“That was an incredibly important initiative by city leaders of the day,” Round Rock City Manager Brooks Bennett said. “If you want to have a full-featured community, you need to have health care—quality health care.”
Forty years later, St. David’s completed a major expansion, bringing the total capacity to over 200 beds, with shell space available to accommodate future growth.
Two other Round Rock hospitals, Baylor Scott & White Medical Center-Round Rock and Ascension Seton Williamson Hospital, have ongoing expansions to double the capacity of each hospital.
“General growth in the area has driven a lot of need for high-quality health care services in our area,” Brooks Bennett said. “Over the past few decades, really, we’ve seen the capabilities expand at all of the major hospitals here.”
The details of recent expansions at area hospitals include:
Ascension Seton Williamson Hospital
- 6-story patient tower
- 160 news beds
- 400 new jobs/employees added
- $230 million
- Expected completion in 2026
- 5-story patient tower
- Expansion of the labor & delivery unit
- 200 new jobs/employees added
- $220 million
- Expected completion in 2026
- 2 new operating rooms
- New 34-bed Intermediate Care Unit
- 75 new jobs/employees added
- $53.1 million
- Expansion completed in January 2024
While St. David’s completed an expansion of its Round Rock site early last year, improvement projects for the two other hospitals in the city are ongoing.
Serving Round Rock since 2007, Baylor Scott & White began its expansion in 2023. The upgrades include phased openings, with the most recent development being the hospital’s five-story patient tower opening at the beginning of the year.
“We’re excited that we’re continuing to open new areas throughout this calendar year,” said Drew Bennett, BS&W vice president of operations.
Ascension Seton Williamson started construction on its expansion in 2024. The hospital has operated in Round Rock since 2008.
“We were the first facility on this corner that was literally surrounded by farmland and pasture land,” said Andrew Gnann, president of Ascension Seton Williamson. “We have seen over time the development that has happened here in north Round Rock has just been tremendous.”
The hospital’s expansion will include a six-story patient tower and house five floors of acute inpatient care. Upgrades include support services such as labs, a pharmacy and kitchen, as well as patient care like the emergency department and observation unit.
“We’re essentially doubling the size of the hospital,” Gnann said.
The background
As of April, Round Rock’s population neared 140,000, making it the largest city in Williamson County.
Neighboring communities such as Pflugerville, Hutto and Georgetown—areas served by Round Rock’s hospital hub—have also experienced steady growth over the past five years. Hutto, in particular, was labeled the 13th fastest-growing city in the country, according to data from the U.S. Census Bureau released in May.
At Baylor Scott & White, patient visits increased by 30%, and births are up 40%—a surge Drew Bennett says is the main driver behind the need for expanded health care capacity.
Gnann echoed that sentiment, attributing population growth as the key factor behind Ascension Seton Williamson’s expansion efforts.
“This area’s been growing so much, which is a great problem to have, but we had to be able to build the capacity to help care for them,” Gnann said.
With this growth, residents increasingly expect access to comprehensive care within city limits, rather than traveling to Austin, said JW Newman, CEO of St. David’s Round Rock.
“[Residents] do have an expectation that they can get the highest level of care here in Round Rock,” Newman said. “The health systems that support this community [must] make the investments to expand their service lines, expand their bricks and mortar [and] expand their footprints to take care of more patients here in Round Rock and Williamson County.”
John Gonzales, Williamson County Emergency Medical Services director, said the hospital expansions are needed, because occasionally paramedics will have to wait to transfer a patient from a stretcher to a hospital bed.
“All these expansions add more inpatient beds, which allows the ER to clear out quicker, which allows beds to become free for [emergency room] for EMS patients to be delivered,” he said.
Each hospital expansion represents tens to hundreds of millions in investments. However, upgrades don’t only include physical building additions.
“A lot of times people think growth is only brick and mortar,” Newman said. “A lot of what we [at St. David’s] focus on right now ... are what technologies that we can invest in to stay on the progressive side of caring for patients.”
At Ascension Seton Williamson, Gnann said the hospital will add “the highest level technology that’s available on the market right now.”
Chantel Graham lived in Round Rock for 26 years before moving to Hutto three years ago. Although she hoped to find physicians to go to in Hutto, she ended up going back to her doctor in Round Rock for regular appointments.
Graham also said that when she needs to see specialists, she finds them in Round Rock.
“When I look at where we’re going to retire, it’s going to have to be a place, if it’s not Round Rock ... it’s going to have to be something similar, but definitely health care and a hospital will be on my radar,” Graham said.
The impact
In addition to increasing hospital capacity, the expansions will create jobs and bring in specialized services specific to the county.
Following its completion, Ascension Seton Williamson will have the only surgical trauma intensive care unit—to monitor those suffering from a traumatic accident or who underwent complex surgery—in Williamson County.
This NICU facility is for babies with mild to critical illness, or those who require life support. It also provides comprehensive care closer to home for Round Rock families, allowing parents to be closer to their newborns and support team. A neonatal transport team will also be available to quickly transport newborns to the center.
St. David’s Round RockMedical Center is planning a further build-out using the shell space of the first expansion, which includes a full floor and two operating rooms.
“We’ve taken care of this community for 40 years, and obviously we want to continue to care for 40 years into the future [and] even more,” Newman said.
Ascension Seton Williamson’s first patient day in the new hospital tower will take place in the summer of 2027, according to Gnann.
As a part of its phased opening, additional features of the Baylor Scott & White expansion will include new operating rooms, endoscopy suites and catheterization labs.
“We will have some ongoing renovations to our campus that will wrap up early 2026 to complete the project,” Drew Bennett said.
