This 100,979 SF, 120-Bed Skilled Nursing Facility was organized into six neighborhoods of 20 private bedroom/baths per neighborhood, served by a Community Center with Chapel, Multi-purpose Room, Therapy, Administrative, Laundry and Foodservice amenities and support spaces. Due to a pending deadline for licensure and occupancy of skilled beds, this was a fast-track design and construction delivery method, resulting in four separate design packages (site-foundation; building shell; building interiors; mechanical-electrical-plumbing), which were distributed sequentially over a four-month bidding and permitting period. The timeline was further challenged with the onset of winter weather conditions. The total time from beginning of design to occupancy was 18 months.