To better serve the outpatient surgery needs of surrounding communities, Mercy Fort Smith planned a new orthopedic hospital addition to its River Valley Orthopedic campus in Fort Smith, Arkansas. The new Mercy Orthopedic Hospital consists of a two-story, 90,000 square-foot medical facility with a surgery center, outpatient rehabilitation clinic, therapy facilities, and patient rooms for surgery recovery. Hawkins-Weir was selected to design the civil-site improvements associated with the new construction, as well as improvements to existing storm drainage, utilities, and access infrastructure around the other existing campus buildings. Preliminary planning efforts included preparation of an ALTA boundary survey, conditional use permit application, and a zoning variance request. Site design included onsite utility relocations and improvements, site grading and storm drainage improvements, stormwater detention and water quality features to reduce transport of sediment, and asphalt and concrete parking lot improvements.