Rocky Mountain: a 73% Return on Onsite Care
Oct 19, 2026 · By Wesley Yielding
Mortenson, general contractor on Xcel Energy’s Rocky Mountain project, spent $415,000 on 1st Response onsite care from Nov 19, 2024 to Mar 5, 2026. The site recorded 1 OSHA recordable case in 575,000 worker-hours, a rate 84% below the construction industry average. Valuing the offsite visits avoided and the gap to the industry injury rate, the program returned an estimated 73% on what was spent, a net savings of about $304,100.
1st Response handled 314 first-aid encounters on the project and resolved 309 of them (98.4%) on site. Of the 113 work-related encounters, 111 (98.2%) were resolved on site.
The encounter and recordable counts are exact. The dollar figures are estimates, and the last section shows every input behind them.
The project
On a site this size, every injury or illness forces a choice: treat the worker where they stand, or send them off the job to a clinic. Mortenson brought 1st Response on site so the first option was always available.
| Owner | Xcel Energy |
|---|---|
| General contractor | Mortenson |
| Site | Rocky Mountain, near Pueblo, Colorado |
| 1st Response on site | Nov 19, 2024 to Mar 5, 2026 |
| Peak workforce | 500 |
| Worker-hours | 575,000 |
| Staffing | One nationally registered paramedic (NREMT-P), 6 to 7 days a week |
| Services | Onsite medical care and first aid, drug testing, case management |
Results: 98% of encounters resolved on site
1st Response resolved 98% of both work-related and personal encounters on site, including 111 of the 113 work-related ones.
| Encounter type | Encounters | Resolved on site | Percent resolved |
|---|---|---|---|
| Work-related | 113 | 111 | 98.2% |
| Personal | 201 | 198 | 98.5% |
| Total | 314 | 309 | 98.4% |
Those 314 encounters covered 196 individual workers across 542 visits. The 228 follow-up visits were handled on site as well, so a worker did not have to leave the job for a recheck.
Two in three encounters were personal, and they matter to the contractor too. A worker with a non-work health problem who gets seen on site stays on shift instead of leaving to find care.
Safety: recordable rate 84% below industry
The site recorded 1 OSHA recordable case in 575,000 worker-hours. A construction workforce working the same hours at the industry average rate would expect about 6.
The industry rate is the Bureau of Labor Statistics figure for private construction in 2024 (BLS). Fast first aid on site helps keep minor injuries minor, and Mortenson’s own safety program shares the credit.
| Measure | Rocky Mountain | Construction industry average |
|---|---|---|
| Recordable rate (cases per 200,000 hours) | 0.35 | 2.2 |
| Recordable cases over 575,000 hours | 1 | 6.3 |
Return on investment: 73%
The savings come from two places: offsite visits the site never needed, and recordable injuries it did not have compared with the industry rate.
The same program cost also paid for drug testing and case management.
| Line | Amount |
|---|---|
| Encounters resolved on site | 309 |
| Assumed cost of one offsite clinic or ER visit | $1,500 |
| Offsite visit cost avoided | $463,500 |
| Recordable cases below the industry rate (6.325 expected, 1 recorded) | 5.325 |
| Average cost per medically consulted work injury (NSC, 2024) | $48,000 |
| Recordable injury cost avoided | $255,600 |
| Total estimated cost avoided | $719,100 |
| Program cost | $415,000 |
| Estimated net savings to the general contractor | $304,100 |
| Estimated return on investment | 73% |
How it worked
Nothing here is exotic. The return comes from putting care where the work is and paying only for what the site needs.
- Care in minutes. Workers were seen within minutes of an injury, on site, instead of after a drive and a waiting room.
- Coverage sized to the job. One provider on the site’s own schedule, 6 to 7 days a week, with no clinic facility to carry.
- Workers stay on the job. No trip, no escort pulled off the crew, no half-day lost to a clinic visit.
- Follow-up on site. Rechecks happened where the worker already was: 228 follow-up visits across the project.
- One provider, several jobs. The same program covered first aid, drug testing and case management.
- Personal health included. 201 non-work problems were seen on site too, which kept those workers on shift.
Where the numbers come from
The counts are measured and the dollars are modeled. Each figure below is labeled as one or the other.
| Figure | Source | Precision |
|---|---|---|
| Encounters: 314 total, 113 work-related, 201 personal | 1st Response electronic patient charts for this site, Nov 19, 2024 to Mar 5, 2026 | Exact count |
| Resolved on site: 309 total, 111 work-related, 198 personal | The same charts. An encounter is resolved when it closes with a completed 1st Response visit. | Exact count |
| Work-related or personal | The final determination recorded on each chart | Exact count |
| OSHA recordable cases: 1 | Reported by the general contractor | Exact count |
| Worker-hours: 575,000; peak workforce: 500 | Payroll hours and headcount reported by the general contractor, which approved these metrics for publication | As reported |
| Program cost: $415,000 | 1st Response contract value | As recorded |
| Industry recordable rate: 2.2 | Bureau of Labor Statistics, private construction, 2024 | Published figure |
| Cost per recordable injury: $48,000 | National Safety Council cost per medically consulted work injury, 2024. Includes wage loss, medical, administrative and employer costs. | Published national average, not the contractor’s claims data |
| Offsite visit: $1,500 | Planning assumption covering the visit, transport and paid time away from work | Assumption, not a billed figure |
How encounters were counted
The count was built to run low, not high.
- Only first-aid encounters count. Drug tests, alcohol tests and physicals are excluded.
- Test and training charts are removed.
- Visits by the same worker within 4 days count as one encounter, so 542 visits became 314 encounters.
- An encounter charted as both work-related and personal is counted once, under its final determination.
How far the estimate can bend
The return stays positive under every conservative case below.
With the recordable line as modeled, the program breaks even at 107 avoided offsite visits, about a third of the 309 resolved on site.
| Scenario | Cost avoided | Return on investment |
|---|---|---|
| Base case | $719,100 | 73% |
| Only half the recordable gap credited to 1st Response | $591,300 | 42% |
| Offsite visit cost cut in half ($750) | $487,350 | 17% |
| Harshest case: work-related encounters only (111 offsite visits) — no credit for the 201 personal encounters, drug testing or case management | $422,100 | 2% |