This 27,000 sq. ft. diagnostic and treatment facility in rural New York is part of a 350-acre campus that serves children and adults with profound neurological and developmental impairments. The building is shaped as a rectangle, split along the long axis, to form four quadrants with two levels each. Staff and back-office areas are invisible and inaccessible to visitors and the center’s patients. At each end of the building and at its major intersections natural light emanates from double-height ceilings and window walls so that the space feels open and simple. Green building design elements, including geothermal heating and air conditioning systems, were incorporated. The project is the first healthcare facility ever awarded LEED certification in New York State.