Benefis Health brought on DAC as lead GC/CM for this project, requiring a remodel and addition to their Emergency Department. With the constraints of an active hospital, the project had to be approached in phases. Phase 1 included construction of the new helipad, mechanical room, and mercy flight locker room. Phase 2 included the remodel of the new entrance and lobby, addition of the new ambulance garage, remodel/addition of the new trauma bay, and remodel of 9 RME rooms. Phase 3 and 4 meant remodeling the original ED department, and the construction of the patient rooms and nurse stations. The above work was all completed adjacent to an active ED department and was completed seamlessly without any disruption to critical patient care.