Filings · Replacement hospitals
Replacement hospitals usually get more floor space and fewer beds than the buildings they retire
In filings that describe both buildings, the new hospital was larger in 8 of 11 and had fewer beds in 10 of 15. A small sample, from 94 replacement filings in the Delgam database.
· State and local filings in the Delgam database; Medicare cost reports
When a hospital's building wears out, it can renovate or start over. Delgam's database holds 94 filings for replacement hospitals, covering 72 projects in 25 states, from certificate of need applications to environmental reviews. Read one by one, 45 replace a whole civilian hospital. The rest replace one tower or wing, merge two hospitals into one, or replace a veterans or military hospital.
72 replacement projects in the Delgam database
One square per project, by what the filing describes. Hover or tap for the project; click for its filing.
- A whole hospital replaced 45
- A whole federal hospital (veterans, military) 6
- One new hospital for two or more 6
- One tower, wing or unit 12
- Campus plan or outpatient center 3
Source: State and local filings in the Delgam database, sorted by hand.
More room
Few filings describe the building they replace as carefully as the new one. 11 state the old hospital's floor area next to the new hospital's. In eight of them the new building is larger; in two it is about the same; in one, smaller. The median replacement has 19% more floor area than the building it retires.
The old hospital and its replacement, floor area as each filing states it
Square areas are to scale across all 11 projects. Ordered from the largest increase.
- Old hospital
- Replacement
Source: State and local filings in the Delgam database. Gross square feet, except where a filing uses another area measure (see the notes).
Fewer beds
Beds go the other way. Of 15 filings that give both counts, 10 plan fewer beds than the old hospital had, three the same and two more. Together they go from 2,702 beds to 1,723. One possible reason: an old hospital can carry licensed beds it no longer staffs. The filings rarely say.
Beds in the old hospital and in its replacement
15 filings that state both. Hollow: old; filled: replacement.
- Old hospital
- Replacement
Source: State and local filings in the Delgam database. Filings usually count licensed beds.
More space and fewer beds mean much more space per bed. In the seven filings that give both figures for both buildings, the median goes from 1,536 square feet per bed to 2,457, and it rises in six of the seven.
Square feet per bed, old hospital and replacement
The seven filings that give area and beds for both buildings.
- Old hospital
- Replacement
Source: State and local filings in the Delgam database.
Not bigger than hospitals already are
Large as the jump looks, the new buildings are not unusual. Set each planned replacement against the 2023 cost reports of general hospitals with the same number of beds, and the median plan, 2,500 square feet per bed, is 0.98 times the typical existing hospital of its size. 10 of 23 plans are above that typical figure, and none is above the top tenth. By the same measure the old buildings were cramped: a median 1,536 square feet per bed, in the seven filings that give it.
Why not measure the old building with its cost reports? Because a cost report counts every building a hospital reports, offices and clinics included. Where a filing also states the old hospital's own area, the cost report's figure was more than 20% larger in four of eight. For the cost of these buildings, see construction cost.
How these figures were made
- Replacement hospitals in public filings, set against the hospital they replace, as the filing describes it and as its Medicare cost reports measured it. Counted: whole-hospital replacements at civilian hospitals filed from 2000 on, 44 projects.
- Only 11 filings state the old hospital's floor area next to the new one's, and 15 its beds; the medians rest on these few.
- A cost report counts every building a hospital reports. Where a filing also gives the old hospital's area, the cost report's figure was more than 20% larger in 4 of 8.
- Filings are plans: areas and beds can change before a hospital opens, and filings give no opening dates.
- Beds in filings are usually licensed beds; cost reports count beds available.
- One filing per project, the most complete. Projects were sorted into kinds by reading each filing's description. Some figures come from research notes on a filing rather than its tables.
| Hospital | Old | Replacement |
|---|---|---|
| Highland Community Hospital, MS | 65,000 | 199,162 |
| Kaiser Permanente San Jose Medical Center, CA | 250,000 | 685,000 |
| Chinese Hospital, CA | 41,230 | 90,000 |
| Kaiser Permanente San Francisco Medical Center, CA | 367,000 | 694,012 |
| Quincy Valley Medical Center, WA | 35,000 | 49,500 |
| St. Luke's Hospital (California Pacific Medical Center), CA | 197,983 | 235,690 |
| Samaritan Hospital, WA | 145,000 | 172,000 |
| University of Maryland Shore Medical Center at Easton, MD | 366,066 | 407,872 |
| Stonewall Jackson Memorial Hospital, WV | 80,819 | 83,000 |
| King's Daughters Hospital, MS | 86,000 | 86,000 |
| Taylorville Memorial Hospital, IL | 117,897 | 95,299 |