When Dr. Sudha Seshadri was recruited more than seven years ago to establish a new type of Alzheimer’s care center at the University of Texas Health Science Center at San Antonio, she was shown to a small parking lot.

The late Dr. William Henrich, who served 15 years as president of UT Health San Antonio, described to her a vision of a new type of brain health facility: one that housed all the different services patients need under one roof, allowing them to participate in cutting-edge research while receiving clinical care.

Today, the $100-million, five-story, 103,500-sq-ft Center for Brain Health is bringing that vision to life in a facility that will house the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, of which Seshadri is director.

“We have a space that is essentially way too small,” says Michael Charlton, UT Health San Antonio's senior vice president for facilities and capital planning. “They’ve been doing these clinical studies here on the campus on one-and-a-half floors of a building.”

The problem? How to fit what will now be a large facility on a very tight site next to the 11-story Medical Arts Research Center, where about 2,500 patients are treated every day. The solution required close planning and coordination and no shortage of zeal.

The top two floors include plumbing and other infrastructure so that it can be more easily converted from offices and meeting spaces to other clinical uses in the future.
Photos courtesy Joeris General Contractors

Making Room

The Center for Brain Health will offer cutting-edge research through the institute. Next door, connected via covered walkway, are the clinical expertise and capabilities at the Medical Arts Research Center. “If [patients] have other conditions or diagnoses they need to address, it’s literally just a short walk away,” Charlton says. “It really opens up the potential for all different kinds of specialties.”

The vision created challenges when construction kicked off in 2023 due to limited laydown space and contractor parking. It also required shrewd use of the available budget to maximize building opportunities.

Today, the Center for Brain Health is about 88% complete ahead of a planned September 2025 construction finish. It is planning a Dec. 10 opening, says Charlton.

The project is part of $1 billion in capital investments that the university says it is making in San Antonio over the next four years, including the eight-story, $472-million Multispecialty and Research Hospital that opened in December 2024.

Tom Smith, project executive at Joeris General Contractors, notes some other numbers: 101 exam rooms, 126 offices and workstations, 12 infusion bays, 15 triage bays, four phlebotomy chairs and seven conference rooms as well as a pharmacy, labs and other ancillary spaces.

“It’s 100,000 sq ft across five plates,” explains Joel Benavides, Joeris director of health care. “It is super-efficient.”

That efficiency reaches out into the future via a design that builds in expectations of expansion when the time comes, which is how the project landed at 100,000-plus sq ft in the first place. Initial programming was for a 60,000-sq-ft building, but that would have meant a maxed-out facility from the start, Smith explains. Doctors who will lead work in the facility opted to increase that to roughly 100,000 sq ft, mainly by adding the fifth floor.

“We did a really good job with budgeting and getting the work bought out within their budget that allowed them to build that top floor now and save some money by using 2022 dollars versus 2027 [costs],” he says.

The covered walkway connects the second floor of the Center for Brain Health with the Medical Arts Research Center next door.
Photos courtesy Joeris General Contractors

A New Era for Brain Care

The Center for Brain Health will include a robust imaging component in a 7-Tesla magnetic resonance imaging (MRI) machine, one of only about 40 in the country, and only the third in Texas, Charlton notes, calling it a signature aspect of the facility.

“I don’t think there’s another center like this in Texas,” Seshadri says. “Our emphasis on the integration of patient-centered, family-centered care and top-notch research, and these engineering ideas we have implemented, I think we are currently state-of-the-art anywhere in the world.”

That custom-built Siemens MRI arrives on June 1, Charlton says, and will be installed over the summer. The facility’s pharmacy and infusion center will increase the San Antonio facility’s number of infusion chairs to 15 from one, greatly boosting its capabilities in that specialty, he adds.

The 55,000-lb MRI requires contractors to include a 12-ft by 12-ft knockout panel in the building envelope to enable not only its installation, but also to complete any later job to replace or repair the machine, Smith says.

Its capabilities far outweigh less powerful MRIs, Seshadri says, allowing for views of areas of the brain where diseases start not provided by smaller machines.

The machine will be shielded via steel and copper boxes, of which a portion will also be removed when the magnet is installed for the MRI, set to occur in June ahead of the project’s scheduled Sept. 10 completion target.

“I think that is the biggest unique piece of the entire project from a construction design [standpoint],” Benavides says. “I’ve done health care projects all over the world, I’ve never done a 7T.”

