This critical access hospital in Iowa necessitated working not just with the owner and the town of Nevada as well as all state and federal authorities, but also with an owner's rep firm. It took a lot of juggling of egos to pull the building together under a tight budget.

The exterior material selected was precast colored concrete panel with a core of insulation. We worked with the local energy company to get a grant for energy saving design which later proved itself effective giving a 2.8 year payback.