Kaiser Permanente

Kaiser Permanente is an integrated health system founded in 1945 and headquartered in Oakland, California, operating hospitals and medical offices across several states. As a health system that owns its facilities, it runs a continuous capital program and acts as the owner on large acute-care construction rather than leasing clinical space. Its Railyards Medical Center in downtown Sacramento topped out on 9 September 2026, roughly 18 months after construction began, at a construction cost of about $1.5 billion, with Hensel Phelps as general contractor and a design by SmithGroup’s San Francisco office. Hospital work of that scale in California runs through review by the Department of Health Care Access and Information.

The organisation traces to 1945 and to an unlikely pairing: industrialist Henry J. Kaiser, who needed medical care for workers on remote construction and shipyard projects, and Sidney R. Garfield, a physician who had been treating them. What began as coverage for a workforce became a health plan open to the public.

Eighty years later it is three linked entities rather than one company: Kaiser Foundation Health Plan, Kaiser Foundation Hospitals, and the regional Permanente Medical Groups. The medical groups own the clinical decisions; the hospital and health plan entities own the buildings and the coverage. That division matters to anyone working on a Kaiser project, because the owner of the real estate and the party specifying how a clinical space must function are not the same organisation.

The estate is substantial: 40 hospitals and 610 medical offices serving 12.9 million members, staffed by 25,270 physicians, 78,630 nurses and a total workforce of 225,854.

Operations span nine regions. Northern and Southern California, Colorado, Georgia, Hawaii, the Mid-Atlantic states of Maryland and Virginia plus Washington D.C., Nevada, the Northwest across Oregon and southwest Washington, and Washington state. Northern California remains the home region and the largest by some distance, with 4.7 million members, 21 hospitals and 203 medical offices, which is why the Oakland headquarters address is more than a formality.

A system of that size does not build occasionally. Owning rather than leasing clinical space means a standing capital program, and the constant is renovation and replacement of a large existing estate as much as new construction. Research is run in-house as well, which adds laboratory and specialist facility types to a portfolio already spanning acute care, outpatient clinics and administrative buildings.