CM at Risk Construction Management in Cheyenne

Cheyenne Regional Medical Center laid out a roughly $115 million renovation to be carried out over about 10 years, beginning with a $10 million first phase to remodel the fourth floor into a mother-baby unit and NICU. Anyone who has worked inside a hospital knows what that means: the patients, staff and ambulances do not stop, and construction has to be walled off, ventilated and sequenced a few rooms at a time. Construction management at risk was made for owners with that kind of challenge.

Under a CM at risk contract, we join the owner and the architect during design, advise on cost, schedule and constructability, and later commit to a guaranteed maximum price for the work. The owner keeps its independent architect and a direct relationship with the design, and gains a builder who has tested the drawings against the market before they go out to bid. If savings appear, they are returned to the owner as the contract provides.

In the early phase we perform cost modeling, constructability review and schedule planning. We help the architect compare structural systems, review the site and utility situation and propose phasing. When the drawings reach a suitable level of completion, we issue bid packages to qualified trades, evaluate the proposals with the owner and set the guaranteed maximum price.

During construction we manage the site, subcontractors, safety, quality, schedule and cost reporting. The owner receives monthly reports that show committed cost, remaining budget, contingency use and the schedule outlook. Open-book accounting means the owner can see what each trade was paid, so the guaranteed maximum price is a number backed by the same records we use.

A guaranteed price is only useful if it is realistic, so we spend the early months on the things that tend to blow it up: unknown site conditions, utility upgrades, long-lead equipment and unclear scope. We recommend geotechnical work and utility studies first, and we build allowances only where information will not exist until later. Each allowance is listed with an owner decision date.

Bidding is done in packages, which allows work to start early. A site package may begin while the building drawings are still being finalized, and equipment may be ordered before the interior package is complete. This staged approach is common on campuses where the owner wants to start a phase quickly. For owners who prefer to include the designer under the same contract, we describe a different route under design-build delivery.

In a hospital or other occupied facility, the work area is isolated by temporary barriers, negative air machines and monitored pressure. Infection control risk assessments determine the barrier type, the dust control and the cleaning. The renovation plan at the medical center included more isolation and negative-pressure rooms after COVID-19, which shows how ventilation has become part of the design, not just the construction.

Life safety has to stay intact during the work. Exits remain open, sprinklers stay in service or are covered by a fire watch, and alarm systems are tested after any change. We coordinate with the owner's safety and facilities staff, schedule noisy or disruptive work for off-hours, and keep daily logs of conditions at the barriers. Those precautions apply to hospital projects and also to schools, offices and occupied campuses.

Phased projects need a schedule that shows each stage clearly: where the barrier goes, how long a room is out of service, what systems are shut down and when the area is returned. We prepare logic-based schedules and review them with the owner's operations team, since clinical or classroom needs, not the contractor's convenience, set the order of work.

Long-lead equipment, such as air handlers, imaging suites or electrical gear, drives the dates, so early procurement is part of the plan. We also schedule utility outages with the owner, minimize their duration and prepare backup systems where needed. Laramie County adopted the 2024 International Building Code and the 2024 International Fire Code with the effective dates of January 1 and April 15, 2025, and we confirm the edition and reviewer for each phase.

The price includes the cost of the work, the construction manager's fee, general conditions and a contingency, with clear rules on who controls the contingency. We show owners how much risk remains in the numbers and how it will be reduced as bids come in. The savings clause is explained at the start.

Renovation work has its own cost pressures: hidden conditions behind walls, phased utility tie-ins, off-hours labor and infection control. We budget for them with allowances and investigation, such as above-ceiling surveys and test openings, before the guaranteed price is set. Our preconstruction estimating is the core of that work.

Besides hospitals, we serve colleges, school districts, public agencies and corporate campuses. The Laramie County Community College main campus in Cheyenne covers 271 acres, and campus work of that scale often moves in phases around the academic calendar. Our work with education institutions and healthcare systems shows that the same discipline, planning around the people who use the building, applies across both.

We also take on projects in Laramie and in smaller Laramie County communities. Travel and trade availability are part of the price, and we state them in the proposal. For the medical center campus in Cheyenne, we know the access points, loading routes and parking pressure that affect deliveries, and we plan accordingly through the Cheyenne Regional Medical Center area.

Tell us the building, the stages and the operational limits. We will show you how a guaranteed price and a phasing plan can protect both the schedule and the people inside.

What is the difference between CM at risk and general contracting?

With CM at risk, we join the project during design and later guarantee the price for the work, while the owner keeps its own architect. A traditional general contractor bids a finished set of drawings. The CM at risk model brings the builder's pricing and scheduling advice in much earlier.

Who owns the contingency?

The contract states it. Typically it is a shared tool, with the owner approving use for items outside the contractor's control. We report contingency use monthly so there are no surprises.

Can work begin before the drawings are done?

Yes, in packages. Site work, foundations or long-lead equipment can start when their drawings are ready, as long as the owner accepts the risk of design changes that affect them.

How do you protect patients and staff during renovation?

With barriers, negative air, pressure monitoring, and dust control, along with scheduled off-hours work and daily checks. We use an infection control plan approved by the owner.

Do you build outside Cheyenne?

Yes, within Laramie County and nearby towns. Travel, lodging and trade availability can affect price, and we explain them when we propose.