Other unique aspects of the building include the fully integrated, patient- and family-centric second floor with spaces for music therapy, art therapy and support group meetings, Seshadri says. Clear delineations between floors and walls, and in restrooms, help dementia patients who have trouble differentiating objects. Fully integrated exam rooms with 55-in. touch-screen monitors allow family across the country to be fully involved with the care of their loved ones.

Ariel Chavela, principal at Alamo Architects, which worked with partner TreanorHL on the design, says because the MRI is a technically complicated piece of equipment vulnerable to vibrations, it is located in the most economical spot: on the ground floor—as is the entire imaging suite.

The second floor of the Center for Brain Health connects to the first floor of the Medical Arts Research Center, he says, and includes such public-facing components as a courtyard for patients and families, a yoga studio, community room and more.

“It is a research building, but it also has this very strong tie to the community,” Chavela says.

Alamo has designed other nearby buildings and drew from those and others in the area—including the Medical Arts Research Center—to inform the stucco-and-metal panel design of the Center for Brain Health.

The Center for Brain Health features 101 exam rooms and 126 offices and workstations as well as 15 triage bays among other components, including a powerful MRI machine of which only a few are in operation in Texas.
Photos courtesy Joeris General Contractors

Making it Happen

The tight site required close coordination and constant communication with campus authorities.

“The site is this little postage stamp corner that was a surface [parking] lot,” says Smith. “It’s been a lot of just-in-time deliveries, a lot of coordinated efforts because we don’t have the luxury of laydown space.”

The team secured an offsite laydown and parking area, and it has had to close a lane of the adjacent street each time materials are delivered. It’s been logistically challenging, he says, and adds an extra wrinkle to being a good neighbor on campus.

Connecting chilled water infrastructure for the building into the university campus system has also been a heavy lift, Benavides says, because it requires coordinating those connections across two major roads as well as to the Medical Arts Research Center next door and its 10 chillers.

“It was about a seven-month effort in running new 24-in. piping all the way around and within a crawl space of an existing building,” Smith says. “It wasn’t just digging utility trenching and laying pipe. It was running under existing buildings, converting those buildings onto the loop as well.”

The team used an existing pedestrian bridge crossing the nearby four-lane road to eliminate the need for directional drilling underneath, thereby avoiding “a dramatic impact to the project,” Smith says, by not having to create a bore pit located within the building footprint, which would have delayed the start of construction.

That’s just one example of the planning that has kept the project moving, with Smith noting the team effort to plan and coordinate all aspects of the project dating to 2022, a “very active and intentional” process including all stakeholders.

“On long health care projects like this, it’s not uncommon for [the owner] to have changes in leadership and [for] certain things [to be required] for certain departments,” Benavides says. “[But it has] been a seamless process.”

The coordination effort is significant, with dozens of stakeholders and a robust fundraising effort that means there are frequent donor and user tours of the project.

“There’s roughly eight to 10 sub-departments that are going to operate out of that facility plus the two heads of the actual institute, and beneath them the heads of the departments and staff that they’re relying on to make some decisions during design, and you’ve probably got 40 to 50 people right there making decisions on project design and construction,” says Benavides.

Cutting-edge technology is not restricted to the building’s care and research components either. Joeris uses drones to monitor exterior progress and quality control, with weekly 360-degree camera captures of the project allowing virtual walkthroughs that can be shared with anyone on the team.

Sometimes the team completes the captures twice a week, Smith says, allowing a sort of time-travel perspective as the project evolves. An example could be after drywall is in place but something needs to be added to a wall.

“Then you can go to a previous picture when it was just framed, and you can pull the rock off the wall and see what utilities are in that wall, if there’s power, if there’s a vent pipe that might not be known [or] steel [or] any kind of structural supports,” Smith says. “It served us really well for a couple of different changes.”

One example was a move to add adult changing stations in restrooms after tile was already placed on the walls. Evaluating former captures allowed the team to locate the best wall on which to place the stations and even in which restrooms to place the stations. Benavides notes this also allowed owners to keep tabs on construction progress.

The entire effort is among the fastest Chavela has seen go from concept to completion.

“I feel like I was there when it was born,” he says, referring to sketching rough conceptual layouts at an initial meeting with Seshadri around five years ago. He cites the importance of the university health science center’s immediate feedback, close coordination and dedication.

“To get it done this fast, it meant everybody had to make a huge commitment,” Chavela says. “UT Health was instrumental in making sure we had everything we needed.”