Stronghold Engineering recently completed the $52 million design-build renovation and sustainable alteration of building systems that covered 506,700-SF at Building 1H, Nursing Tower P-1, and Nursing Tower R-1 at Balboa Naval Medical Center. This meticulously developed renovation involved the latest technology and infection control procedures as well as complex phasing to an occupied medical facility. All phases were planned around existing and ongoing hospital operations. We did not access any area or department until thorough preplanning was completed and approved, which included provision of notifications for work. Whenever possible, we scheduled work during off-hours and weekends to minimize our impact to the Medical Center’s operations. This project was a huge success with an EXCEPTIONAL CCASS rating and over 238,000 man-hours with no lost time.