RBGB conducted an in-depth energy and water audit of this 170,000 ft2 regional hospital, which was recently won the No. 1 Small Hospital in Georgia award. The investigation identified several minor and major efficiency improvements, including recommendations for improved sustainable facility management practices. The hospital was planning a major expansion and, as predicted through energy calculations, the hospital was able to add 25,000 ft2 of new patient care space and still have a lower annual energy bill than before the expansion. This was achieved because the hospital implemented many of the energy efficiency recommendation¬s, re-organized the operations and maintenance department and built the new addition using high performance building criteria.