The need to meet healthcare needs of a growing Davis County community prompted a change to the entire scope of a project that was already in design. The decision to build a hospital rather than a clinic meant a redesign for a 180,000 sf full-service hospital. The five-story structure is attached to a four-story medical office building and built adjacent to a new central utility plant. The substantially different structural engineering requirements for a full hospital required adjustments in site preparation. Because the soil is generally silt and clay, the clinic and hospital foundations are supported on rammed-aggregate columns. While the central plant, hospital and MOB foundations each needed reinforced soils, and the MOB and hospital are joined, they are structurally separate because of different risk categories. The Outpatient Clinics are home to Primary Children’s Outpatient services, the Intermountain Layton Parkway Clinic, Intermountain Community Pharmacy and additional doctor’s offices. The hospital features 43 beds, emergency services and major hospital services.