Mercy West is a 250-bed hospital located in Cincinnati, Ohio. During the latter stages of the project, the builder’s risk insurance carrier expressed concerns regarding particulate contamination of the HVAC system during construction. In lieu of performing duct cleaning, which would require the installation of several access points in the supply and return duct system, the Hospital chose to conduct an IAQ assessment at the completion of construction activities and prior to building occupancy. L&A reviewed mechanical and architectural drawings to develop a representative sampling plan for the facility. Based on building size and configuration, there were eighty one (81) sample locations. The sampling approach was tailored to evaluate contaminants that are frequently of concern in a newly constructed facility (ventilation parameters, airborne particulate, mold, volatile organic compounds and formaldehyde) but also those (Aspergillus) that are important from an environmental infection control perspective. L&A was also responsible for documenting the condition and placement of HVAC filters in all thirteen air handling units. Data obtained during the assessment indicated all IAQ parameters were within acceptable limits for patient and occupant safety, and that particulate accumulation concerns that arose during the latter stages of construction did not negatively impact the condition of ventilation components or affect the air quality within the occupied space. These findings satisfied concerns of all parties and duct cleaning was not required. The comprehensive report was further utilized to document measures taken to ensure an acceptable Environment of Care to the Joint Commission (JCAHO).