Does Your Florida Project Need AHCA Plan Review? Three Questions That Decide

Wilson & Company August 5, 2026 Medical

The reviewer is set by what happens inside the room, not by the sign on the door — and confirming it in writing is free.

A Florida medical practice signs a lease, hires an architect, and gets drawings well underway before anyone asks the question that should have come first: who reviews this project? For most offices the answer is the county building department. For some it is the Agency for Health Care Administration, on a statutory clock the county cannot influence. For others it is the Department of Health, under a rule that has nothing to do with construction permitting at all. AHCA plan review is not triggered by the word “medical” on the door. It is triggered by specific procedures, specific services, and specific license types. Three questions settle which path a project is on, and the last one costs nothing.

What triggers AHCA plan review — and what changes if it does

Under Florida Statute 395.0163, AHCA plan review reaches outpatient facilities that provide surgical treatment requiring general anesthesia or IV conscious sedation, that provide cardiac catheterization services, or that are to be licensed as ambulatory surgical centers — along with hospitals, nursing homes, and the other AHCA-licensed facility types. Where AHCA has jurisdiction, the consequence is structural rather than procedural. Florida Administrative Code 59A-3.080 states that no construction work, including demolition, may start until the Office of Plans and Construction gives written approval. The rule reaches “any and all additions, modifications, renovations, or refurbishment of the site, building, equipment or systems” of an existing facility — so an equipment swap inside a licensed facility can require approval before a single fastener comes out. AHCA review is only one part of the regulatory picture. Other healthcare construction regulations can affect accessibility, life safety, patient safety, and how a medical space is designed, permitted, and inspected. The clock is set by statute rather than by workload. The agency has 60 days to approve or disapprove after it receives the fee, extendable once by 15 days at the director’s discretion, and if it fails to act the plans are deemed approved. The fee is $2,000 initial and non-refundable, plus an amount not to exceed 1 percent of estimated construction cost or the actual cost of review, whichever is less. One clause deserves a calendar reminder. Construction must commence within 12 months of approval or the approval is deemed abandoned. Owners who secure approval and then pause for financing have lost it that way.

The second state agency that reviews medical offices

A project can fall outside AHCA’s reach and still answer to Tallahassee, from a different agency and for an unrelated reason. Florida Administrative Code 64B8-9.0091 requires an office where a physician performs Level II or Level III office surgery — or liposuction removing more than 1,000 cubic centimeters of supernatant fat — to register with the Florida Department of Health. The Department must inspect the location before the registration is approved, and the office submits to an annual inspection after that unless it holds accreditation from AAAASF, AAAHC, JCAHO, or another Board-approved organization. The practical shape of it: a buildout that adds procedural capability to an ordinary medical office can move that office out of local-permit-only territory and into a state registration-and-inspection regime, administered by DOH rather than AHCA. Two agencies, two unrelated triggers, and no one sends a notice when a project crosses either line.

Two weeks and no fee buys a written answer

The third question is the cheapest in healthcare construction, and it is the one owners skip. AHCA’s Office of Plans and Construction runs a no-fee cursory review — a desk review that determines whether a project requires formal agency submission. It takes a completed Cursory Review Application and a detailed description of the proposed construction, sent to the office’s desk review address, with sketches, plans, or photographs where they help. AHCA’s published process states that a response letter should arrive within two weeks. That letter says one of three things: formal review is required, the project may proceed without it, or the agency needs more documentation. Any of the three beats an assumption, because all three arrive in writing. Weigh it against the alternative. A project that guesses wrong finds out at the worst possible moment — after demolition, against a rule stating that the demolition itself required approval first. The recovery is a 60-day statutory review of drawings never prepared for agency scrutiny, running while the space sits idle and the lease runs. Centerwell - Greer SC

Close the gate deliberately

None of this is difficult. It is an application and two weeks of patience, spent before the design contract is signed rather than after the drawings are done. The gate closes quietly, which is why it gets missed. No one announces that the regulatory path is now locked. There is only the point where changing it means redrawing, resubmitting, and waiting out a clock that belongs to the state. So ask it early, and ask it in writing: has anyone confirmed which agencies review this project, or are we assuming? If the answer is uncertain, get the determination before it costs a quarter — and if you want help preparing the submission, talk to a contractor who has been through the review.

