Swedish Response to Seattle Times Series

The Seattle Times has published a series of articles about Swedish Health Services. We want to provide our response to the series as well as information about steps taken to ensure that Swedish continues to provide the highest-quality care to our patients.


As a nonprofit healthcare provider that has served this community for more than a century, Swedish is committed to doing what is right for our patients, our community and our caregivers. We place great importance on our legacy of integrity and honesty, and we expect every person at Swedish to honor those values in all activities. In cases where there are perceived or real conflicts of interest, we thoroughly examine them and manage them as appropriate.


Our Code of Conduct sets a high standard for caregivers and physicians to act in an honest, fair and ethical manner in all interactions with patients, colleagues, payers and vendors. We also have a robust Integrity and Compliance Program that ensures we are following the ethical commitments, laws, rules and regulations that govern our business conduct and that when issues arise, they are appropriately identified and addressed.


Swedish's Relationship with David Sabey

David Sabey has been a longtime supporter of healthcare in our region, including Swedish and Providence, and has made generous philanthropic contributions over the years. Our relationship with him originated many years ago with then-Swedish CEO Richard Peterson. In 2002, Mr. Peterson approached Sabey Corporation about purchasing and remodeling the historic James Tower, as it was in need of significant investment because of age and damage from the Nisqually earthquake. Sabey Corporation is the landlord of a portion of Swedish’s Cherry Hill campus. The campus is home to other life sciences tenants as well. We are grateful that David Sabey shares our vision of Swedish as a world-class healthcare organization and leader in medical science, research and innovation.

Ensuring Fair Market Value for All Swedish Leases

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As part of contract negotiations, Swedish confirms that all rental rates are fair market value to ensure compliance with relevant laws, including IRS laws. Many factors inform a fair market valuation, including the length of lease term, the permitted uses of the space, the class of the building, build-out of the facilities, and use of customary rent escalators, among other things. These standards are met in the leases with Mr. Sabey’s companies just as they are in our leases with any other landlord.

Compliance and Oversight

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Swedish and Providence have robust compliance programs and contract review process that comply with IRS and other legal requirements for real estate and other transactions. In contract negotiations, Swedish and Providence confirm that all rental rates and other fees are fair market value. All transactions with Mr. Sabey’s companies are negotiated at arm’s length and reviewed through the same process that would apply to any other third-party vendor.

Development of Swedish's Cherry Hill Campus

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Swedish has a long-term strategic vision for improvements to the Cherry Hill campus. Our Major Institution Master Plan (MIMP) for the Cherry Hill campus, available on the City’s website, is stewarded by Swedish CEO Dr. Guy Hudson and the Board of Trustees, and is consistent with the City’s requirements. 

In Mr. Sabey’s role as landowner of a part of the Cherry Hill campus it would be expected for him to be involved in the City zoning processes.

Throughout the MIMP process, one of Swedish’s primary goals was to work collaboratively with interested parties, including our Cherry Hill neighbors, to ensure we were responding to and addressing questions and concerns. We also provided periodic briefings to the City of Seattle to ensure they were closely informed on our design planning and rationale.

There was a relatively small number of neighbors who were very vocal about their concerns, with the number one concern being the potential impact on local traffic and parking. We spent many hours discussing these concerns and working to address them. In order to understand if the sentiment of the small number of neighbors who were vocal at the meetings represented the larger community as a whole, Swedish and Mr. Sabey co-sponsored a third-party survey of 600 Seattle residents. Twenty-five percent of those surveyed were Squire Park residents and the survey results demonstrated that what we were hearing at the community meetings was not representative of the sentiment of most residents. Swedish also developed an Integrated Transportation Board (ITB) to look into parking issues and create solutions. The ITB is made up of stakeholders at the Cherry Hill campus and neighbors from Squire Park.  

Swedish has also made a significant investment in providing our caregivers with commuting and parking alternatives to meet the 50 percent single occupancy vehicle (SOV) rate required as part of the approved MIMP. We recently received certification of our Caregiver Commute Survey from the City of Seattle confirming that our SOV rate at Cherry Hill has dropped to 47.6% due to these initiatives. This is a significant decrease from our SOV rate last year (56%) and we will continue to focus on this effort.

In general, we have seen dramatic change in tone from neighbors in the past few months as we have worked to foster collaborative relationships.

It is also worth noting some of the other community benefit in which we have invested in the Cherry Hill area:

  • In 2016, Swedish Cherry Hill alone provided $32,975,827 in community benefit
  • Swedish partners with the food bank at St. Mary’s (5 blocks away) by supplying newborn baby items for the Baby Corner – formula, clothing, sundries for the past 5 years
  • For 10 years, Swedish has supported a giving tree for Centerstone and their home bound food bank clients (currently taking place)
  • Swedish supports the United Negro College Fund portfolio project for the past 6 year  – A 10 week work session on Saturdays, 25 students from local high schools get help and assistance at our Cherry Hill campus – they are paired with a mentor who helps with college applications, FAFSA forms, personal statements, etc. Swedish has enabled over 250 local high students achieve their goal to attend college.

Below you will find claims from the Seattle Times on various topics, along with our response to those claims.


The Seattle Times articles suggest there may be ongoing patient safety concerns at Swedish’s Cherry Hill campus.


