The Nelson Harvey Building patient tower occupies a densely urban site within the heart of the Johns Hopkins Hospital campus. Ayers Saint Gross teamed with Wilmot Sanz to renovate the exterior and interior of the nine story, 33-year-old, 118,500 SF building. The innovative and sustainable approach in developing a new hybrid building envelope combining high-performance over-cladding with the existing envelope resulted in a modern design aesthetic that is energy efficient, environmentally sustainable and highly resilient. In addition to the new exterior over-cladding systems, the renovation includes new patient rooms, a first-floor lobby, main entrance, and plazas.