As a health system planning exercise, this project was a full course meal, “from soups to nuts”. The presentation will highlight the process and orchestration of clinical, administrative and engineering leadership to create an executable 5-year capital investment operating plan covering leases, major and minor construction, real property equipment replacements and non-recurring maintenance dollars covering a six state, 7 health system network. This five-course meal includes Campus and Facility Assessment, Service Delivery Plan (SDP), Campus and Facility Planning, Integrated Priority List (IPL) and 5-year Operating Plan to be completed over a 15-month schedule. The Service Delivery Plan, the soup, outlines the distribution of services and their capacity throughout the system’s geography as facilitated with their Integrated Clinical Communities. The Campus and Facility Assessment, the salad served with the soup, identifies the major infrastructure issues, limitations and potentials of the facilities and campuses. The campus and facility planning, main course plate 1, identifies the phased implementation of a campus vision based on the local leaderships planning priorities and requirements of the Service Delivery Plan. The IPL, the main course plate 2, consolidates the lease requirements of the service delivery plan, the infrastructure needs of the facility assessment, and the phased projects of the facility master plan. Dessert, the 5-year Operating Plan, established each health systems capital investment plan based on budgetary guidance by project type and each system 10-year IPL. The ingredients of this full course meal, starts with an understanding of the patient geography, their demographics and health care demand, assessing the infrastructure’s limitations and potentials, modeling a variety of facility and, non-facility solutions, recognizing budgetary constraints and iterating on dessert to ensure the final investment plan is palatable. The comprehensive menu of the Network and its 7 systems’ final capital investment plan highlights the need for early leadership and budgetary guidance and flexibility from the local capital asset management team. Core Competencies: Strategic Planning, Space Planning and Programming, Design, Equipment Planning AIA Course Number: 2026.03.015 AIA LU/HSW = 1 LU