MarinHealth is a health system with a 235-bed tertiary care hospital that includes a Level III trauma center, emergency department, and labor and delivery unit. The system engaged ECG to develop an updated enterprise-level strategic plan in FY 2021 following the expense of a $500 million patient tower needed for seismic compliance, greater-than-expected operating pressures in FY 2019, and weak operating performance leading up to the coronavirus pandemic.