY TYPE SPECIALIZATION
Whether you require an Office-Based Lab (OBL) or an Ambulatory Surgery Center (ASC), we engineer the infrastructure to meet specific regulatory standards. We handle the greater complexity of ASC buildouts, including comprehensive recovery bays and advanced surgical suites.
04 CONSTRUCTION TIMELINE MANAGEMENT
Accelerate your clinical opening with our efficient project management. A typical OBL fit-out is completed within 3-12 months, while more complex ASC projects are delivered within 6-18 months, managed from permitting to final inspection.
REQUIREMENTS & ENGINEERING
05 What are the Texas requirements?
For an OBL: register every fluoroscopy or CT unit with Texas DSHS Radiation Control (25 TAC 289.226 / 289.227) with a shielding plan from a licensed medical physicist; if you use moderate or deeper sedation, register with the Texas Medical Board for office-based anesthesia (22 TAC Chapter 192); a CLIA certificate for any in-house lab work; TDLR Texas Accessibility Standards review and inspection for any project over $50,000; local building, MEP and fire permits. Accreditation (AAAHC, The Joint Commission or IAC) is optional, but most payers want it. For an ASC: all of the above plus HHSC licensure (26 TAC Chapter 509), a Life Safety Code survey, and CMS certification.
06 What equipment changes the building design?
The imaging system. A fixed angiography system weighs 3,000-5,000 pounds and either hangs from a ceiling structure or sits on a floor plate with a recessed pit, so the slab and roof structure get engineered around it. The vendor site-planning drawings set the room size, ceiling height, cable trenches, chilled water or air cooling, and transformer location - order that drawing set before design starts. CT adds more shielding and floor load. MRI adds RF shielding, a magnet quench vent and a five-gauss line. Sterilizers and anesthesia change plumbing, exhaust and medical gas.
07 Do I need lead-lined walls?
Yes, for any fluoroscopy or CT room. A Texas-licensed medical physicist calculates the shielding from your equipment, your workload and the rooms around you. Typical results are 1/16 inch (1.6 mm) of lead in the procedure room walls, a lead-lined door and a leaded control window, and sometimes shielding in the floor or ceiling when there is occupied space above or below. The report is part of the DSHS registration, so it has to exist before framing starts, not after.
08 What electrical requirements does a cath lab have?
A fixed angio system needs its own dedicated feed, usually 480V three-phase through a 100-150 kVA transformer sized to the vendor spec, with a separate equipment room for the generator cabinets and a dedicated cooling load. Add a UPS for the imaging computers and often for the system itself, and run a full electrical load study of the building service before you sign - many second-generation medical suites do not have the capacity. ASC operating rooms go further: an NFPA 99 essential electrical system with a generator, and isolated power where required.
PERMITS, CONVERSION & PLANNING
09. WHAT PERMITS ARE REQUIRED?
City of Houston building permit with structural, mechanical, electrical and plumbing plan review; fire marshal review; Harris County or the applicable city if you are outside Houston limits; TDLR accessibility registration and inspection; DSHS radiation registration; health department review for any in-house pharmacy or lab; sign permits; and the landlord own approval of the plans. For an ASC, HHSC reviews the plans against the licensing rules before construction.
10. CAN AN EXISTING MEDICAL OFFICE BE CONVERTED?
Often yes, and it is usually the cheapest path if four things check out: the slab and structure can carry the imaging system, there is 10 feet or more of clear height for a ceiling-mounted system, the electrical service can be upgraded to the vendor spec, and the HVAC can be rezoned for the procedure and recovery areas. Second-generation medical space also saves on plumbing and finishes. The pre-lease review is exactly this check.
11. HOW DO I CHOOSE AN ARCHITECT?
Pick one who has drawn an OBL or an ASC in Texas in the last three years and who will coordinate directly with the equipment vendor site planner and the physicist. Ask for three completed healthcare projects and the names of the engineers they used. A general commercial architect learning the FGI Guidelines on your job costs you months in resubmittals. Antero works with a short list of healthcare architects and can bring one in at the pre-lease stage.
12. CAN I EVENTUALLY CONVERT MY OBL INTO AN ASC?
Sometimes, but only if you plan for it on day one. The ASC has to be a separately licensed space with its own entrance, 8-foot corridors, fire-rated separations, sprinklers, generator, medical gas and sterile processing, and HHSC has to approve the plans. Most OBLs that convert actually build the ASC next door and keep the OBL running. If an ASC is the goal, lease the extra square footage now, set the structure and corridor widths to ASC standards, and leave a generator pad and gas manifold location in the design. It costs a little more up front and saves a second construction project later.