St. Peters Surgery Center and Clinic

Completion Date: July 2022
Size: 46,000 SF
Location: St. Peters, MO
Type of Project: Healthcare, Ambulatory Surgery Center, Multi-Tenant Medical Office Building
Ryan Responsibility: Development, Architecture, Interior Design, Construction, Real Estate Management, Capital Markets

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Engaging all five of Ryan’s service offerings, the St. Peters Surgery Center and Clinic in St. Peters, MO, is a state-of-the-art orthopedic healthcare facility and surgery center housing complementary services all under one roof. The single-story, 46,000-SF facility features an ambulatory surgery center (ASC) and clinic with four tenants: Surgery Partners, Advanced Bone & Joint, RAYUS Radiology and Axes Physical Therapy. Made possible through the collaborative nature of the design-build approach and our longstanding relationship with Surgery Partners, the project showcases how a complex design, tight schedule and budget, and varying tenant requirements can spark innovation from the entire team to create an outstanding result.

Coordination between four distinct tenants created a unique challenge. Consideration was required for the needs of their service lines and varying ages of their patients, as well as their desires for the space and for their staff. In addition, having a fully functioning ASC located in the same building as a medical office space meant that all mechanical redundancies and structural requirements were designed in a way that the ASC space could ultimately stand on its own without relying on any of the medical office building infrastructure components.

With a modern and timeless design, the building includes four operating rooms, 25 orthopedic clinic exam rooms, imaging and a 4,700-SF physical therapy suite – providing orthopedic patients a spectrum of care in one location in addition to other specialty surgical procedures performed on-site. The facility achieves a cohesive feel through strategic patient, staff and material flow; connectedness between interior and exterior designs; and welcoming common space, including a shared lobby and a surgery center lobby. Full-height windows and large skylight bring additional natural light into the shared lobby space and reduces energy consumption. Sustainability was also addressed through a highly efficient lighting system and low-flow plumbing fixtures.


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When the market is unpredictable, count on financing flexibility.

From top-notch medical facilities to quality care, trust is a non-negotiable part of the healthcare experience. As Surgery Partners and Advanced Bone & Joint leadership began exploring the increasingly complex options for site selection, ownership and tenant strategies for their new multi-service Medical Office Building (MOB) and Ambulatory Surgery Center (ASC), they found they needed a partner they could trust with not only with their vision, but their investment in the future of their businesses.

Having collaborated with Surgery Partners to deliver nine successful design-build healthcare projects in as many years, Ryan was a natural choice for this location. We quickly made ourselves an extension of their team—championing their best interests (always) and challenging their assumptions (as necessary). At the time of our involvement, they were pursuing the redevelopment of an abandoned grocery store with the end goal of ownership.

Early diagnostic analysis by Ryan A+E as well as our construction and capital markets teams revealed that the cost to refurbish this space would be nearly the same as a design-build of a new, client-tailored facility. It was an easy choice to make—they would build a new facility.

Then came the question—or rather many questions—of the right financing model. The COVID-19 pandemic had destabilized the financial market and it was our responsibility to present our clients with financing options that they could understand, and, most importantly, trust. A typical joint-venture partnership did not quite check all the boxes. This project required a customized approach.

With our development and capital markets teams being in-house, we can be flexible with our options to best meet the clients’ needs. Our team ultimately structured the final agreement to truly benefit all stakeholders, mitigate risk-related apprehensions and accommodate a unique physician investment opportunity.

Patient-Centered Design

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Creating a common ground for multiple service providers and elevated patient comfort.

Trading in traditional healthcare pastels and harsh lighting for rich wood and ample natural sunlight, visitors will quickly find that St. Peter’s Surgery Center and Clinic is anything but an ordinary medical office building (MOB). From the welcoming front doors to the inviting frames of the check-in desks, entering the space feels more like walking into a high-end hotel than a clinic. Environmental graphics and wayfinding signage also provide a sense of calming reassurance.

The overall impact of being in this environment of medical excellence? Confidence. Comfort. Specialness and uniqueness. Which are exactly the feelings our clients charged Ryan’s architects and interior designers with creating.

