The Kalispell Regional Medical Center (KRMC) Surgical Services Addition is a three story building that serves as the primary surgical facility, with new patient recovery rooms and a medical office addition for the hospital. The structure was designed with the future expansion of two additional floors in mind. The total added area for the project exceeds 125,000 sq. ft. with over half of the building footprint constructed over the existing hospital. BCE engineers wove new structural columns through the existing hospital while keeping the existing building operational during construction. BCE engineers also provided valuable cost-estimating services throughout the design process to aid the design team in the decision making process, assuring that the project would not exceed the budget requirements set forth by the hospital. A structural steel system with concentrically braced frames and non-structural light gage steel stud walls created a flexible floor plan for future revisions to the space, and the ability to support new medical equipment from a stout structure throughout the life of the building.