Frequently Asked Questions

San Francisco General Hospital Rebuild

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1.         Why do we need to rebuild?
State law requires that all acute care hospitals meet the highest seismic safety standards or face closure in 2013.  San Francisco General Hospital and Trauma Center (SFGH) has concluded that the safest, most cost-efficient and least disruptive way to comply with the state law is to build a new structure that will meet the standards that will be in effect by 2030.

2.         What happens if we don’t build a new hospital?
If San Francisco does not meet the state-mandated goals, SFGH will face closure by 2013. Because most of our patients are uninsured or covered by MediCal, the 98,000 adult and pediatric patients who seek the hospital’s 24-hour emergency, urgent and non-urgent services every year will likely have nowhere else to go. In addition, SFGH operates the only Trauma Center for all San Franciscans. There is no other San Francisco hospital with the ability to treat these critical and often life-threatening cases.

3.         Where will the new hospital be built?
The new hospital will be located on the West Lawn of the campus on Potrero Avenue. It will be seven stories high, with two stories below ground.  The new building will be curved to allow for the best patient care inside and a graceful design on the outside. It will also incorporate environmentally sensitive design principles to bring it to a LEED certification level of Silver or better.

4.         How much will it cost?
Current estimates for the new building indicate that the new hospital will cost at least $800 million.  That cost is consistent with the cost of other hospital rebuilds in the Bay Area.  SFGH will have a more precise estimate of the costs by the summer of 2008.

5.         How will the city pay for it?
The Mayor will ask the Board of Supervisors to place a General Obligation Bond measure before voters in November 2008 to pay for the design and construction costs of the project.  Operating costs will continue to be paid for out of the city’s budget.

6.         When will construction take place?
If the voters approve a General Obligation Bond in November, initial site work will begin in 2009. Construction of the hospital will begin in 2010 and will be completed by 2015. 

7.         How good are the cost estimates, given that Laguna Honda is now more expensive than originally estimated?
The Laguna Honda bond measure was passed before design, environmental review, programming and other significant work was initiated.  Construction did not begin until five years after the bond measure – years in which construction costs skyrocketed.  With the SFGH Rebuild, the City invested $25 million up-front to do the crucial programming, environmental, and design development work before proposing a bond measure.  Work will begin shortly after the passage of the Bond, minimizing the risk of future inflation.  In addition, the project is utilizing “Design Assist” project delivery, in which subcontractors provide input to early design work, thus avoiding other cost problems later on.  This is a best-practices approach to construction management that the City has never utilized before.

8.         Will the new hospital be able to care for more patients?
SFGH has studied future health care needs to ensure that we are building the right hospital for San Franciscans over the next 30 years. The current hospital operates at 95% or greater capacity (as opposed to 80% or less for private hospitals), which does not allow for the best patient care or for spikes in the number of patients needing care. Our studies show that health care delivery in the future requires more space than we have in our current facility to accommodate the greater use of equipment, expand the emergency room capacity, and increase the number of private rooms and critical care beds.  Because of these factors, the new hospital has greater space and capacity for patient care than exists today. In fact, there is room to care for 32 more inpatients in the new hospital.

9.         Why can’t we just retrofit the existing hospital?
SFGH studied the possibility of retrofitting the current building and found that it would be nearly impossible to care for all existing patients while retrofitting the building.  Retrofitting would likely require closing at least two floors at a time in order to do retrofit work that would take years. In combination with other building code upgrades that would be required, a retrofit would ultimately result in a loss of patient care beds. Finally, the cost of such a disruptive and difficult project would, at the end of the day, approach or even exceed the cost of building a new, completely compliant hospital that would not cause the same level of patient care and capacity disruption. 

10.       Does the new hospital have a helipad?
Although SFGH believes that a helipad is needed on the campus, no helipad is planned on the new hospital.  SFGH continues to work with the Planning Department to place a helipad on the roof of the existing hospital.

11.       What’s happening with the old hospital?