As a couple people have said, make really short stacks of elevators. And forget the staff elevators altogether. Stupid customers would rather take an elevator up 5 floors, get off, get on another, and repeat that 7 times rather than wait for one for 2 min. If you build elevators like that you'll be 5 stars in no time even with just enough rooms/laundries/receptions and one of every other type of building.
I'm surprised this game isn't rated higher actually. I can be stingy with my 5/5's but this game is unique, polished, re-playable, and fun. This is the best game I've seen in this genre hands down!
Wooot!! Badges!!! For those that get stuck at the start of the game, go to the "Medical school" and click on the different tabs to see the different courses. When you run out of cash, click on the little chart above the bed to get a patient to try and diagnose to earn money. Click the book to diagnose. I know it gets a bit grindy in the latter part of the game but I'm working on that for Med school 2!
This game was really a "proof of concept" for me. I was really hoping it would get some badges! I had big plans to add to the game, add features, and make it less of a grind in the higher levels. I got a bit discouraged though when Kongregate deemed it not badge worthy =(. Some day I'll rekindle my love for it and start making MS2 but no current plans for it yet. I really appreciate everyone's support though!