During the past decade, Trinity Health Michigan has brought more and more services to the people of Livingston County. Now the health system will add a $238 million, acute-care hospital in Brighton to the cornucopia of health care options it offers in the area.

“We felt it was necessary to bring more services to this community,” said John O’Malley, President of Trinity Health Livingston and Trinity Health Medical Center - Brighton.

The growing area warrants additional facilities to ensure access to medical services. Livingston County gained nearly 16,000 residents from April 2010 to July 2023, resulting in a population of 196,757, according to the U.S. Census Bureau.

The nonprofit, nationwide Trinity Health system has served the Livingston community for nearly 100 years. Current services include an emergency department, imaging, and primary care. During the last 10 years, Trinity Health Livingston added specialty services, including bariatric surgery to its 66-bed hospital in Howell. The next nearest hospital is about 24 miles away.

“We brought more and more services to the community, including surgical service,” O’Malley said. “We have been able to add services to keep the Livingston County patients local, so they do not have to travel.”

The new four-story, 174,000-square-foot, acute-care facility features eight large operating rooms with robotic surgical technologies as well as 18 short-stay unit beds and 56 acuity-adaptable rooms, allowing patients to stay in the same bed as their need for intensive care or a lower level of care changes.

“The universal beds allow the patient not to move around to get care,” O’Malley said. “We can provide the same level of care where they are located, which minimizes mistakes.”

The project also includes shell space, an intensive cardiac rehabilitation area, imaging on the first floor, specialty practice space, and a full basement. The new structure connects on the first two levels with the existing building.

The hospital will open as a level 4 trauma center with a goal of becoming a level 3 trauma center. O’Malley predicts that the facility’s intensive care will become elevated to care for critically ill patients while allowing those patients to remain in their own community.

The existing outpatient building, called Trinity Health Medical Center - Brighton, will receive 45,000 square feet in renovations on multiple floors. The emergency department and outpatient laboratory will be expanded and renovated. Imaging service also will receive an upgrade, with in-house magnetic resonance imaging (MRI) and CT.

“There is a lot of innovation added to the existing facility,” O’Malley said.

Bonds and donations have funded this project.

Trinity hired family-owned and -operated Granger Construction of Lansing, Michigan, as the construction manager. SmithGroup of Detroit serves as the architect, and IMEG of Farmington Hills, Michigan, serves as the engineering firm for the new hospital. The team has used building information modeling (BIM) for the project to minimize field impacts related to cost and schedule. Construction began in April 2022.

In using BIM, Granger is able to prefabricate portions of the mechanical and electrical work, providing a faster and safer approach with less work on ladders or lifts. Granger embraces new technologies to maximize efficiency.

Before Granger could begin construction of the new hospital, much work needed to take place to relocate the existing employee parking lot, loading dock, mobile MRI, electrical generator, and numerous utilities. The team moved the temporary loading dock and MRI trailer to the front of the existing medical building. Crews also built a new parking lot.

“For the complexity of the nature of the existing equipment, utilities, and departments that had to be rerouted and relocated in order for Granger to even start excavation for a new building, we had a lot of challenges,” said Tiffany Spano, Senior Project Manager for Planning, Design, and Construction for Trinity Health Michigan. “The most intricate part was the phasing.”

Spano praised Granger’s value engineering ideas, as saving money is not the only objective. “We wanted to leave a well-built, manageable building,” said Ryan Snellenberger, Superintendent with Granger.

Those value engineering ideas included combining mechanical systems and the steam plant. Granger also found ways to temporarily use existing mechanical equipment, specifically chillers, to avoid renting that equipment. Soil engineers weighed in on seismic bracing and came up with other determinations. The team also looked at alternative manufacturers for chilled water piping. Spano said that the ideas have been on going and will continue in order to assist with current project budget constraints.

“We relocated every public utility that serves the existing facility, while maintaining all operations,” Snellenberger said. “They did not have to cut or scale back any services.”

Granger had to move the only water source serving the existing facility. Crews installed a new water supply as well as storm and sanitary infrastructure around the exterior of the basement.

“It was quite the logistical puzzle to put together,” Snellenberger said. “We came up with an idea of back feeding the building from an alternative water source, not the typical source. We reversed the flow of water and were able to do smaller shutdowns, with disruptions that were less noticeable. We never left the facility for a period of time where they had no water.”

Subcontractor Eagle Excavation of Flint, Michigan, excavated and then graded the building without incident. Crews installed a tangent earth retention system on the new building’s south side to protect the existing building’s slab-on-grade foundation. The new structure sits about 32 feet to the north of the existing building. The lower level will house facilities management, central supply, the loading dock, and other back-of-house departments.

Foundation work began in July 2023. The first-floor imaging department will sit on a slab-on-deck and connect with the existing imaging department in the original building.

Granger used a new product for back fill, called Elastizell Engineered Fill. The cementitious material has a typical density of 25 pounds per cubic foot and weighs about one quarter of compacted soil, yet it is stronger.

“This allowed us to backfill ahead of pouring slab on deck, required structurally, helping us advance our exterior enclosure schedule,” Spano said.

Crews began erecting steel in October 2023, with the final beams installed earlier this year. Granger now is working on the glass and masonry exterior. The building has a traditional roof.

“As with any construction project, when you tie in a new structure to existing it presents challenges,” Spano said. “As-built conditions may not be 100 percent accurate; therefore, presenting the potential for added cost and schedule implications. Additionally, the initial design was centralized electrical — for normal and emergency power — within the new building, which presented its own challenge in trying to maintain operation for a 24/7 Emergency Department. With the help of Granger, Centerline Electric, and IMEG, we have modified this plan to alleviate any ‘blackout’ in which we cannot take care of our community.”

“There has been significant planning and thinking about the cause and effect with these efforts,” Snellenberger added.

The project was about 40 percent complete as of the writing of this article. Most work takes place during daytime hours.

“We want to deliver the project on time and under budget, and be the preferred health care provider in Livingstone County,” Snellenberger said.

The health system anticipates opening the new hospital in 2026. Spano said she expects the new hospital will be “huge for the community,” because all services will be located at the same place.

“We will continue to grow and add new services,” O’Malley said. “We want to be a full-service community hospital.”