Project category: New construction (completed May 2006)

Chief administrator: Marty Guthmiller, Chief Executive Officer, (712) 737-5274

Firm: HGA Architects and Engineers, (612) 758-4564

Design team: Dan Rectenwald, AIA, ACHA, NCARB, Principal; Russell Redman, AIA, Project Manager; Amy Douma, LEED AP, Project Designer; Jennifer Klund, RA, Project Architect; Rand Liedl, CID, Interior Designer (HGA Architects and Engineers); Brian Crichton, Associate Architects (CMBA Architects)

Photography: Dana Wheelock Photography

Total building area (sq. ft.): 125,000

Construction cost/sq. ft.: $178

Total construction cost (excluding land): $22,200,000


For years, Orange City Area Health System struggled with an outdated building on a landlocked, two-acre site. Several years ago, it decided it was time for a change. The result is a new, integrated replacement facility that has allowed the health system to expand and retool its operations.

Orange City and neighboring Alton, Iowa, supported the project through bonding bills and significant financial contributions. The new hospital is the story of two towns coming together—to build an investment in their future.

Even with community support, the hospital needed to improve operational efficiency to remain financially viable in the long term. Staff efficiency was crucial; travel distances were minimized where possible, driving a compact design.

Flexibility and expansion potential were also considered. Standardized exam rooms allow swing use during peak times and permit practices to grow and evolve. In addition, the building's segmented shape encourages departments to expand over time independently.

The following objectives guided the overall design: providing patient privacy and dignity, welcoming family members, connecting patients to nature and light, and conveying a sense of permanence and prominence. Most importantly, the design needed to reflect the character of the community itself, embodying its agricultural ties and unique spirituality.


Creating the right atmosphere began with the site design. The 36-acre site offers convenient access and idyllic views of the agricultural landscape. The building's curved shape helps nestle the facility into the rolling topography. A strong axis orients the building toward the site entry and provides light and views through the building's core.


Local-vernacular structures influenced material selections. The exterior is composed primarily of brick and culture stone, while the wood beams and ceiling panels in the lobby allude to the farm buildings common to the area.

The patient care unit encircles a healing garden in a quiet area of the site. Glass-enclosed family lounges overlook a pond and fertile farmland; their position at the end of corridors provides natural light throughout the patient care units.

Central to the project's design is Faith Chapel. Its unique spiraling shape draws the eye upward toward a dramatic view of the sky. Serving as a quiet respite from the hospital activity, the chapel is an appropriate expression of this deeply spiritual community.