Frequently Asked Questions

Does a dental office need AHCA approval in Florida?

AHCA plan review turns on the procedures performed, not the practice type. A dental office providing surgical treatment requiring general anesthesia or IV conscious sedation falls within the statutory trigger in s. 395.0163. Because the line is drawn by procedure, confirm it through AHCA’s free cursory review rather than by assumption.

How long does AHCA plan review take?

By statute the agency has 60 days to approve or disapprove after receiving the fee, with one 15-day extension available at the director’s discretion. If AHCA fails to act within that period the plans are deemed approved. The separate no-fee cursory review returns a response letter in about two weeks.

Can a private plans reviewer speed up AHCA review?

No. Florida’s private provider option under s. 553.791 puts the local building official on a fixed clock, but it has no effect on AHCA’s statutory review period, which runs on its own authority. A licensed-facility project faces the state timeline no matter how fast the county moves. Continue Reading

Top view on the construction site of residential buildings during the construction process with two workers standing with drawings

Healthcare Construction Regulations Every Medical Practice Should Know

Wilson & Company July 1, 2026 Medical

Healthcare construction comes with a different level of oversight than a typical commercial build-out. A small medical office, dental practice, outpatient clinic, behavioral health facility, and surgery center won’t all have the same requirements, but they do have one thing in common: the building has to support patient care. That changes how the project is planned, permitted, built, inspected, and turned over. Accessibility, life safety, infection control, building systems, and construction phasing all matter more when patients and staff will be using the space for care. For medical practice owners, the goal isn’t to memorize every code or regulation. The goal is to know where healthcare construction regulations can affect the project before they become delays, redesigns, inspection issues, or field problems.

Healthcare Construction Has More Layers Than Standard Commercial Work

Most commercial construction projects are focused on creating a safe, functional space that meets local code. Healthcare construction has that same responsibility, but there’s another layer added. The space has to work for patients, staff, equipment, cleanliness, accessibility, and daily operations. That means an exam room can look large enough on a floor plan and still create problems in the field. There may not be enough clearance for staff to move around the patient, the door swing may interfere with the room layout, or the equipment may need power, plumbing, data, or backing that wasn’t coordinated. Those are the kinds of details that make medical facility construction different. The work isn’t just about getting walls built and finishes installed. It’s about making sure the space functions the way the practice needs it to function once patients are inside.

1. Life Safety Requirements

Healthcare facilities still have to meet building codes, fire codes, accessibility standards, and local permitting rules. The difference is that life safety often receives closer attention because patients may have limited mobility, staff may need to assist during an emergency, and certain rooms may include specialized systems or equipment. Depending on the facility type and scope of work, life safety planning may involve:

Exit access and egress routes
Fire-rated walls, doors, and ceilings
Fire alarm and sprinkler systems
Emergency lighting
Smoke separation
Firestopping around wall and ceiling penetrations
Access for inspections and maintenance

A small construction detail can create a bigger issue if it affects one of these systems. Running new plumbing or electrical lines through a rated wall, for example, means that penetration has to be sealed correctly. If it isn’t, it can hold up inspections and create rework.

