The Pikeville Medical Center, located in Pikeville, KY, engaged J.S. Held to provide project management services starting in 1998. Over the years, multiple construction projects ranging from 25,000/SF to 500,000/SF, including the completion of an 11-story medical tower, a 10 story parking garage (394,768 sf with 1,162 parking spaces), a new physical therapy building, operating room expansion, new outpatient surgery expansion, new emergency room expansion, research and development tower, cancer treatment center, two new linear accelerators, and 3 catheterization labs. We provided these services while simultaneously managing the construction and renovations of several existing facilities. J.S. Held worked collaboratively with hospital staff and the design team to develop the design of future facilities. As a result of our early involvement, J.S. Held was able to provide critical engineering ideas, optimize utilization of available space, and provide constructability reviews.