With plenty of vacant properties available and a growing demand to bring healthcare directly into communities, the conversion of former retail spaces into clinics and other types of facilities just makes sense. “Ambulatory healthcare is the new retail property anchor tenant for existing, older retail centers,” says Eric Dinges, associate vice president at RTKL Associates (Baltimore). “Their locations in the heart of communities, providing ease of access, are becoming attractive for community-based outpatient centers.”

But that doesn’t mean the decision is a no-brainer. Buildings designed to attract window shoppers and showcase the latest jeans are rarely move-in ready for a provider hoping to perform, say, same-day surgeries.

Such conversions come with unique challenges, and here we’ve assembled a few projects that have faced (and are meeting) these challenges with aplomb.

Rockford Orthopedic Associates, Rockford, Ill.

A few years ago, having outgrown its main facility in Rockford, Ill., Rockford Orthopedic Associates considered expanding its existing building to deliver more services to more patients needing orthopedic services, musculoskeletal care, and prosthetics. But then, through a real estate analysis process led by AMB Development Group, the team discovered a mostly empty strip mall nearby. By taking over the space previously occupied by a grocery store, hardware store, and gift shop, Rockford Orthopedic learned it could grow its offerings at a fraction of the cost of an on-site expansion, while also adding a location with direct vehicular access from a desirable intersection.

Another opportunity afforded by the retail structure was more than 40 feet of clear space from grade level/floor one to the underside of the ceiling structure in the base building. Nelson (Chicago), working with AMB (which served as the project developer, project architect, and design builder), suggested that Rockford Orthopedic take advantage of the layout to integrate a second floor or mezzanine for administrative staff use.

It did—and the new mezzanine, connected to the first-floor patient rooms (or “labs,” as they’re called here) with a decorative staircase, creates a flexible space for staff offices, training, and future staff needs. The facility opened in July 2013 with a public open house celebration and now serves as the “exclusive home” of the Rockford Ice Hogs semiprofessional hockey team.

Lightwell Greater Boston Orthodontics, Boston

The retail roots of the Lightwell Greater Boston Orthodontics site are practically unrecognizable, as this former neighborhood paint store was renovated inside and out to dramatic effect. Built by Merge Architects (Boston) and opened in 2013, the practice moved into a storefront building that was more than 100 years old—and the three exposed-masonry sides of the building envelope desperately needed to be brought up to code. “It was literally raining through the walls when we first surveyed the property,” says Merge principal Elizabeth Whittaker.

The “ortho bay” of treatment chairs was planned for a back area of the building that couldn’t have any windows because a portion was below grade. But skylights at the upper level of the double-height space brought in some natural light, and the designers ratcheted up that effect via plywood ribs wrapped in one-eighth-inch-thick polycarbonate panels that curve all the way up from the floor and appear to direct the light downward.

Saint Agnes Hospital medical center, Catonsville, Md.

It took two years of searching for just the right spot before Saint Agnes Hospital in Baltimore made the call to take over a former 38,000-square-foot furniture store to expand its care services. Looking to create a patient-centered medical home, the development team wanted a well-situated community space that could house 20 primary care physicians; numerous specialists; and space for imaging, laboratories, and physical therapy—as well as dedicated patient education rooms focusing on wellness topics.

RTKL Associates (Baltimore), the architect for the project-in-progress, is tackling the necessary infrastructure upgrades for this 1950s building to bring it up to code and support the more “intensive” services of a healthcare provider. Plumbing is one big issue: Retail spaces don’t have nearly as much need for running water as health facilities do, and in this case, the design team is adding more than 100 new fixtures. The building originally had two.

In addition, the entry sequence is being relocated away from the more retail-focused layout that brings customers in via the longest end of a store and guides them through the merchandise. Instead, says RTKL’s Eric Dinges, the new orientation will allow “multiple clinical entries, longer and larger main lobby space, and the shortest distance to the clinics themselves.” The new medical home is scheduled to be complete in April 2015.

Maplewood Spine Clinic, Maplewood, Minn.

The biggest challenge of relocating a specialty spinal clinic into a former outdoor recreation store in Minnesota? Light. The single-story retail building in Maplewood, Minn., had lots to offer HealthEast Care System, including a great location right in the heart of its main patient base, close proximity to one of the system’s hospitals (for ancillary support), and—structurally—minimal columns for HGA (Minneapolis) to plan around. But there were also very few windows bringing in natural light to benefit both patients and staff working 8- to 10-hour shifts each day. In addition, the existing entry was on a corner, creating a concern about travel distances for patients.

Skylights solved the natural-light problem, and the design team also broke up the long interior spaces with interesting fixtures, millwork, and finishes on walls and ceilings. Clinical areas were strategically sited to keep travel distances short for the most vulnerable patients: For example, the exam/consult areas are located right near the entry, while procedure and rehab areas are closer to the exit.

The clinic opened in August 2012, and research conducted a year later showed that the community’s been quite pleased with the result. While only 37 percent of patients at the previous clinic said they’d recommend the facility to friends and family, the number soared to 95 percent with patients at the new space. Patient visits jumped from 22 per day to 59 per day after a year, with monthly revenue hitting $357,000 over $139,000 during that time.