In Costa Rica there are four hospitals that only exist on paper, models and promises: the new Limón Hospital, the Cartago Hospital, the Geriatrics and Gerontology Hospital and the Tower of Hope of the National Children’s Hospital.
These are projects that together exceed $870 million and that they are trapped in a combination of failed tenders, expropriation processes and internal procedures that have slowed down key stages of pre-investment and start of works.
On April 9, during a board session of the Costa Rican Social Security Fund (CCSS), the president of the entity, Mónica Taylor, recognized that the institution does not have the “installed capacity” to complete the necessary phases from the moment the need for a project is established until its execution is achieved in a period of less than 10 years.
That time gap It not only impacts the costs and interest of construction companiesbut also reveals the needs that the medical centers raise at the beginning of the project compared to the reality they face when, finally, a contract is signed.
Limón: a hospital without providers
In Limón, The new hospital was conceived as an investment of more than $200 millionbut the construction companies ended up taking a step back. They alleged insecurity problems in the province and risks associated with the constant closures on Route 32, factors that increase uncertainty for any large-scale work.
According to the Infrastructure Manager of the CCSS, Jorge Granados, The main complaint of the construction companies is not only in the environment, but in the rules of the game: Since it is a cartel under the “turnkey” model, the Administrative Contracting Regulations do not allow price adjustments to be applied.
In such long periods, the impossibility of adjusting the amounts against the behavior of the dollar exchange rate and the cost of inputs becomes a risk that many companies prefer not to take.
Cartago: a project with contested terrain
In Carthage, the story of setbacks is different, but just as long. Although the work, valued at $394.9 million and awarded to the company Van Der Laat y Jiménez SA, received a start order in October of last year, the construction company could not begin the design phase because the CCSS did not yet have the preliminary project that should serve as the main input for the plans at the time of endorsement.
Before reaching that point, the project had already faced a struggle over the terrain. The Government opposed the hospital being built on the lot acquired in El Guarco, alleging environmental and technical problems supported by erroneous documents.
Later studies confirmed the viability of the site, but the wear and tear had already been done. Added to this was the departure of the first awarded company, which withdrew from the project alleging fluctuations in the dollar exchange rate and criteria found between the Fund and the Ministry of Health regarding the convenience of building on that land.
After four years since the start of the tender and a new delay in the design phase, The authorities maintain that the hospital would be delivered until 2030.
Children’s Hospital: 14 health orders and a tower on pause
The Tower of Hope at the National Children’s Hospital It was presented as a bid to strengthen critical care, but its path also stopped.
The bidding process, which began in 2024, led to an award last June to the company Structures SA for nearly $130 million, an act that was later annulled by the Comptroller General of the Republic when it determined that the company did not meet all the requirements.
On March 24, the CCSS board of directors agreed to declare the process void, this time for reasons that go beyond the administrative file.
The director of the hospital, Carlos Jiménez, explained to the directors that the medical center accumulates 14 health orders and has suffered flooding due to deficiencies in water management systems, Therefore, the ongoing tender did not contemplate the urgent additional works required by the current infrastructure.
Reports from the Directorate of Architecture and Engineering recommended prepare a new specification and terms of referenceadjusted to the real scope of the project, in order to guarantee an appropriate solution to the problem and the public interest.
The Infrastructure Manager of the CCSS, Jorge Granados, said that The board instructed to develop a comprehensive project and tender it again, with the expectation of publishing the new tender in the second half of this year.
Geriatric Hospital: the wait until 2038
The new Geriatrics and Gerontology Hospital is also moving on the distant horizon.
The first phase of this project exceeds $145 million and, according to the schedule known on March 3, 2026, The complete infrastructure would be available until 2038.
Meanwhile, the Health Board has warned that the current building has structural limitations, observations regarding human safety standards and less than optimal evacuation conditions for the elderly population it serves.
In this case, the main delays are attributed to the processes of expropriation of 16 properties surrounding the center current doctor.
Granados explained that The project remains in the development stage and it has not been put out to tender precisely because it is necessary to complete the land acquisition first.
Once the expropriations are completed and the activities planned in the schedule are completed, the tender could be issued, although the deadlines depend directly on the conclusion of these procedures.
The manager also stressed that the long execution times of the projects, in general, are due in some cases to external factors such as expropriations and permits, and in others to internal aspects such as the availability of personnel.
What effect does it have on construction companies?
The Costa Rican Chamber of Construction warned that several contracting processes are resulting fruitless and delay key infrastructure investments.
The union points out that some “turnkey” signs transfer to companies risks that do not correspond to them, such as the variation in input costs, international market conditions and the exchange rate.
The executive director, Randall Murillo, indicated that they have recommended move towards more balanced hiring schemes, with a clear distribution of responsibilities and price adjustment mechanisms.
The absence of these tools, he added, discourages the participation of construction companies, It makes bids more expensive for the State and increases the risk of business bankruptcies and works remaining unfinished.
