COEUR DALENEKootenai Medical Center is considering a $24 million expansion plan that would include adding about 87,000 square feet of floor space and a 400-stall parking garage at the busy North Idaho hospital in coming years.


In the near term, the plan calls for the construction of a 36,000-square-foot fourth floor on the three-story tower at the east end of the hospital complex; two, 7,000-square-foot ground-floor laboratory and administration wings; and a 12,000-square-foot addition to the emergency department on the complexs south side. It also recommends acquiring a five-acre parcel next to the hospital complex thats currently owned by the states Panhandle Health District.


Longer term, the hospital will need an additional 25,000 square feet of space. Two possibilities are that Kootenai Medical Center (KMC) could construct a multi-story office building on the campus or demolish the hospitals original buildingwhich now is a wing of the overall complexto build a second hospital tower.


All of those items are contained in a draft plan currently being finalized for the hospital by a Minneapolis consulting firm, says Kootenai Medical Center CEO Joe Morris.


Though the plan charts KMCs growth over the next 10 years, demand for its services by North Idaho residents makes it likely that many of the projects would be built before 2006, Morris says.


KMC, which was founded in 1966, undertakes similar planning efforts every decade, Morris says.


Every 10 years we find it necessary to look down the road and project population, project volumes. He adds, though, that the plan is more a road map for development than something the (hospital) boards going to adopt and rigidly follow for the next 10 years.


In addition to its physical expansion, KMC intends to expand the services it offers, he says.


The hospital will add a second MRI unit within the next year, at a cost of $2 million to $3 million, and is mulling whether to add interventional cardiology and cardiovascular surgery to its clinical services, Morris says. Currently, most North Idaho patients who need open-heart surgery and, in many cases, cardiac catheterization, travel to Spokane for those procedures.


KMCs planning effort comes amid an onslaught of hospital expansions in this area. All four Spokane-area hospitals have announced major upgrades in recent months.


KMCs growth will be necessary to accommodate an expected population increase in Kootenai County in the coming decade, Morris says.


In its report, consulting firm Williams & Associates predicts that Kootenai Countys population will grow to 132,900 by 2010, up 23 percent from 107,800 at the start of the decade. There also will be modest population increases in the other four North Idaho counties that KMC servesBenewah, Bonner, Boundary, and Shoshonethe report says.


To serve that greater population, the consultant recommends that KMC add the 87,000 square feet of hospital space, the parking garage, and 23 beds.


Design work on the 36,000-square-foot fourth floor to the tower likely will begin next year, Morris says. We will need a fourth floor by 2005, and it takes a year and a half to two years to do the construction, he says.


The report also says that at the time the fourth floor is being built, the hospital should explore adding a fifth story to that tower in the future.


The two 7,000-square-foot additions would be built on the north and south side of the hospital complex, near the tower, and would house reconfigured laboratory and administration space.


The emergency-room expansion would be added to the south of the present emergency room, and will be needed by mid-decade, if not sooner, the report says. Morris says the hospitals ER will accommodate 42,000 patient visits this year, and is the busiest emergency room in the state of Idaho.


The price tag for those four projects would be nearly $20 million in todays dollars, the report says. That figure, however, doesnt include financing or equipment costs, or the cost of the parking garage, which is expected to run about $4 million.


To enable the hospital to build the garage, KMC is negotiating with the Panhandle Health District to swap land the hospital owns near Ironwood Drive for the health districts five-acre parcel adjacent to the northwest corner of the hospitals 27-acre campus.


Because KMC is bounded on the north by Interstate 90, on the east by U.S. 95, and on the south by Ironwood Drive, it can only expand to the west, Morris says.


The hospital hopes to trade property to the north of its North Idaho Behavioral Health building, located a block away at 2301 N. Ironwood Pl., for the Panhandle Health District land, he says.


Wed like to resolve that by the end of the year, Morris says.


If its successful in doing so, the hospital could build the 400-stall garage on the new acreage, potentially within three to five years, he says.


One of the luxuries we have is that we have a lot of land, but a great percentage of it is covered by parking, he says. Building a parking garage would free up more space for future construction, he says.


A garage also could serve a multi-story office building, if KMC decides to build one, he says.


Eventually, KMC expects to raze the one-story structure that housed the hospital, then known as Kootenai Memorial Hospital, when it opened, Morris says.


By 2006 well be 40 years old, and a more productive use of this site is not going to be a single-story, pitched-roof building, but a multiple-story building. Eventually were going to want to eliminate that building. That provides us with our next growth.


The hospital added to that original structure several times over the years, then built the three-story tower wing in 1984. In 1996 KMC built its Health Resource Center as a freestanding building to the north of the main hospital complex, then earlier this year opened another freestanding structure, the McGrane Center for Rehabilitation and Therapeutic Care.


KMC, a public hospital with 225 licensed beds and about 1,100 full-time equivalent employees, would use its reserves and debt financing to pay for the projects, Morris says.