In Nov. 2018, voters approved an $800 million bond package for JPS Health Network so the county medical district could undergo a renovation that would allow it to keep up with other area hospitals.
Nearly eight years later, all eight construction projects for the master facility plan are either underway or have been completed. In April, builders began moving dirt on the new hospital – the final and largest project.
At this time, JPS does not plan to add projects to the near-decadeslong overhaul of the public medical district. Given that, the Fort Worth Report has broken down the status of projects in the master facility plan — including looking at what has changed in eight years.
The Report obtained specific project costs through public records requests.
The Master Facility Plan
The most expensive project on the master facility plan is the new hospital. The $1.5 billion medical center costs more than four times as much as the next most expensive project. The new 1.1 million-square-foot patient tower will have the capacity for 740 beds, with space to grow to 800 in the future.
JPS’ current 582-bed hospital building is at capacity.
The Medical Outpatient Building and Central Utility Plant are expected to open in 2029 at costs of $360 million and $330 million, respectively.
The outpatient building will “bring multiple specialties together under one roof,” according to the JPS website. The facility will house outpatient services as well as an ambulatory surgery center, a retail pharmacy and other provider clinics. It will be connected to the new parking garage, which was finished earlier this year and is one of four completed projects.
The Central Utility Plant will provide energy, heating, cooling and backup systems to the hospital.
The Psychiatric Emergency Center first opened in Sept. 2025 and cost nearly $77 million. The center is the first standalone facility in Tarrant County to provide psychiatric emergency services.
Medical Home Southwest Tarrant was the first project opened as part of the medical system’s modernization efforts. The $37 million center, named after former Tarrant County Commissioner Roy Charles Brooks, is the only project in the master facility plan outside of JPS’ main campus.
Temporary parking opened in Sept. 2023 and was located where the new hospital is being built. The parking lot cost $13 million and was in use while the new garage, which is now operational, was under construction.
The Las Vegas Trail Health Center, a collaboration between JPS, Cook Children’s Health Care System, the city of Fort Worth and other community organizations, opened last summer and provides primary care, women’s health care and mental health services. Although the project is listed on the JPS master facility plan website, it is not included in cost estimates because it was built by others and leased by JPS.
Also part of the master facility plan is a new $16 million Health Center for Women and renovation of the JPS Professional Office Complex at 1400 S. Main St.
History of the renovation
Hospital systems and other businesses often make adjustments to long-term plans as time goes on, said Daniel Karnuta, a professor at the University of Texas at Dallas’ Naveen Jindal School of Management. Karnuta was previously chief financial officer for a healthcare finance consulting company.
Hospitals consider factors such as the demographic makeup of the community they serve and the age of facilities to predict what they may need in the future. Changes to demographics and technology can lead hospital systems to alter plans.
“You’ve got to skate to where the puck’s going, not to where the puck already is,” he said.
Economic factors such as inflation can contribute to higher cost estimates, he added.
For JPS, the estimated cost of the master facility plan has grown from $1.2 billion to $2.5 billion since it was first announced.
The estimate first rose to $1.5 billion in 2022 and then $2.1 billion in 2024. Managers were told at an Aug. 2024 meeting that the increase was due to inflation and rising labor and materials costs.
JPS Senior Vice President Shannon Fletcher wrote in a July 23 statement to the Report that the $1.3 billion increase was caused by “inflation in labor, construction, and equipment costs.”
Even with the increase, construction costs for the projects are at median benchmarks, the statement said.
Tarrant voters approved the $800 million bond for JPS in 2018. That amount was never intended to cover the entire cost of meeting the county’s needs, JPS President and CEO Dr. Karen Duncan told the Report in 2023.
The COVID-19 pandemic posed a significant challenge to the health system’s plans as it prompted supply chain and other delays, Duncan added.
Costs additional to the $800 million bond are covered by the hospital’s budget, which takes revenue from sources such as state and federal monies, patient care, the retail pharmacy and property taxes.
The hospital’s portion of the project went from $400 million to about $1.7 billion.
County Commissioners, who appoint the hospital system’s managers and approve its budget, have lowered the tax rate in recent years.
A map of the future JPS Health Network’s medical district campus. (Courtesy | JPS Health Network)
In 2023, commissioners lowered JPS’ tax rate for fiscal year 2024, resulting in the hospital system budgeting for an expected decrease of $26 million in tax revenue from the year prior.
In an Aug. 2023 meeting of the finance, planning and investment committee, then-Chief Financial Officer Sharon Clark told managers that “if the court doesn’t lower the tax moving forward, I think our master facility plan will be good.”
Commissioners would later lower JPS’ tax rate for fiscal year 2025 and again for 2026.
JPS has also changed the projects included in the plan as the years have gone by.
JPS Chief Operating Officer Jill Farrell said at an April groundbreaking for the new hospital that changes to the facility plan came from the hospital system’s reevaluation of the community’s needs.
The plan originally included four new medical homes, or community-based clinics. Ultimately, this count was reduced to one — Medical Home Southwest Tarrant.
One addition was the Health Center for Women, which JPS plans to open in December. Despite not having been listed as a project on the master facility plan website until this year, the health center “has always been included in the master facility plan and overall project budget,” Fletcher said in a statement.
“It is now being identified as a separate project” within the master facility plan because of construction timing, she added.
Some projects were also consolidated. The new hospital, Pavilion North Expansion and a hazardous waste/support building were combined for reasons including cost, improving the flow of the campus and preserving land for future growth.
McKinnon Rice is the health reporter for the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at mckinnon.rice@fortworthreport.org.
Ismael M. Belkoura is the nonprofit editor for the Fort Worth Report. His position is supported by a grant from North Texas Community Foundation. Contact him at ismael.belkoura@fortworthreport.org.
At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
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