At the outset of this 40-bed rural replacement hospital project, the Health Care Authority made emphatically clear that NO cost could be added to the project. With this direction, we worked with the design team and owner to generate a Potential Cost Savings Plan (PCSP) to help offset possible changes. Cost-savings ideas were immediately incorporated, which created an owner contingency. Some redesign also occurred – upgrades to finishes, revised room layouts, added vestibules, multiple changes to low voltage and security systems and additional medical gas outlets. In many of these cases, the revisions required changes to in-wall electrical and plumbing, which needed to be carefully coordinated to avoid rework and minimize impact to the schedule. The changes were all financed by our PCSP. As a result of these efforts, we returned over $400,000 to the owner early enough to allow them to reinvest it back into the project. The final cost still came in below the initial budget.