Kane County Hospital, serving rural Southern Utah and Northern Arizona, underwent a comprehensive expansion and remodeling project to enhance its critical care and swing-bed facility by over 17,000 sf. Design services aimed to boost the emergency room, surgery recovery, and pharmacy capabilities while renovating the security infrastructure, hospital lab, imaging department, and waiting areas. Despite the challenges of operating within an active healthcare facility and navigating rural logistical constraints, the project achieved notable successes, including significant value engineering savings. These savings enabled the construction of a new three-bay ambulance building, complete with classrooms and a large conference room, along with additional earthwork upgrades and stormwater detention ponds. Alongside these improvements, upgrades were made to the hospital's infrastructure to accommodate the expanded capacity. This comprehensive upgrade enhances medical services for the local community while extending its reach to visitors, supporting healthcare accessibility in this remote area.