Abstract
The shifting paradigm in healthcare services demands that hospitals move beyond a sole focus on construction efficiency, requiring instead agile physical and managerial infrastructures to navigate uncertainty. This study aims to analyze the impact of Structural Retrofitting Capability and Scalable Utility Design on Long-Term Expansion Agility, with Strategic Future Growth Planning serving as a mediating variable within a large-scale private hospital network in Indonesia. An explanatory quantitative method was applied using a census technique targeting 51 expert respondents from project and facility management, analyzed via the Three-Box Method and SEM-AMOS. Descriptive results reveal a behavioral asymmetry: managerial cognition falls into the High category, whereas physical building assets fall into the Medium category. Inferentially, the two physical infrastructure variables along with the strategic planning mediator exert a significant simultaneous effect on Expansion Agility with an value of 35.6%. Partially, Structural Retrofitting Capability exhibits a positive and significant direct effect on Expansion Agility. Conversely, Scalable Utility Design shows no direct effect; instead, its relationship with Expansion Agility is fully mediated by Strategic Future Growth Planning. It is concluded that structural building robustness independently and directly boosts physical hospital agility during expansion, whereas utility sophistication absolutely requires orchestration from a strategic planning vision to be successfully converted into a long-term business maneuvering advantage.