Swedish Medical Center is inching ever closer to making a long sought dream a reality; bringing a hospital to Issaquah. This week excavation around the building site began.

However, the process has been marred by lawsuits and appeals to the state Department of Health (DOH)from several medical providers in the area, including Overlake Medical Center, to revoke the certificate giving Swedish permission to open and operate such a facility.

Swedish, which currently operates a smaller facility across from Sammamish State Park in Issaquah, has been in the planning phase for a number of years to bring a full scale hospital to the area.

But the one dark spot for Swedish, said Kevin Brown, a Swedish senior vice president, is the appeal protesting the organization’s Certificate of Need (CoN), a document issued by the DOH allowing the operation of a hospital.

During the process when Swedish was applying for the CoN, Brown said, a number of groups fought the issuance of Swedish’s certificate. Swedish’s application for the new hospital was approved in July of 2007, and at the end of 2008 the organizations fighting the CoN dropped their appeal.

Swedish thought the fight was over. But at the beginning of June this year, Overlake filed a motion in Thurston County Superior Court against the DOH asking the state to revoke Swedish’s CoN.

Overlake Medical Center has just recently opened a facility in Issaquah.

“Obviously, we have lots of concerns about that, but also we think the community will have significant concerns about using the community’s resources to defend a regional lawsuit over the CoN,” said Brown.

The real issue, said Dr. John Milne, the supervising physician and director of medical services at the Issaquah campus, revolves around some very specific wording in the original application.

“The argument being made by Overlake is that the state has not appropriately monitored us in the process of the CoN,” Milne said. “The crux of it is that when we do a CoN we have to define the address of exactly the parcels.”

Milne said that in 2004 the hospital was planned for a parcel on the east side of Highlands Drive, where master developer Port Blakely wanted the hospital to be, given the rest of the development.

“When it actually came time to purchase the ground, at the request of Port Blakely, we moved that site, approximately 200 yards to the west of where the address in the CoN is located,” Milne said.

Overlake is arguing that Swedish now needs to file amendments to change the CoN.

Milne said everyone agrees that this change needs to happen, and that it will. But the sticking point is that usually in projects like this amendments are filed in mass at the end.

“Overlake is arguing that because we haven’t filed it on the front end that the state has been negligent,” said Milne. “They are also making a number of claims that we’ve deviated from our budget for the process and they are making some assumptions based on the economy that we aren’t on budget, but we’re on budget.”

In a written statement Overlake said: “As a regional hospital with deep roots here on the Eastside, Overlake has a responsibility to ensure the Department of Health follows the hospital Certificate of Need process as it’s written and by sharing our concerns through the legal process, we are exercising our right to do so.”

Brown said part of the irritation for Swedish is that that they know the address needs to be changed, but feel Overlake is making it a bigger issue than it actually is.

“Unlike the prior challenges, this just flat out asks the state to repeal our CoN and clearly is an attempt to block development of a hospital in this market,” said Milne. He said there is some potential to slow or delay the project and creates large amounts of legal fees on both sides, which Milne said would be better utilized some where else.

“It clearly effects the way we are able to deliver patient care,” said Milne.

Swedish a little off schedule

According to Brown, ground work on the new hospital started this week partly to take advantage of the fact that another local project needed dirt, and was willing to buy it from the Swedish site. Swedish plans to open the medical office building, the first part of the project, by the beginning of July in 2011. Originally, this portion of the project was hoped to be finished by the end of 2010, said Milne, with the target of opening the in-patient portion in 2012.

He said the in-patient opening date hasn’t changed, but they discovered once the planning got going that working to integrate the two and creating a truly holistic patient center was more difficult than if there were two separate buildings, which pushed the opening dates for the buildings closer together.

The overall design of the buildings hasn’t changed, but he said they were fine tuning and making sure everything worked together in the way they wanted.

“The difficulty of building the ambulatory center is a fraction of the difficulty in building the in-patient center, as far as the layout of the rooms and the connections with services goes,” said Brown.

The first phase of the hospital is scheduled to open toward the end of the first quarter of 2012, Brown said, with 80 beds, and from there the rest of the beds, up to the max of 175 will be phased in as needed.

“We’re very excited,” said Brown. “The feedback we’ve gotten has been great, and is usually ‘Can you open sooner?’.” The facility will include a layer of underground parking below the office building and a four story hospital building, featuring all the aspects of a community hospital. The building will also be incorporating green building practices and Brown said it will be LEED certifiable, but that they aren’t going for the certificate on the wall.

“We’re trying to lead with our energy efficiency target and we think if we can do that it will be a nationally recognized feat that people will come from all over to see how we’ve done it,” said Brown. Swedish is looking to take what green practices they can make practical for the setting they are in and apply it to the new hospital.

“There are a lot of really important lessons for us to learn from the work that has been done by the people who are incorporating a significant percentage of those types of building ideas and concepts,” said Milne.

Brown said their hope is to create a highly energy efficient building which uses only 150 BTU’s per square foot. BTU stands for British Thermal Unit and is the standard measure of thermal energy. For example, Brown said, the newer tower at Evergreen Hospital in Kirkland averages between 300 and 350 BTU’s per square feet, which is impressive.

“That just shows how aggressive the goal is,” said Brown. Brown said they are working with the project’s engineers on how to make this goal a reality, but are confident that if they succeed the hospital will be an example for new hospital projects across the country.

Until Swedish hears otherwise the project is moving forward, with excavators on-site taking away dirt while the organization takes advantage of a prime construction market.