Harris Health John M. O'Quinn Hospital: What the $2 Billion Build Costs and Where It Stands
The new hospital on Harris Health's Lyndon B. Johnson Hospital campus in northeast Houston broke ground in May 2024 as a $1.6 billion, 390-bed project. Two and a half years later, Harris Health's own project FAQ describes something different: an estimated completion cost of approximately $2 billion for the hospital and associated campus projects, 330 private patient rooms on opening day, and unfinished space for 120 more, for a maximum of 450 beds. Many news stories and older project summaries still carry the $1.6 billion and 390-bed figures. They are out of date.
This page walks through what changed, what the money buys, who is building it, and where the schedule stands as of Harris Health's September 2026 construction update.
The cost: from $1.6 billion to about $2 billion
At the May 9, 2024 groundbreaking, Harris Health's press release called it "a new $1.6 billion hospital," roughly 1.3 million square feet with 390 private rooms and space to add 60 more. HFM Magazine reported the same figures in August 2024.
The FAQ now answers the cost question directly. Asked whether the cost changed, Harris Health says yes: the estimated completion cost "for the new Level I trauma-capable hospital and associated campus projects is now approximately $2 billion," up from the initial $1.6 billion. It gives two reasons:
- Inflation in construction materials and supplies, plus competition for labor and subcontractors caused by higher construction volume in Texas.
- Changes in scope and cost to the new campus patient parking garage and the power plant.
The FAQ also spells out what the $2 billion covers: all construction costs, plus all equipment, technology and furnishings needed to operate the hospital, an expanded garage with 1,200 parking spaces, 3,000 square feet of office space and 10,000 square feet of retail, and a stand-alone central utility plant of 89,000 square feet that houses primary and emergency power, steam and chilled water.
That scope note matters for anyone benchmarking. The $2 billion is an all-in owner figure, not a building contract amount. Divide it out and you get:
| Measure | Calculation | Result |
|---|---|---|
| Per opening-day bed | $2.0B / 330 beds | about $6.1 million |
| Per bed at full build-out | $2.0B / 450 beds | about $4.4 million |
| Per square foot of hospital | $2.0B / 1.3M SF | about $1,540 |
Those numbers include equipment, furnishings, the garage and the central plant, so they will look high next to any building-only benchmark. For comparison, Gordian's RSMeans model for a three-story hospital averaged $482 per square foot nationally in Q2 2026 (via Building Design+Construction, May 2026), and Revista put the median completed hospital at nearly $2 million per bed in 2025. Our hospital construction cost per bed guide explains why a large trauma-capable hospital with a central plant and garage lands far above those medians, and why the per-bed figure says more about scope than about efficiency. Harris Health itself says that on a cost-per-square-foot construction comparison, the project sits in a competitive range with similar Texas projects.
The bond and the bigger plan
Harris County voters approved a $2.5 billion bond package in November 2023, according to HFM Magazine and Harris Health's January 2026 release. The bond is not the same thing as the hospital budget. It also funds new community health centers, outpatient renovations and work at Ben Taub Hospital.
The size of the overall facilities plan has been reported differently over time. The 2024 groundbreaking release described a $2.9 billion strategic facilities plan; Harris Health's January 23, 2026 topping-out release and the current FAQ both call it a $3.2 billion strategic facilities plan. HFM reported in 2024 that Harris Health aimed to raise $300 million in philanthropy to help close the gap between the bond and the plan.
The largest gift so far came at the January 2026 topping-out: The John M. O'Quinn Foundation committed $40 million to the Harris Health Strategic Fund's capital campaign, and the hospital was named the Harris Health John M. O'Quinn Hospital in recognition.
The FAQ says the hospital's higher cost does not cancel other bond projects. Bond funds remain for new health centers and outpatient renovations, and plans for a new patient bed tower at Ben Taub continue, though Harris Health says scope and final cost of each are still subject to change. For contractors, that means there is more public healthcare work coming out of this program, procured publicly by a county hospital system. Our guide on how to win public works construction contracts covers how that kind of solicitation usually works.
Why the bed count dropped to 330
The FAQ addresses the room count head-on. When voters approved the bond in 2023, the plan was to open with 390 private patient rooms. After a review of community needs and Harris Health's finances, leadership decided the hospital can operate with 330 beds on opening day. The building is still designed for a maximum of 450, with space for 120 beds left unfinished until demand and funding justify finishing it. Harris Health says a final decision on the exact room count is expected by 2027.
Of the 330 rooms, the FAQ says 180 are designed for surge capacity, meaning they can be used as double rooms during community emergencies, and one floor of surge rooms will have negative-pressure capability.
A note on the public record: Harris Health's project status page still describes the job in its original terms, a 1.2 million square foot, 390-bed hospital with two top floors shelled for expansion to 450. The FAQ (1.3 million square feet, 330 opening-day beds) is the more recent and more detailed statement, and the 1.3 million figure matches the groundbreaking release and the electrical subcontract announcement. If you are benchmarking against this job, use the FAQ numbers and say so.
The hospital will open with LBJ's current Level III trauma designation and work toward Level I verification by the American College of Surgeons and the Texas Health and Human Services Commission. The FAQ says that process usually takes several years and the application could begin as early as 2033. So "Level I trauma-capable" is the accurate description for now, not "Level I trauma center."
