Strategic Growth Plan Statement of Facts

Hospital Capacity

Inpatient and intensive care hospital bed capacity is currently inadequate in our region.

• Washington state is ranked 51st among all states and the District of Columbia for hospital bed capacity per 1,000 people. (1)
• In February 2022, the UW Medicine system warned that capacity was virtually maxed out across all four campuses.
• In July 2022, multiple Washington state hospital administrators reported their facilities were over capacity. (2)
• In August 2022, Harborview, the state's only level 1 trauma center, had to divert patients to other hospitals due to 130% occupancy with patient beds in hallways, offices and conference rooms.
• When a hospital is overcrowded, the whole system backs up such that patient wait times for care in its emergency department go up significantly, and elective surgeries are cancelled. Inpatient surgeries are also delayed until beds become available.

EvergreenHealth does not have enough hospital beds today.

• District voters approved a levy to fund construction of EvergreenHealth's eight story Silver hospital building in 2004. Since it opened in 2007, EvergreenHealth's in-patient days have increased 71%.
• Since 2007, surgeries at EvergreenHealth have increased by 30%.
• In 2022, the hospital was above optimal occupancy 98% of the time.
• In 2023 year-to-date, the occupancy rate has been above optimal 100% of the time.

Yet the public hospital district population continues to grow.

• Since the Silver Building opened in 2007, the public hospital district population has grown by 27%. (3)
• The district population will grow another 12% to reach 386,176 residents in 2037. (4)
• Adults over 65 years old need more care. That population in the district will grow 19% just in the next four years. (5)

In summary, patient access to healthcare in our region is challenging today and will increasingly constrict.

• In addition to being able to provide enough typical acute care, the Eastside must be ready for another pandemic, earthquake or other mass casualty event.
• Most hospital facilities in the city of Seattle are out of room to expand. They cannot be counted on to support overflow.
• Half of health care systems in Washington are affiliated with religious organizations, which restrict services based on religious protocols.

Response to the District's Needs

EvergreenHealth is in a unique position to provide more hospital bed capacity through expansion on its existing main campus, thereby leveraging access to the spectrum of services and specialists already in place.

• A Certificate of Need (CON) from the Department of Health is required to increase the number of licensed acute care beds. CON filings suggest that EvergreenHealth is the only local non-religious community healthcare system proposing to add inpatient beds in the region. (6)

Our strategic growth plan will serve the community for the next 25 years and relies on multiple sources of funding. (7)

• In addition to the featured project (North Building), the strategic growth plan includes development of outpatient surgical capabilities and medical office space, and cardiac lab expansion in the hospital.
• EvergreenHealth could fund its campus development in a number of different ways potentially including revenue bonds, philanthropy, third-party development, and an unlimited tax general obligation (UTGO) bond levy.

Priorities for the Strategic Growth Plan will efficiently increase hospital capacity.

1. North Building – The North Building is the featured element of our strategic growth plan. This facility will expand inpatient capacity in a new 8-10 story building to replace the original Red Building. Upon full occupancy, this could support 5-7 inpatient care units, 2-3 floors of ancillary and support space and additional underground parking. Medical/surgical, critical care, pediatric, behavioral health, and observation care are likely areas of expansion. Ancillary support would include lab, pharmacy, diagnostic imaging, and staff training space among others. The initial building construction is estimated to yield completion of 5 floors leaving 3 or more floors for future development based on community needs.
2. Surgery Center expansion (2-Silver) – The only remaining unfinished space in the Silver Building is the second floor. This level was designed to support surgical/procedural space and features a higher floor- to-ceiling clearance. With bond proceeds, we would build out inpatient/outpatient surgical space to accommodate growth, the need for larger surgical suites, and to modernize equipment.
3. Evergreen Surgery Center (ESC) renovation – This component would renovate the existing ESC space with 6 larger surgical suites and procedure rooms for an array of specialty surgeries. With the movement of more complex surgical cases to the outpatient environment, ESC would feature as the hospital's multi-specialty outpatient surgical center.
4. Parking – In addition to underground parking for the North Building, the plan includes an expansion of the Central parking garage. While this would add parking capacity for the campus, it would also provide important seismic stability to the existing garage.
5. Seismic resiliency – Removal of the existing 1980's emergency department and critical care addition will alleviate the campus of the most seismically at-risk building. The movement of patient care and acute care support services out of the original buildings (Green and Purple) into a new building that meets the requirements for immediate occupancy after a seismic event is a significant step in making the campus more resilient.

1. Kaiser Family Foundation, 2021 data.
2. King5 news report.
3. King County population data.
4. ESRI & Office of Financial Management.
5. ESRI & Office of Financial Management.
6. Washington state Dept. of Health.
7. NBBJ architectural draft plan.