2. ADA Accessibility

ADA compliance matters in every commercial building, but it’s especially important in healthcare spaces. Patients may be using wheelchairs, walkers, crutches, mobility scooters, or assistance from a caregiver, so the building needs to account for that from the parking lot to the exam room. Accessibility can affect parking, entrances, reception areas, waiting rooms, restrooms, hallways, exam rooms, door clearances, turning space, patient transfer areas, and routes to treatment or diagnostic rooms. These details are much easier to address during design than after construction starts. If an exam room layout doesn’t leave enough clearance, or a restroom isn’t planned correctly, fixing it later can mean moving walls, doors, plumbing, or millwork. That adds cost, time, and inspection risk. disabled person in a wheelchair walking past a disabled parking sign

disabled person in a wheelchair walking past a disabled parking sign

3. Infection Control

Construction creates dust, debris, noise, vibration, and airflow changes. In a regular office build-out, that may be inconvenient. In an active healthcare facility, it can affect patients, staff, supplies, treatment rooms, and clean areas. That’s why infection control planning is a major part of healthcare construction, especially during renovations. The project team may need to separate construction activity from clinical operations, control dust, manage airflow, and coordinate access so patients and staff aren’t walking through or around active work zones. That planning may include:

Temporary construction barriers
Dust containment
Controlled access points
Air filtration or negative air when needed
Separate clean paths and construction paths
Daily cleanup
Material staging away from patient areas
Communication with staff before disruptive work happens

The goal isn’t to pretend construction won’t be disruptive. It will be. The job is to manage that disruption with phasing, containment, scheduling, and communication.

4. Medical Infrastructure

A healthcare space usually needs more infrastructure than a typical office. The exact requirements depend on the type of facility, but medical construction may involve systems that affect walls, ceilings, floors, inspections, and the sequence of work. Common infrastructure considerations include:

Specialized HVAC
Additional electrical capacity
Backup power
Plumbing for clinical areas
Medical gas systems where applicable
Vacuum systems
Data and low-voltage systems
Imaging equipment requirements
Sterilization areas
Specialty equipment clearances

Dental office construction is a good example. A dental practice may need plumbing, compressed air, vacuum lines, imaging equipment, sterilization flow, and equipment-specific electrical connections. If those items aren’t coordinated before work begins, the team may discover conflicts after walls are framed or concrete has already been cut. That’s when changes get more expensive. Medical systems need to be planned while the project is still flexible, not figured out after the space is already taking shape.

5. Medical Building Codes

One of the first questions on a healthcare project is what the space will actually be used for. A general exam-based medical office is not reviewed the same way as a surgery center, procedure space, behavioral health facility, or hospital-related build-out. That distinction matters because the type of care being provided can affect plan review, permitting, inspections, room layouts, life safety systems, mechanical and electrical systems, equipment coordination, and opening approvals. A project can look straightforward from a construction standpoint and still have healthcare-specific requirements that affect the schedule. That’s why the intended use of the space needs to be clear before design and construction decisions get too far along.

Renovations Have to Work Around Active Operations

Many healthcare construction projects happen inside existing facilities. If a clinic, medical office, or dental practice is staying open during construction, the project has to be planned around patients, staff, appointments, deliveries, exits, utilities, and daily operations. That can involve:

Phased construction
Temporary partitions
After-hours work
Planned utility shutdowns
Alternate patient or staff routes
Noise and vibration control
Protection of existing life safety systems
Regular communication with the practice team

This is where construction planning becomes operational planning. If concrete needs to be cut, that creates noise and vibration for adjacent spaces. If ceilings need to be opened, that can affect dust control, above-ceiling inspections, and existing systems that still need to remain active. A good healthcare renovation plan doesn’t promise that nobody will notice the work. That’s not realistic. Instead, it explains what will happen, what could be disruptive, and how those disruptions will be managed.