Who is building it
HKS is the architect; HFM Magazine credits the design to HKS Architects, and Harris Health's project partners page lists HKS, McCarthy and JLL among the project team. McCarthy Building Companies awarded the electrical subcontract described below, and McCarthy's project executive is named on Harris Health's project status page.
Harris Health's FAQ says there are four major contracts on the hospital project: a design contract and three prime construction contracts. The design team had a 30% minority- and women-owned business goal and has met it. Each construction prime had a 35% MWBE goal; two have reached it, and the third is on pace with its original dollar goal of roughly $350 million in MWBE awards.
The largest trade package with a public number attached is electrical. On October 3, 2024, Tutor Perini announced that its subsidiary Fisk Electric had been awarded the first phase, about $29 million, of an electrical contract with McCarthy Building Companies currently valued at about $147 million on a guaranteed maximum price basis. Fisk's scope covers core and shell and tenant finish-out electrical and fire alarm for the hospital tower and podium. The release said work would start in the fourth quarter of 2024, with substantial completion of the full electrical contract expected in the fourth quarter of 2028.
How Harris Health is controlling cost
The FAQ lists several measures that will look familiar to anyone who has worked large healthcare:
- Concrete structure. Concrete was chosen over steel for affordability and to offset inflation. (The January 2026 topping-out still featured the traditional final steel beam.)
- Early buying. About $750 million in supplies and materials had been purchased at the time of the FAQ, which Harris Health says saved about $28 million. Generators and electrical gear were bought early to lock pricing and protect the schedule.
- Prefabrication. Exterior walls, patient bathrooms, patient room headwalls and components of the mechanical, electrical, plumbing and technology systems are prefabricated.
- Utility coordination. Coordinating underground electrical work with CenterPoint Energy as part of the foundation work saved $21 million, per the FAQ.
The building also carries features that add first cost: it is designed to LEED Silver, with two cogeneration systems and power generation in the central utility plant, and it sits on an elevated concrete slab five feet above the existing hospital's elevation, based on FEMA 500-year flood standards, with detention ponds on the campus.
Where the job stands: September 2026 update
Harris Health's September 2026 LBJ campus update said construction remains on schedule with 24 months of construction remaining. Highlights from that report:
- More than 3.5 million man-hours completed across all contractors.
- Hospital tower interiors progressing on Levels 1 through 12, including walls, MEP, headwalls and flooring, with conditioned air activated on Levels 1 through 6.
- The last tower crane removed.
- Elevator installation advancing toward temporary use in the fourth quarter of 2026.
- The structural tie-in of the bridge to the existing hospital complete, with floors placed and glazing nearing completion.
- Curtain wall installed up to Level 12, with roofing underway.
- Central utility plant piping, roof work and domestic water tank testing progressing; the visitor garage in waterproofing, glazing and HVAC rough-in.
The existing LBJ Hospital stays in operation, and the new tower connects to it by the overhead bridge. Tying a new structure into an occupied hospital whose emergency department cannot lose access, power or medical gas is one of the harder coordination problems on a job like this, which is why the bridge tie-in shows up as its own line in the monthly report.
The road to January 2029
The milestone table on Harris Health's status page (September 2026):
| Milestone | Target |
|---|---|
| Building substantial dry-in | October 2027 |
| Final inspection start | June 2028 |
| Certificate of Occupancy | July 2028 |
| Substantial completion (contractual) | September 2028 |
| First patient | January 15, 2029 |
| Visitor garage | Construction use 2027, public use Q1 2029 |
The six-month gap between Certificate of Occupancy and first patient is normal for acute care. Occupancy is when medical equipment installation, clinical activation, staff training and licensing surveys can begin in earnest. Harris Health says staffing for the expanded campus will start in 2028, and it hopes to hold the grand opening near Martin Luther King Jr. Day, January 15, 2029.
If the dates hold, the hospital opens about 56 months after the May 2024 groundbreaking. For the federal side of large hospital delivery and what happens when scope is not locked down early, see our coverage of VA hospital construction delays.
Questions readers ask
How much does the John M. O'Quinn Hospital cost?
Harris Health's FAQ puts the estimated completion cost at approximately $2 billion for the hospital and associated campus projects, up from $1.6 billion at the May 2024 groundbreaking. The figure includes construction, equipment, technology and furnishings, an expanded 1,200-space garage, and an 89,000 square foot central utility plant.
Why did the cost go up?
Harris Health cites inflation in materials and supplies, competition for labor and subcontractors as Texas construction volume rose, and changes in the scope and cost of the patient garage and power plant.
How many beds will it have?
330 private patient rooms on opening day, with unfinished space for 120 more, for a designed maximum of 450. The original 2023 plan called for 390 at opening. Harris Health expects to make a final decision on the room count by 2027.
Who is building it?
HKS is the architect and McCarthy Building Companies is on the construction team; Harris Health says the project has three prime construction contracts. Fisk Electric holds an electrical contract with McCarthy valued at about $147 million.
When does it open?
Certificate of Occupancy is targeted for July 2028, contractual substantial completion for September 2028, and first patient for January 15, 2029.
Is it a Level I trauma center?
It is being built to Level I trauma standards. It will open with LBJ's Level III designation and pursue Level I verification, which Harris Health says could begin as early as 2033.
Does the existing LBJ Hospital stay open during construction?
Yes. It remains in operation, and the new hospital connects to it by an overhead bridge whose structural tie-in was complete as of September 2026.
