Swedish Medical Center targets Issaquah for emergency room, hospital

Swedish Medical Center is planning a major expansion into Issaquah — first with a stand-alone emergency room and later with a 175-bed hospital.

The Seattle-based nonprofit announced its plans yesterday after quietly researching Eastside expansion options for three years. A new general hospital would be the first to be built in King County since 1985 and would reverse a wider trend of hospital consolidation and cutbacks.

Swedish hopes to open the emergency room by February. It is close to finalizing a deal to lease a 55,000-square-foot building near Interstate 90 and Highway 900, said Swedish vice president Kevin Brown, who is heading the expansion.

Swedish expects it will take much longer, perhaps seven years, to gain approval for the hospital from state and local authorities and complete construction.

Swedish plans to spend between $16 million and $20 million on the emergency room and in excess of $100 million building the hospital.

Brown said Swedish is already the third-largest hospital provider to Eastside patients, many of whom would prefer not to travel across Lake Washington. Almost one-third of Swedish doctors live or practice on the rapidly growing Eastside, he added.

"We wanted to get as close to the patients as possible," Brown said. "We are very excited about it."

A free-standing emergency room would be the first of its kind in the state. Emergency rooms are usually attached to hospitals, but Swedish officials believe the idea of a stand-alone unit will catch on in Issaquah.

Issaquah Mayor Ava Frisinger said both developments would be welcome.

"Having a 24-hour ER I think would be very beneficial," she said. "There are a number of accidents on I-90, and it would be good for people to get help quickly and be brought to a place where they can be stabilized and transferred elsewhere."

After researching other stand-alone rooms around the country, Swedish found that 90 percent of patients can be treated on-site and sent home, Brown said. The emergency room will have CT and MRI scanning technology. Patients with more serious conditions will be transferred to Swedish hospitals, he said, or to outside hospitals if they prefer.

The emergency room will be open 24 hours a day and will accept all patients regardless of health-insurance status, Brown said. It will have about 75 physicians and other staff. Swedish expects 15,000 patients in the first year, rising to 30,000 annually soon after, he said.

Swedish needs to do more research before deciding what specialty services the hospital will provide, Brown said. No site has been chosen, and it has not been decided whether the emergency room would be combined with the new hospital.

The move is bound to fuel a rivalry between Swedish, the state's largest hospital provider, and Overlake Hospital Medical Center in Bellevue, the Eastside's largest hospital.

Overlake had begun applying with state authorities to open a 30-bed satellite hospital in Issaquah but let the application lapse in 2002. Since then, the hospital has opened two women's clinics in Issaquah and has more medical services planned for the area. It still has plans for the satellite hospital.

In November, Overlake surprised many industry watchers by beating Swedish in a race to secure a partnership with Group Health Cooperative, which had decided to shut down its Eastside Hospital in Redmond. Under the arrangement, Group Health patients will begin getting care at Overlake by 2007.

Overlake CEO Ken Graham predicted state authorities would look carefully at Swedish's ambitions, a process Overlake would likely be involved with. With the Group Health deal, Overlake will be responsible for 63 percent of overnight patients in Issaquah and neighboring Sammamish, he said.

"I just think Overlake has an extremely strong position in the community," Graham said. "If Swedish wants to join in, it's up to them."

Spokeswomen from Evergreen Hospital Medical Center in Kirkland and Valley Medical Center in Renton said Issaquah was outside their core service areas. Swedish plans to operate the emergency room under its existing licenses and does not need further approval. But to open a hospital, it will need to convince the state Department of Health that the beds are needed — a process that, with appeals, often takes two years or more.

Janis Sigman, who runs the state's certificate of need program, said the state requires that four criteria be fulfilled:

• There must be a need for the services that is not being fulfilled at other nearby hospitals.

• There must be a financially feasible plan.

• There must be adequate quality of care.

• There must be no cheaper way for patients to get the care.

Washington has 95 community general hospitals, 58 of which take fewer than 100 patients. The last general hospital to open in King County was St. Francis Hospital in Federal Way.

The number of hospital beds available in the state per 1,000 residents dropped from 2.5 in 1992 to 1.9 in 2001 — well below the national average of 2.9 that year — according to state Hospital Association figures.

Last year, Swedish's operating margin was $27 million on a net revenue of $893 million. Swedish has a total of 1,245 beds at three hospitals: Swedish/First Hill 697; Swedish/Providence 385; Swedish/Ballard 163.

Staff reporter Carol M. Ostrom contributed to this report.

Nick Perry: 206-515-5639 or nperry@seattletimes.com