Master planning efforts for the replacement of twenty (20) air handling units at The University of Kansas Hospital (TUKH), a world-class academic medical center. Generally, the units requiring replacement serve critical spaces that must remain functional, such as operatory and imaging suites, requiring strategic approaches to minimize outages and downtime. Our efforts will provide TUKH with a long-term plan extending over 10 years for a systematic, yearly upgrade of air handling units and associated components. In addition, we evaluated code required airflow, building load and life cycle cost analysis, anticipated maintenance schedules and budgets. In addition, hot and cold deck distribution is prevalent throughout the hospital. Our efforts involved providing new distribution strategies and efforts to convert these systems to primary supply and return with hot water reheat. Moving forward, this plan will provide a roadmap to modernize Bell Hospital.