As a visual amenity accessed only for maintenance, the green roof is seen primarily from above. Consequently, the design emphasizes pattern, color, and landform. With a goal of creating interest for onlookers that changes over time (daily for short term patients, weekly for long-term patients, and monthly for staff), the design deploys landform-driven shadow, windblown ornamental grasses, and plant material with bold seasonal color.

Studio Sustena drew inspiration for the green roof’s “Riverscape” layout from Charlottesville’s meandering river and adjacent mountains and agricultural fields. The river itself is constructed with recycled blue glass aggregate. 100% of the water used to irrigate the green roof is supplied by harvesting condensate from the HVAC system.