Seven million dollars of neuroscience ICU renovation at 301 W. Expressway 83 ran from October 2024 to August 2025, according to the state's project record. Intensive care work like that is done around people who cannot leave, and it is the sort of project where a construction manager at risk earns its fee: the owner needs a builder in the room during design, who prices as drawings develop, commits to a guaranteed maximum price and takes responsibility for getting the work done around people who cannot leave.
Under this method the owner hires the architect separately and brings us on during design. We provide cost modeling, constructability reviews, scheduling, phasing and early procurement. When the design is far enough along, we propose a guaranteed maximum price, backed by subcontractor bids. After that, we take the risk of delivering the project for that number, and savings are shared according to the contract. It suits owners who want design control and cost certainty at the same time.
Below we cover how we work in this role, why it fits healthcare, public and complex commercial work, how phasing and safety are planned and what the fee covers. A related delivery method is design build.
The medical district in McAllen includes projects of every scale. A cath lab renovation at 101 E. Ridge Rd. covered 805 square feet at $500,000 and ran from March to September 2025. A VA MRI addition and renovation at 901 E. Hackberry Avenue combines an 1,839 square foot addition and a 1,500 square foot renovation at $2.4 million, with construction running from September 2025 to November 2026. Small areas and large budgets per foot are normal in that environment.
Civic owners also face complexity. The city has been considering a $160 million airport expansion that would add terminal space and parking, with work possibly starting in 2027 after a study found the terminal getting tight on space, according to a 2024 news report. A project of that kind has public funding, public scrutiny and an operating facility, which is when CM at risk makes sense. See our medical district page for local experience.
An occupied facility sets the rules. Infection control barriers, negative air, dust monitoring, vibration limits and noise windows are written into the plan, usually in consultation with the owner's safety team. Utility shutdowns are scheduled in short windows with backup plans, and routes for materials and debris are planned so they do not cross patient or passenger paths.
We prepare a phasing plan before pricing, because the plan sets the cost. A project that can be done in one go in an empty building is cheaper than one that must be built in five pieces. Because we sit with the owner during design, we can suggest phasing options that reduce disruption, such as building a new wing first and moving staff before renovating the old one. That is where this method has its greatest effect. Our occupied-site phasing experience applies directly.
For healthcare projects, we follow infection control risk assessment procedures, and the owner's infection prevention staff approve the barriers and monitoring. Every crew on site is briefed on the requirements and held accountable. For airports, security badging, escorted deliveries and restricted areas are part of the plan.
Accessibility compliance is also part of safety. Projects costing $50,000 or more must be registered with the Texas Department of Licensing and Regulation, and every renovation of that size is on the state's project record. We build the review into the schedule. Owners in healthcare and public agencies often include these steps in their requirements, and we are used to following them.
One advantage of CM at risk is the ability to release work in packages. Demolition, site work, steel and long-lead equipment can be bought before the whole design is complete. On a hospital project that might include medical gas, air handling units or switchgear. The result is a shorter overall schedule and early certainty on the largest buy-outs.
We maintain a master schedule with owner and architect input and update it every week. Float is shown, not hidden, and the owner sees the effect of each decision. Where a date is fixed, such as a license inspection or a funding deadline, we build backward from it. Related scheduling methods are discussed under commissioning and closeout.
Our contract is transparent. The owner sees subcontractor bids, our fee and general conditions, and the contingency. We build the guaranteed maximum price from bids whenever possible, not from allowances. If a trade comes in under budget, the owner and the construction manager share the saving as agreed. If bids exceed budget, we work with the architect on value engineering before the owner commits.
We also run subcontractor selection openly. We prequalify bidders, invite local firms and explain scope, and we level bids so that the owner compares like with like. This process takes time, but it protects the project and the owner's money.
The construction manager's fee covers preconstruction services, supervision, scheduling and risk. General conditions cover site staff and temporary facilities. The cost of work includes trade contractors and materials. We show all three separately. The contingency is for unforeseen conditions and is controlled by the owner, who also receives any unused balance under most contracts.
The cost driver that surprises owners most is renovation uncertainty. Hidden conditions in older buildings can change quantities and sequence. Our approach is to investigate early with probes, as-built review and owner input, and to carry a reasonable contingency. That makes the guaranteed number more reliable.
Tell us the facility, the budget and the constraints. We will outline the preconstruction plan, a phasing approach and a price range.
With CM at risk, the owner contracts with the architect and the builder separately, while in design-build one team holds both. CM at risk gives the owner more direct control over design, and design-build gives a single point of responsibility. We offer both and help you choose.
Once the design is developed enough that we can price with real bids, typically at the end of design development or at early construction documents. Before that, we provide estimates.
Under most contracts, the owner keeps the savings or shares them with us by agreement. The terms are set at the beginning so there is no dispute.
Yes. Infection control, shutdown planning and phasing are the core of that work. We prepare the plan with your staff before pricing.
If the law and your procurement rules allow it. Public entities often use it for complex facilities. We follow your process and provide the documentation you need.