Originally built in 1927, Barlow Respiratory Hospital is a 49-bed Long-Term Acute Care Hospital (LTCH) located in downtown Los Angeles adjacent to Dodger’s stadium and Chavez Ravine. In 1990 the site was named a Los Angeles Historic-Cultural Monument. The scope of work, under the jurisdiction of OSHPD, includes the installation of new fiber wrapping of existing cast-in-place concrete primarily at all exterior wall as well select locations throughout the hospital to improve the shear capacity of the structure. In addition, structural steel drag strut plate connectors are installed at strategic locations through the hospital to transfer loads from concrete slabs to shear walls. Once the structural upgrades are complete, architectural improvements, ADA, Fire Life Safety, and MEP upgrades will be incorporated into the refurbished spaces. Not only is the preservation of the existing historical building important, the entirety of the work is being performed during high census periods within an active and occupied hospital environment where communication, infection control, noise, flexible phasing, and shutdown coordination are vital to success.