RKTB helped New York Methodist Hospital resolve its spatial problems by removing portions of two floors and replacing them with five new floors, creating 80,000 SF of additional usable space. At the same time, the entire emergency room on the ground floor was renovated to work with the new structure. Circulation was reduced to provide greater area for patient services in the expanded emergency room, allowing for an enlarged, centrally-located nurse's station, an increase in the number and size of exam rooms, a waiting room, holding area, new women's health services and relocated Pediatrics. Dietary Services, offices and storage facilities are also on the ground level. Triage, reception and registration are concentrated at the main entrance, which will be upgraded at a later stage. The redesign provides space for future trauma expansion as well.

The 3rd floor houses a 15-bed pediatrics department plus a 5-bed pediatric intensive care unit, and each of the single bedded rooms accommodates a sleeper lounge for parental overnight stay. The 4th, 5th and 6th floors each contain 30-bed medical surgical units; of the 90 beds, 82 are single-bedded rooms. The 30-bed seventh floor has every bedroom capable of positive or negative pressure to deal in part with the need for chemical or bioterrorism response.

The addition, which connects three existing buildings in the Park Slope hospital complex, was designed to integrate harmoniously into the neighborhood’s predominantly brownstone architecture.