Early Contractor Involvement Helps Catch Problems Sooner

Healthcare-specific requirements are manageable, but they need to be understood before the project is already locked in. An experienced healthcare contractor can look at a project with the field work in mind: how materials will get in, which areas need to stay open, where temporary barriers may go, what systems need to remain active, and which inspections could affect the schedule. That practical review can help identify issues related to existing building conditions, utility capacity, equipment requirements, infection control, life safety systems, accessibility, construction phasing, permit sequencing, and inspection timing. This doesn’t replace the architect, engineer, or code consultant. It adds a construction perspective to the planning process. When that input comes while the project is still being shaped, the team has more options. When it comes after drawings are finished or construction has started, the same issues may still be solvable, but they’re usually harder, slower, and more expensive to fix. Two building contractors discussing project while standing at construction site, copy space

Two building contractors discussing project while standing at construction site, copy space

Address the Requirements Before They Become Field Problems

Healthcare construction regulations are much easier to manage before the project is already in the field. Once drawings are finalized, permits are submitted, or walls are being opened, the same issues can still be solved, but there are usually fewer options and more disruption. If you’re planning a medical office, clinic, dental practice, or other healthcare facility in Central Florida, Wilson & Co. can help review the space, scope, phasing needs, infrastructure, and inspection requirements before construction begins. That early construction perspective can catch problems before they turn into schedule delays, change orders, or operational issues after opening. Continue Reading

Shot of medical practitioners having a conversation in a hospital.

Key Design Considerations for Modern Healthcare Facilities

Wilson & Company July 1, 2026 Medical

A healthcare facility has to do more than provide space for patient care. It needs to support staff workflows, accommodate equipment and technology, meet regulatory requirements, and adapt as the organization grows. Many of the decisions that shape a facility’s long-term performance are made long before construction begins. Room layouts, patient flow, infrastructure, and operational needs all influence how effectively the space functions once it’s occupied. The most successful healthcare facilities aren’t defined by how they look on opening day. They’re defined by how well they support patients, providers, and staff every day afterward.

How Does The Space Need to Work?

Many healthcare projects begin with discussions about room counts, floor plans, and square footage. Those conversations are most effective when they’re guided by a clear understanding of how the facility needs to operate. Patient volume, provider schedules, staffing levels, equipment requirements, support spaces, and future growth plans all influence how a healthcare facility should be organized. A clinic seeing a high volume of patients may prioritize circulation and efficiency, while a specialty practice may require larger treatment rooms, additional privacy, or dedicated equipment areas. A layout can look efficient on paper and still create operational challenges once the facility is occupied. Storage may be too far from treatment areas. Exam rooms may be undersized for equipment. Staff may need to travel farther than expected throughout the day. These issues are much easier to address during planning than after construction begins.

Patient Experience Starts Before Care Begins

Patient experience begins long before a provider enters the room. The process starts when patients arrive at the property, find parking, enter the building, check in, move through the facility, and eventually leave. If that journey creates confusion, congestion, or unnecessary travel through the building, it affects both patient satisfaction and operational efficiency. A patient may move from reception to a waiting area, then to an exam room, diagnostic space, treatment area, and checkout. When those spaces aren’t organized logically, bottlenecks and delays often follow. Accessibility is part of the equation as well. Patients may be using wheelchairs, walkers, mobility scooters, or assistance from caregivers, and the facility should support those needs from the parking lot to the treatment room. The easier the facility is to navigate, the easier it is for patients to focus on their care. Practitioner doctor holding lungs radiography explaining medical diagnosis to senior patient with walking frame during checkup visit consultation in hospital waiting room. Medicine service and concept

Practitioner doctor holding lungs radiography explaining medical diagnosis to senior patient with walking frame during checkup visit consultation in hospital waiting room. Medicine service and concept

Staff Workflows Matter Too

A healthcare facility has to work for patients, but it also has to work for the people delivering care. Providers, nurses, technicians, administrative personnel, and support staff all interact with the building differently throughout the day. Small inefficiencies in the layout can create ongoing operational challenges that affect productivity and patient flow. Support spaces are a common example. Nurse stations, provider work areas, storage rooms, equipment rooms, and utility spaces may not receive the same attention as patient-facing areas, but their location and organization can have a significant impact on daily efficiency. When support spaces are designed around actual workflows, staff spend less time navigating the building and more time focused on patient care. Problems behind the scenes often become visible to patients through delays, congestion, and workflow disruptions.

