This project consisted of a 5-story addition on top of the 3-story hospital, raising the building height to eight stories. The piles under the existing building were designed by LMJ for the future expansion back in 1997, but code changes required the addition of two shear towers on each end to add lateral stiffness. LMJ value engineered the original foundation design converting battered piles, which were impossible to install in the cramped space, to vertical piles using additional borings, computer analysis and lateral pile load testing.