I was sent this picture and had a discussion with someone in the industry today and wanted to look for some additional opinions.
***Disclaimer: We know that they connected the outlet piping to the relief vent and that needs to change**

Here's the basic scenario:

1)Line feeding from the Cryogenic Fluid Central Supply System is 4" copper at 95 Psi

2)Vertical 2" line just before regulators feeds the Hyperbaric
3)Regulators will reduce pressure from 95 Psi to 53 Psi feeding 3" main line to the building. Bed tower is about 550 beds, 60+ ED Bays and 15+ OR's

So, other than the relief vent/outlet piping what are the thoughts?

My main concern looking at it is the power curve and rated output on the installed regulators being substantially lower than the rated output out at the CFCSS. 

I agree with Bob‘s statement. The dual line regulator system for a 500 bed hospital is definitely too small.

Here is a picture of what we typically provide when a second set of final line regulators is needed inside of a hospital facility, downstream of the bulk oxygen source.  It is a good bit more robust than what you had pictured, the one in this picture is serving a 400 bed facility.  The regulators have 1" NPT inlet and outlet ports.  These are the same as the final line regulators (balanced design) used on a lot of final line bulk oxygen manifolds.  This picture was taken prior to final verification so pay no attention to the valve positions.