Originally constructed in 1736, Bellevue Hospital Center is the oldest hospital in the United States. LERA was the structural engineer for a new 207,000-sf (19,200-sm) ambulatory care facility to accommodate the hospital’s 489,000 yearly patient and surgery visits, in addition to the consolidation of critical care units in 48,000-sf (4,500-sm) of renovated space and the remodeling of 90,000-sf (8,400-sm) of existing general care inpatient units. LERA’s innovative structural design solutions helped to create a new grand gateway to the Bellevue campus that connects the new building to the historic Administration building, transforming the venerable institution into an advanced medical center while preserving its historical significance. The soaring, 7-story atrium features a 67-ft by 175-ft skylight supported by a series of sloped bowstring truss pairs that span 67 ft from the new structure to a point that is 26 ft higher on the existing building.