Trinity Livingston Hospital’s construction team celebrates a Topping Out Ceremony after overcoming early challenges.

The Trinity Health Livingston Hospital Expansion project team hosted a Topping Out Ceremony on Wednesday, May 22, 2024. This marked a major milestone in the progress of the $154 million project in Brighton, MI.

Project Scope

This project involves constructing a four-story, 170,000 SF addition to the outpatient hospital as well as renovating portions of the existing facility. The addition will provide 56 in-patient beds along with the following features:

  • 18 Short Stay Unit beds
  • 8 licensed Operating Rooms
  • Expanded Emergency Department services and imaging addition
  • Hospital-based medical and surgical specialty practice space alongside an Intensive Cardiac Rehabilitation Unit
  • New cafeteria
  • Shell space for future growth

Once complete in early 2026, plans call for transferring in-patient services from Trinity Health’s Howell hospital to the Brighton campus, establishing a full-service facility.

Early Construction Challenges

The Topping Out Ceremony was especially satisfying to team members at Granger Construction, Trinity Health’s Construction Management partner for this project. Not only did the event celebrate placement of the last steel beam in the building frame, but it also marked significant progress on a challenging build.

From the start, Granger knew this project would be difficult. The jobsite alone was located directly adjacent to an active 24/7 emergency department, outpatient surgery center, medical office building and cancer center. Once construction began in April of 2023, several unforeseen conditions were also unearthed during excavation, including a high water-table, unsuitable soils and incorrectly documented existing utilities. Additionally, over 2,000 pages of drawings needed to be reissued and numerous design changes were made – all of which delayed placement of structural concrete foundations and slowed the start for most earthwork and utility activities.

Additional challenges included:

  1. Relocation of primary power (switch, transformer and building backup generator) that serves the occupied building which required the team to utilize a trailer-mounted rental emergency generator throughout the remainder of the project. The existing facility generator was not able to be reused in the long term for the new facility.
  2. Relocation of natural gas service (twice), domestic water and fire suppression – all while maintaining services to a fully occupied hospital.
  3. Addition of deep 12” dewatering wells for water management was required upon finding the extent of the higher-than-anticipated water table.
  4. Undercutting 5’ under all footings and walls in 1/2 of the building to provide adequate bearing pressure for the addition’s structural design requirements.
  5. Complete resequencing of foundation flow based on the delayed release of re-steel. The structural concrete design had major changes post-buyout including extending the depth of the footing that resulted in delayed submittals that had to be resubmitted several times to capture all changes.
  6. At least five other “make ready” projects were managed by the team to facilitate the larger hospital addition project.

Successful Project management

Despite facing a myriad of early challenges, the project team worked collaboratively to problem solve and prioritize the Owner’s best interests to reach this critical construction milestone.

Known challenges were thoughtfully and painstakingly accounted for during pre-construction planning. Then, in response to substantial changes, Granger’s Construction Services Self-Perform team successfully developed an acceleration plan. This included resequencing the foundation installation to meet the original structural steel installation date while maintaining Owner-approved costs.

Trinity Livingston Hospital’s Topping Off Ceremony marked substantial completion of steel erection for this project. Ongoing work includes a small Emergency Department addition,. installation of roofing systems, exterior enclosure systems and brick. The first phase of the renovation of the existing Emergency Department was turned over and work has started in Phase II.


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