Built with 2,670 tons of steel and 16,500 cubic yards of concrete, the new Sutter Medical Center rising next to Highway 101 promises to change the landscape of health care in Sonoma County.
The two-story, $284 million building - Sonoma County's first new hospital in more than 20 years - will be anchored by a foundation extending 10 feet into the ground, designed to hold the building rock steady in the event of an earthquake.
The sleek structure will replace the former Community Hospital, parts of it 76 years old and built near a major earthquake fault line.
But it also puts Sutter on a firmer footing for the ongoing battle by three health care giants for about $800 million a year in patient revenue. That's twice the value of county's wine grapes.
Sutter Medical Center and Santa Rosa Memorial Hospital, both part of large health care organizations, are up against the behemoth, Kaiser Permanente's Santa Rosa Medical Center, which dominates the marketplace with 144,500 members.
The county's four smaller hospitals - in Petaluma, Sebastopol, Sonoma and Healdsburg - have affiliated with larger partners to share resources and survive amid rising costs.
"It's a competitive marketplace," said Todd Salnas, chief operating officer at 278-bed Santa Rosa Memorial Hospital. "Everybody has a partner."
Judy Coffey, senior vice president at 173-bed Kaiser Medical Center, said it's a "healthy competition" that will continue.
Each of the three heavyweights is part of a nonprofit health care chain:
Kaiser Permanente, founded in 1945, serves 8.9 million members at 36 hospitals in California, eight other states and the District of Columbia, with operating revenue of $44.2 billion in 2010.
Sutter Health, founded in 1981, operates 20 hospitals in Northern California, plus one in Hawaii, with patient services revenue of $7.9 billion in 2010.
St. Joseph Health System, which traces its roots back 100 years, operates 14 hospitals, including Santa Rosa Memorial and Petaluma Valley, with revenues of $4.3 billion in 2010.
Sonoma Valley Hospital and Palm Drive Hospital in Sebastopol are affiliated with Marin General Hospital. Healdsburg District Hospital is affiliated with Santa Rosa Memorial Hospital.
Kaiser, Memorial and Sutter are the first, second and fourth largest private-sector employers in the county, respectively.
Faced with declining patient levels five years ago, Sutter announced plans to close the aging Chanate Road facility and transfer to Memorial its contract with Sonoma County for indigent care. The transfer did not work out and Sutter, in a dramatic reversal, revived its plan to build a new 82-bed hospital next to the Wells Fargo Center for the Arts.
Next month, after more than a year of preparatory work, steel girders will begin rising from the 25-acre site. The exterior of the 183,000-square-foot hospital exterior will be completed by year's end.
The project is on budget and on time, and "it will stay that way," said Tom Minard, Sutter Health senior construction project manager.
The construction project will create more than 1,500 jobs, according to Sutter. Due to open for patients in October, 2014, the hospital will enable Sutter to deliver what Mike Purvis, chief administrative officer, calls "21st-century, patient-centered care."
Each of the 82 single-bed patient rooms will be equipped with a full bathroom, a 32-inch, high-definition TV and power-operated window blinds between layers of glass. They will feature a clinical zone for caregivers to work on one side of the bed and a family zone, equipped with a sleeper chair, on the other side.
The earth-tone walls and views of the surrounding hills are appealing, but the focus is on efficiency, Purvis said.
For example, the hospital will include a 24-bed Universal Care Unit located next to the emergency and surgery departments. Those beds will temporarily hold patients who need to be evaluated or to await test results following surgical or emergency treatment, thus avoiding being admitted to a regular bed.
Getting people home without a hospital admission lowers the cost of care, a major mandate for the health care industry, Purvis said.
Kaiser and Memorial also are investing millions in their facilities.
Kaiser added a $233 million tower to the hospital on Bicentennial Way in 2010. It included 56 beds - all in private rooms - and doubled the size of the emergency department and intensive care unit.
The fifth story, left an empty shell, can add 24 more beds if needed.
"We aspire to be the role model for how health care is delivered," said Kirk Pappas, Kaiser's physician in chief.
Kaiser is the nation's first and largest integrated health care organization, combining physicians and other providers with hospitals and insurance.
Most other physicians operate in a fee-for-service system, which Pappas contends is "broken" because it "doesn't drive quality outcomes."
Despite the economic slump and local job losses, Kaiser Santa Rosa gained 3,000 new members last year.
Memorial Hospital on Montgomery Drive next month will begin a $15 million expansion of its emergency room, which is the region's designated trauma center and treats an average of 100 patients a day.
Scheduled for completion in early 2014, the project will expand the ER from 9,000 to 13,000 square feet and add seven beds for a total of 26.
Memorial's "market niche" is to provide trauma and cardiac care services for the "sickest of the sick," said Gary Greensweig, chief medical officer.
The Catholic hospital also takes pride in a wide range of community services, mostly for the elderly and underprivileged, with an investment of $42.6 million in the past year.
But no one is offering assurances that Sonoma County will continue to support three major hospitals.
"I don't think I can predict that," said Memorial's Salnas. But the St. Joseph Health System "will continue to be here, carrying out our mission and taking care of those who need care in our community," he said.
Purvis offered a similar assessment: "I do know that we need Sutter."
And Kaiser officials say their integrated system and emphasis on prevention will stand up over time.
"It has been around here for 60 years," Pappas said. "It's in our DNA."
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