The existing facility at Jackson Memorial Hospital comprises a 3-story medical building. Part of the footprint, which was constructed circa 1995, was designed to accommodate future vertical expansion. The building consists of concrete columns supporting flat concrete slabs with 4-inch drop panels, supported by pile foundations. An expansion joint runs north-south through the building, which from a structural point of view means that we have two separate buildings. A structural study was performed to analyze the existing structure and maximize the number of levels that can be achieved in the vertical expansion. From the results of that study we determined that we can add two full levels and a third partial level to the east portion of the project. Three full levels can be added to the west portion due to that part of the building not having a basement level.