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ROCHESTER - Mayo Clinic on Monday unveiled billion-dollar expansion plans for its Rochester campus that had been at the heart of a legislative standoff last month.

Construction could start in 2024 on a redesign that streamlines the spaghetti layout of Mayo's parking, clinic and hospital facilities and modernizes the campus for new medical and wearable personal health technologies.

"We want to improve the way patients experience Mayo Clinic," said Dr. Craig Daniels, the physician lead for the expansion. "We recognize that arriving in Rochester now to our campus can occasionally feel a bit disjointed — with a number of different buildings, a number of different arrival points, a number of different places to park and enter and exit."

A preliminary map reveals a project that could reshape the skyline of Minnesota's third-largest city and bring more jobs and families to Rochester.

New clinical space would extend from the Gonda Building, the recognizable Mayo tower with its valet entrance and marble-filled lobby. The expansion would loop around the north side of Calvary Episcopal Church and stretch westward two blocks. Parking and non-clinical buildings to the north and south would include new or existing structures, including the historic Lourdes High School building that Mayo bought in 2013.

"It's exciting to have that kind of growth in this community and that kind of investment," Rochester Mayor Kim Norton said. "Of course, there's a lot of work to be done as this rolls out."

A Mayo lobbyist last month emailed Gov. Tim Walz and warned that the yet-to-be-announced project could be in jeopardy if he signed state legislation that would regulate hospital nurse staffing and penalize hospitals with excessive cost growth. She estimated that Minnesota could lose a privately funded project that quadrupled the $1 billion price tag of U.S. Bank Stadium.

Ahead of schedule

A vote by the health system's board later this year will determine the final scope and cost of the project, but on paper it appears to be one of the largest hospital expansions in Minnesota history.

Daniels said the project, entitled "Bold. Forward. Unbound. In Rochester," was announced Monday in its preliminary phase because it will require civic support over changes in roads and utilities. It might require state support from lawmakers and the Minnesota Department of Health if it increases Mayo's bed capacity and requires a public interest review.

Daniels said the clinical expansion will allow patients to receive more services in one location rather than across the sprawling campus, and will take advantage of digital and data technologies. It will be wired so that doctors can consult data sources patients bring with them, such as smart watches measuring their steps and sleep and pulse — information that is invaluable to clinicians.

"We want to make sure we care for patients in a way that preserves that human touch ... but we have to use technology because that's going to unlock cures and experiences for patients that currently aren't available," he said.

The project would put Mayo ahead of schedule, Daniels said, on its $3.5 billion investment goal for Destination Medical Center (DMC), the initiative to transform downtown Rochester into an international medical hub. Mayo set that goal in 2013 as part of its pitch to state lawmakers for $585 million in public funding for infrastructure improvements surrounding its campus.

The medical giant at the time threatened to move components of its system out of state without public support for DMC, which gained commitments of $410 million in state funding as well as $128 million from Rochester and $46 million from Olmsted County.

Mayo has spent $934 million thus far through DMC, including a record $173 million in annual spending in 2022. DMC officials say about $1.4 billion in investments have come to Rochester as of last year but look to boost non-Mayo private investment to keep up with Mayo's spending.

The project's announcement preceded a major bioscience conference this week in Boston, where Gov. Tim Walz and other state officials will be promoting Minnesota. DMC Executive Director Patrick Seeb said the project will certainly make it easier to sell Rochester to life science companies looking to open new research labs.

"It represents a great place for a company who wants to expand, who wants to get involved with new innovation," Seeb said.

Richard Tsong-Taatarii, Star Tribune

Walz in a statement said he has been working closely with Mayo officials to secure a project that will "pave the way for Minnesota to lead in biomedical innovation."

'Tough questions'

If the project triggers a state review, it could encounter some upset state lawmakers whose health care reform proposals were upended this spring by Mayo's threats. Rep. Sandra Feist, DFL-New Brighton, said she would give the project close scrutiny to make sure the expansion serves the public's interest.

"I plan to ask a lot of tough questions," she said.

Daniels said Mayo made the right moves during the session because they ensured an expansion project in Minnesota that could "lead health care transformation" worldwide. The health system also operates hospitals across southeast Minnesota and large medical centers in Phoenix and Jacksonville.

"We think we did the right thing for Mayo Clinic and our patients," he said. "We know we did the right thing for the city of Rochester, our staff, and for the future of health care."