Utuqqanat Inaat is an eldercare addition to the existing hospital in Kotzebue. Utuqqanat Inaat was designed around the needs of elders. The project incorporated elements of the “Green House” model of care and is technically and programmatically very similar to the Quyanna Care Center expansion. Administrative spaces were pulled out of living areas to give elders the sense of their own space separate from the institutional hospital. The kitchen was planned to encourage elder participation in cooking and allow for the preparation of traditional meals. Private bedrooms surround a great room with an open kitchen and dining areas to facilitate socialization. The rooms are staggered to minimize the experience of traveling long hallways. Due to staffing limitations, the facility was attached to the existing Kotzebue Hospital instead of being built as a standalone structure. This raised the challenge of creating a homelike environment in an institutional building; great care was taken to separate service functions from residents’ living spaces. Staff can enter the Eldercare Facility without entering the main home. The interstitial spaces above and below allow access to plumbing without disruption to residents. The addition had to adapt to the conditions of Arctic construction. It was elevated on pilings to preserve the integrity of the permafrost, and a particular snowdrift analysis guided the configuration of the stairs and roof, as well as deflection details at the wall and roof.