Technology and Equipment Planning

Modern healthcare facilities rely on systems and equipment that often influence the building itself. Depending on the facility, planning may need to account for:

Imaging and diagnostic equipment
Telehealth capabilities
Electronic medical record systems
Security and access control systems
Patient check-in technology
Specialized medical equipment

These systems can affect electrical capacity, plumbing requirements, HVAC design, low-voltage infrastructure, room dimensions, equipment clearances, and future maintenance access. A dental office provides a good example. Imaging equipment, compressed air systems, vacuum systems, and sterilization areas all require coordination during design. If those requirements aren’t identified early, conflicts may not surface until construction is underway, when changes become far more disruptive and expensive.

Planning for Future Growth

Healthcare organizations rarely operate exactly the same way five or ten years after a facility opens. Patient volumes change. Services expand. Additional providers join the practice. Technology evolves. Equipment needs shift. Future growth often depends on decisions made during design. That may include:

Reserving expansion space
Increasing utility capacity
Creating adaptable room layouts
Planning for future technology upgrades
Designing systems that can support additional services

A practice planning to add providers in the future may benefit from reserving adjacent space or increasing infrastructure capacity during the initial project. Decisions like these often require minimal investment during planning but can significantly reduce future renovation costs and operational disruptions.

Compliance Requirements

Healthcare facilities must balance operational goals with accessibility requirements, life safety considerations, permitting requirements, and building codes. Design decisions may be influenced by:

ADA accessibility requirements
Life safety and emergency egress requirements
Fire protection systems
Utility access requirements
Inspection and permitting requirements
Equipment clearances and maintenance access

A layout that appears efficient on paper may not work once required clearances, accessibility standards, and life safety requirements are considered. Equipment placement may seem practical until utility access or maintenance requirements are reviewed. Compliance considerations are easiest to address when they’re incorporated into planning from the beginning.

Designing a Renovation

Designing a renovation is different from designing a new facility on an empty site. Many healthcare renovations take place while patients are still receiving care and staff are still performing their daily responsibilities. Design decisions often need to account for both the finished facility and the construction process itself. Planning may need to address:

Construction phasing
Temporary barriers
Patient and staff circulation routes
Material staging areas
Noise and vibration control
Dust containment
Construction access restrictions

If concrete needs to be cut, that creates noise and vibration for adjacent spaces. If ceilings need to be opened, that can affect dust control, inspections, and systems that need to remain operational. Maintaining patient care and daily operations during construction requires just as much planning as the finished layout itself.

Design Decisions Affect Everything

Healthcare projects involve a wide range of interconnected decisions. A layout change may affect patient flow. Equipment selections can influence utility requirements. Technology upgrades may require additional infrastructure. Future expansion plans can impact decisions being made today. Early coordination helps identify those conflicts before they affect budget, schedule, or construction. The earlier challenges are identified, the easier and less expensive they typically are to solve.

Modern Healthcare Facility Design Is About Supporting Care

The most successful healthcare facilities aren’t defined by how they look. They’re defined by how well they support patients, providers, and staff every day. That starts with thoughtful planning long before construction begins. Wilson & Co. works with healthcare organizations throughout Central Florida to help navigate the planning, design, and construction considerations that shape successful healthcare projects. Planning a healthcare construction project? Contact us to start the conversation. Continue Reading

How Long Does It Take To Build a Medical Office?

Wilson & Company April 23, 2026 Medical

If you are planning a medical office construction project, you are probably asking a practical question right away: how long is this going to take? The challenge is that medical office timelines are not always as straightforward as they look from the outside. What seems like a simple build-out can involve a series of decisions that affect not only how long the project takes, but how smoothly it moves from one stage to the next. Understanding that process early can make it easier to plan ahead and avoid unnecessary surprises along the way. Continue Reading