May 1st, the Washington State Department of Health will rule on the Certificate of Need (CON); whether or not CHI closes hospital operations in Bremerton and moves all services to Silverdale. CHI will invest $680 million to expand campus size and build a state-of-the-art facility; they will save $9 million annually in improved efficiency. It will take just 75.5 years to recoup the cost.

To put the size and expense of this project into perspective, Becker’s Hospital Review compiled a list of the most expensive hospital expansion projects in the nation for 2016. CHI is listed at number 13 because the cost prediction was initially $530 million; however, expenditures are now predicted at $680 million, bringing CHI up to the 6th most expensive project in the United States.

Reviewing the list of the top 20 carefully, a few trends emerge. Most expansion projects involve demolishing aging facilities and building new structures with more beds, private rooms, ER bays, and goals of enhancing the “hospital” experience. NOT ONE other hospital expansion involved closing the doors and walking away from an “aging” structure, leaving it empty, and never looking back.

The “aging” facility in Bremerton has an assessed value of $72 million and a property tax bill of approximately $950,000, from which CHI is currently exempted, as they provide charitable care to the uninsured. The whole idea of exempting nonprofits from paying taxes is based on the belief these entities provide charity for the underserved and underinsured and value the facilities in which they provide healthcare for communities. This will no longer be the arrangement for CHI and the City of Bremerton.

Hospital bed availabilities are expressed in number of beds/1,000 population. According to the Kaiser Foundation, Washington and Oregon are the two lowest states in the nation with bed ratios at 1.7 bed/1000 population. After the 6thmost expensive hospital expansion project in the United States is complete, Kitsap County will have a mere 1.3 beds/1,000 population. The expansion does nothing to help this important disparity in our region, which is considerably underserved.

The most expensive hospital expansion of 2016 is at Jackson Health in Miami, Florida which will spend $1.8 billion for new facilities and adding 20 beds. That works out to $90 million/bed. Florida has 2.6 beds/1,000 population, twice that of Kitsap County. The most frugal expansion being completed is at the University of Virginia Medical Center, adding 80 beds for $394 million, which works out to $4.9 million/bed. Virginia has 2.1 beds/1,000 populations.

At both Harrison Hospital campuses, there are currently 347 beds, 24 of which are NICU designated. Once the $680 million expansion project is complete, the final bed tally will be 350 beds. Kitsap County will gain 3 beds for the 680 million dollar expenditure, which is about $225 million per bed in cost.

There are THREE core issues with walking away from the hospital facility in Bremerton: 1) no charity care will be provided in exchange for the generous tax exemption of almost $1 million provided by the City each year and 2) there has been no definitive provision for emergent, urgent, and primary care for the populace within the city limits and 3) the aging facility on 7 acres of unusable land being vacated and leaving environmental hazards such as asbestos and legionella with no plans for its future.

To look from another angle, we should ask what Kitsap County is gaining from this $680 million expansion? All services will be in one place.