Year-in-Review 2023: Rural, public health tops 2023 project list

Year-in-Review 2023: Rural, public health tops 2023 project list Des Moines County officials are joined by Chamber of Commerce Ambassadors, designers, builders and others for a groundbreaking ceremony at the site of the new Des Moines County Public Health Building in Burlington, Iowa. CANCO photo

6 months, 2 weeks ago

The year is ending with Carl A. Nelson & Company healthcare projects completed, on the drawing board and underway. 

By Craig T. Neises | Carl A. Nelson & Company

For Carl A. Nelson & Company (CANCO), healthcare projects in 2023 were largely aimed at improving access to care for underserved populations in rural and urban communities. The year ends with projects completed, on the drawing board and in-progress for clients in Iowa and Illinois.

Two of those projects broke ground, ceremonially as well as with the start of construction, during 2023. They each remain underway as the year comes to a close, with completion slated for 2024.

Another project, begun in 2022 but completed in 2023, will help the client address public health on a statewide scale. The Biosafety Level 3 Lab and Support Spaces Addition project led by CANCO at the University of Iowa State Hygienic Laboratory was conceived in response to the COVID-19 pandemic to increase testing capacity for infectious diseases.

Working as construction manager at-risk, CANCO performed portions of the $9.2 million, 7,500 SF addition, and managed subcontractors to complete the project, which was built adjacent to functioning laboratory facilities that had to remain operational. The project included multiple testing spaces, as well as supporting improvements to HVAC systems.

Among community-focused healthcare projects in 2023 was CANCO’s latest major effort for repeat client Community Health Centers of Southeastern Iowa, Inc. (CHC/SEIA) — an addition to the existing dental clinic in Keokuk, Iowa, which broke ground in March. The other, a new Des Moines County Public Health building in Burlington, Iowa, began with a groundbreaking ceremony in September.

Being led by CANCO in the construction manager agent role, the 8,000 SF, approximately $4 million public health facility will replace a hilltop site in downtown Burlington, where the agency has been located since 1944. Due to limited and sloped parking, a front entrance that requires use of a ramp and otherwise antiquated or inadequate spaces inside, the location can be challenging to access even by people in good health and without mobility issues, and has become a limiting factor on the service’s ability to provide care to the community.

“This new facility will allow public health to grow, and better serve the community,” Public Health Director Christa Poggemiller said during the groundbreaking ceremony, citing improved parking, increased lobby space and the ability to offer services on a drive-through basis when necessary.

Meanwhile, the $8.26 million, 18,300 square-foot addition to CHC/SEIA’s Keokuk dental clinic is more than 8,000 square-feet larger than the organization’s current space. It quadruples the size of the Dental Clinic building completed in 2018, and will allow for expansion of medical and behavioral services, as well as creating the opportunity to open an in-house pharmacy.

Progress at Community Health Centers of Southeastern Iowa, Inc.’s integrated healthcare expansion in Keokuk, Iowa. (CANCO photo)

University of Iowa State Hygienic Laboratory BSL-3 Addition in Coralville, Iowa. (CANCO photo)

“Today signifies our commitment to our patients and communities by expanding our footprint. … This groundbreaking honors our mission and vision: to provide quality and affordable services to everyone, especially those in need,” CHC/SEIA Board Chairman Jeff Strause told a crowd of employees, local officials and others before taking his turn pushing a golden spade into freshly turned soil.

The construction management at-risk project was joined by two others in 2023 for CHC/SEIA, both in West Burlington, Iowa: renovation of a former urology clinic building as a behavioral health center, and a pharmacy addition at CHC/SEIA’s medical and dental clinic. In all, CANCO has completed or is in-progress on 10 projects for CHC/SEIA, dating to the 2007 construction of the original medical/dental facility in West Burlington.

Healthcare design-build projects led by CANCO and completed in 2023 were in Vinton, Iowa, with remodeling of the dialysis unit at Virginia Gay Hospital; and in Waterloo, Iowa, where the company led a design-build project for Peoples Community Health Clinic. The latter includes more than 12,000 SF in new and updated space on two floors to accommodate expanded services such as behavioral health, pharmacy, adult services, urgent care and expanded mammography, as well as community development and homeless services programs.

Projects on the drawing board as 2023 comes to an end include renovations at Van Buren County Hospital in Keosauqua, Iowa; public health facilities for Lee and Washington counties in Iowa; a new administration building for Infinity Health, a CHC based in Leon, Iowa; and redevelopment of a pair of former nursing homes — one in Burlington for use as an adult day care, the other in Hamilton, Illinois, with the goal of developing what has been dubbed a Rural Health Village.

As it approaches its 75th year, Memorial Hospital in Carthage, Illinois, provides a range of services that span from ambulatory and emergency care, to diagnostics, rehabilitation and a host of specialties supported by a physicians group out of nearby Quincy and Peoria, Illinois. The hospital also operates an assisted living and memory care campus in Carthage, and has seven physician clinics spread across the county, including in the city of Hamilton, where the RHV project is being undertaken.

The chance to purchase the nursing home building came amid a push by the State of Illinois to improve healthcare access in rural parts of the state, and as the hospital completed a Community Health Needs Assessment was looking to increase services in Hamilton, which is the biggest of Hancock County’s small cities at about 2,500 residents, plus residents of rural areas and smaller towns on the west side of the county.

“We knew we needed a new and expanded primary site,” CEO Ada Bair said. “And that’s what allowed us to begin to really think about what this would look like from a big-picture perspective.”

The big-picture was based on looking beyond the primary care, pediatric and orthopedic services currently offered in the Hamilton clinic to consider issues of access to care and services that are lacking in Hamilton, and could be addressed in a complementary fashion with an approach that extends beyond a traditional clinic setting. As an example, Bair said the food service space isn’t envisioned as a cafeteria for staff and visitors, but as a source of outreach into the community — possibly as a senior or low-income meal site, and through educational programs related to food and nutrition.

Whether the Rural Health Village concept turns into the next trend in healthcare remains to be seen. But Bair said it’s a concept that could translate to just about any rural locale where there is an existing organization — hospital, clinic or public health department — willing to lead it.


Carl A. Nelson & Company has been providing design-build, construction management and general contracting services since 1913, with healthcare projects completed across Iowa and elsewhere in the Midwest. To learn more about our services to hospital, clinic and other healthcare clients, visit, or call (319) 754-8415.