Hawarden Regional Healthcare (HRH), a critical access facility built in the 1930's, experienced substantial growth and was providing services in an aging building that had long run out of its useful life. Their mission was to develop a facility that reflected their expanding growth, commitment to service excellence, and responsibility to all they served. The Samuels Group worked with HRH and Hoefer Wysocki Architecture on a plan that included a mix of new construction and renovation to include a new emergency department, radiology, a specialty clinic, registration, kitchen, a new surgery suite with an operating room supported by three prep and recovery rooms, and eight private rooms. The new design maximizes patient services, streamlines support areas, emphasizes expandable zones and services, and provides new efficient mechanical systems. The Samuels Group served as Construction Manager, as Advisor and assisted with an analysis and complete assessment of the existing facility, planning, budgeting, funding, and community involvement efforts.