A rendering of the proposed facility in Round Rock (Provided by Ascension Seton)

Ascension Seton Williamson, the branch of the nonprofit health care giant that serves Williamson County, is announcing a $230 million expansion in Round Rock.

As the first-of-its-kind trauma center in the county, “this expansion will allow us to meet the increased need for medical and surgical services, particularly for cardiovascular, neurology and orthopedic health in our community,” said Andrew Gnann, president of Ascension Seton Williamson, in a press release Tuesday.

The expansion will include a 216,000-square-foot, six-story tower with a 160-room capacity; two operating rooms; expanded space for emergency, imaging, cardiac cath and surgery departments; and a 12-bed observation unit. The massive new development will require more than 400 new staff to operate. Additionally, there will be 34,000 square feet of buildout at the nearby medical plaza, which will house outpatient wound care, cardiac rehab, and pediatric rehab.

Such an investment is warranted, as Ascension Seton Williamson had almost 64,000 patient visits in FY 2022, 34% of which were underinsured. However, what Ascension chooses to spend its money on is under intense scrutiny here in Austin: Bargaining between unionized nurses and management at Ascension Seton on 38th Street is at a standstill, with managers refusing to meet with nurses face-to-face, and nurses speaking out about alleged “nightmare” conditions as a result of acute understaffing. Plus, Ascension is locked in a legal battle with Travis County’s health care district, Central Health, which is claiming that Ascension is lowballing the amount of low-income patients it has promised to serve in Travis County. Because of this, Central Health made moves in its current budget toward building out its own hospital system, rather than contracting with Ascension.