Swedish Cherry Hill has a strong quality of care and patient safety record. As a continuously improving organization, Swedish is committed to learning from past mistakes and providing effective means for caregivers to communicate concerns.   

Recently, surveyors from the state Department of Health and Centers for Medicare and Medicaid Services confirmed that Swedish Neuroscience Institute has not seen an increase in complications or infection rates in recent years, nor any pattern or trend suggesting quality of care concerns.

Surveyors also recognized that Swedish Cherry Hill operating rooms were appropriately staffed, and caregivers worked appropriately scheduled hours. They noted that we have already undertaken a number of improvements to reaffirm our commitment to providing the highest quality care to our patients. And there were no adverse survey findings related to overlapping surgery.

Overall, Swedish experienced an increase in the number of surgeries, as well as an increase in the complexity of cases. Despite this, our O/E (observed-to-expected) mortality rates decreased.

Our most recent internal data show that Cherry Hill has achieved best-in-class performance in many quality measures, including catheter-associated urinary tract infections, central-line associated bloodstream infections, surgical site infections and falls with injury.


The Seattle Times series claimed that Swedish has pursued higher patient volumes in spine surgery and neurosurgery for improper reasons.


The volumes at Swedish Neuroscience Institute (SNI) have increased over the past few years, but the growth is due to community need and the ability to serve more people. Our goal is always to provide the most appropriate care for each and every patient.

Treating more patients who need care is our goal. Surgery volumes have increased at the Cherry Hill campus, which houses the Swedish Neuroscience Institute. Below are important facts that explain volume increases, impact to patients in need, and how our finances were affected. For Swedish Cherry Hill, when comparing 2015 to 2016:

  • With the Affordable Care Act, we experienced a 130% increase in patients with Medicaid, many of whom were newly insured and very sick, having foregone treatment for years.
  • Emergency room visits increased 3%.
  • Staffing increased 7%.
  • We experienced an $11.3 million increase in the uncompensated cost of care for patients with Medicaid and an $18 million net operating loss.

SNI is a world-famous neuroscience institute with a proud history of excellent patient safety and high quality outcomes, and because of this has become a destination for some of the most complex patients. Patients from 44 states traveled to Seattle and entrusted SNI with their care.

The Swedish Quality and Patient Safety team partners with its neurosurgery colleagues to measure process and outcomes in a variety of areas. We do also know that we are a learning organization and are reviewing our processes, outcomes and other data to continually improve patient outcomes and our caregivers’ ability to deliver the best care possible.

  • We take the decision to operate on an individual patient very seriously and determine the best treatment based on care needs of each individual patient, determining appropriateness and medical necessity for surgery or other alternative treatments. In fact, in 2016, only 37% of patient referrals for surgical consultation actually resulted in surgery.
  • Based on 2016 data, a patient would be 31% less likely to die while undergoing a craniotomy at Cherry Hill than nationally expected results.
  • At Swedish, we have a very robust quality program that measures meaningful outcomes using national benchmarks derived from an independent comparative database called Premier. Many of our outcomes exceed these benchmarks.


The Seattle Times suggested that Swedish brain and spine surgeons who conducted overlapping surgeries may have compromised patient care.


The DOH and CMS surveyors did not find any evidence that overlapping surgeries compromised patient safety.

While the available data, including our experience at Swedish, overwhelmingly supports the safety and efficacy of overlapping surgeries, Swedish has decided to take an enhanced approach moving forward. We have established more specific parameters around attending surgeon presence during surgical procedures. We have also enhanced monitoring, centralized scheduling and revised patient-consent communications.

The policy changes were developed collaboratively with surgeons, anesthesiologists, charge nurses and other caregivers. They reflect our mission of putting patients first, and our intention to listen, learn, and be open to changes in traditional practices. We want patients to feel comfortable and confident in the high-quality care they receive at Swedish.

Read the full Swedish press release about the updated overlapping surgery policy.

In addition, a study published Nov. 8, 2017, in JAMA found that outcomes for neurosurgery patients who received overlapping surgery were the same as those of patients who didn't receive such treatment.

This research, which included 2,275 neurosurgical cases, found no difference between overlapping and nonoverlapping surgery for mortality, morbidity, or worsened functional status at discharge and follow-up. These data suggest that overlapping surgery can be safely done without risking patient safety in a large series of mostly complex neurosurgical cases.

August 9, 2017

Swedish Updates Overlapping Surgery Policy

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August 7, 2017

Swedish CEO Dr. Guy Hudson and Interim Chief Medical Officer Dr. Charles Watts share an update on Swedish’s overlapping surgery policy with Swedish caregivers

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June 19, 2017

Swedish Board of Trustees Names Dr. Guy Hudson as CEO

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March 19, 2017

Providence St. Joseph Health President and CEO Dr. Rod Hochman's Message to Caregivers and the Community, "Restoring Trust at Swedish"

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March 15, 2017

Introducing Dr. Guy Hudson as Swedish's Interim CEO

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March 8, 2017

New Swedish CEO Dr. Guy Hudson explains Swedish's commitment to quality and safety, and its promise to care for all

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March 8, 2017

Swedish's Promise to Care for All — an overview of the community benefit provided by Swedish in 2016

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March 8, 2017

Fact Sheet about Swedish Cherry Hill, the Swedish Neuroscience Institute, and Swedish's Commitment to our Community

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