Our cross-disciplinary expertise combined with our deep knowledge of the healthcare industry and, more specifically, the aesthetics and logistic operations of Surgery Partners, established a firm foundation for design; which, in turn, created a foundation for a strong shared vision between Ryan and Advanced Bone & Joint, the anchor tenant in the building. While the vision of an elevated, cohesive, complementary-service MOB and ambulatory surgery center (ASC) seemed straightforward enough, the design process proved to be a delicate balancing act.

Since design preceded the final tenant list, we were challenged with remaining flexible and ready to adjust our designs to meet various requirements and regulations, depending on the service of the potential tenant. For example, while the majority of the utilities and amenities—particularly common areas like the waiting room—could be shared by three of the four tenants, Missouri state regulations required the ASC to operate independently of the rest of the building. We analyzed the impact of every adjustment and weighed each impact against the patient experience to ensure that navigation between services was clear and simple. And with the addition of each tenant, we used precedent imagery to ensure that brand integrity was preserved while maintaining a sense of overall aesthetic cohesion throughout the facility.

Ultimately, we delivered a facility that houses an interconnected suite of medical services and keeps the patient experience front-and-center.

Operational Optimization

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Innovative strategies that create the most direct route to success.

With its thoughtful approach to the Medical Office Building (MOB) model—providing complementary surgery, physical therapy, radiology and orthopedics services all in one place—the St. Peters Surgery Center and Clinic has effectively shortened the patient journey from days and miles to minutes and steps. But it didn’t begin this way. At our initial point of engagement, our clients—Surgery Partners and Advanced Bone & Joint—wanted to develop a facility to house both of their services.

Leveraging the power of diverse expert perspectives and multiple cross-supporting services working together under the same roof to deliver a higher level of service to clients is core to how we work. This same potential was bubbling just below the surface of our earliest conversations with our clients: what if we could develop a facility that could house more services to benefit their own clients—the patients? 

We listened closely to our partners, analyzed project site options, and worked together to eliminate two initial site choices, both of which were prohibitively small. Following area analysis of available sites, we located a 6-acre site within a mile of multiple non-competing healthcare facilities and a hospital. The larger site opened up new possibilities for the facility and the number of service providers that could effectively work together.

This inspiration carried the project forward and led to numerous solutions that maximized efficiency and ROI. For example, when we analyzed the initial plans to install two operating rooms (ORs), we found it would be much more profitable operationally to install six. This also gave them room to grow, should they need more ORs in the future. Ultimately, they opted for four, which ended up being the perfect solution for their needs. By the grand opening, news of the facility was all the buzz and physician groups outside of orthopedics were asking to schedule surgeries in this new surgery center.

Today, thanks to equal parts vision, collaboration and flexibility, St. Peters Surgery Center and Clinic has raised the bar for simplicity, comfort and sophistication in the area’s healthcare landscape.


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From local contractors to trusted tenants, we collaborate as a single team.

Close, trusted client partnerships have been a top priority for Ryan Companies for nearly a century. We not only understand and champion our clients’ best interests and project visions, but we also share their challenges and victories as a true extension of their team. This is exemplified in our decade-long relationship with Surgery Partners and (by extension in the case of St. Peter’s Surgery Center and Clinic) their partners Advanced Bone & Joint.

The vision for the project was clear: a multi-tenant medical office building (MOB), with an ambulatory surgery center (ASC), each providing complementary services in one building, directly across the lobby from one another. But the opportunities for partnerships—both in the construction of the facility itself as well as the final tenants—were numerous and required tremendous scrutiny for fit, expertise, risk and commitment.

On the construction front, we first sourced referrals for like-minded, healthcare-experienced subcontractors in the area with preexisting relationships with our clients, while tapping into the local network. We simultaneously called in the most experienced members of the Ryan Midwest team, many of whom had built strong relationships with local vendors, subcontractors and the local community.

In determining the right tenants to share the space, the Ryan development team worked closely with Advanced Bone & Joint leadership to solidify the right service complements to surgery and orthopedics: imaging specialists RAYUS Radiology and Axes Physical Therapy. Now, thanks this close collaboration and dedicated partnership, patients can effortlessly experience a complete suite of services all in one location.


Merit Award - Healthcare, 2022


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