While general hospitals are financially stretched thin by the COVID-19 pandemic, Children’s Hospital of Philadelphia is opening a new $289 million, 52-bed hospital less than 20 miles northwest of its urban flagship, in the heart of King of Prussia’s shopping district.

The facility, which has a pediatric emergency department and 16-bed intensive care unit, is intended to ease pressure on CHOP’s crowded West Philadelphia hospital and attract new patient families from farther west, who may not have been able or willing to travel into Philadelphia for care. Opening Wednesday, it shares a campus with one of CHOP’s busiest specialty care centers, on South Goddard Road.

» READ MORE: Take a virtual tour of CHOP's new King of Prussia hospital

“We want this to be a front door to CHOP,” said Allison Ballantine, associate chief medical officer at Children’s Hospital of Philadelphia in King of Prussia. “We want to be here for folks who have had to drive to the city and also new patients.”

The opening of the new hospital, which was financed through a combination of bonds, reserves and fund-raising, bucks a decade-long trend of consolidation in the hospital sector, as more care transitions from hospitals to outpatient clinics and ambulatory care centers.

“It’s occurring for economic reasons. The larger a health system is, the better prices it can negotiate with payers ... higher payments for its services,” said David Blumenthal, president of the Commonwealth Fund, a health policy nonprofit organization. “It’s a very straightforward supply and demand.”

Analysts expect the pandemic will accelerate that trend.

“The pandemic has made us realize that it’s important to have capacity when we need it. We won’t know when the next pandemic is going to be — we want to make sure we have access to care,” said Richard Gundling, a senior vice president for the Healthcare Financial Management Association.

At the same time, the extra staffing, personal safety supplies, and medical equipment needed to handle the pandemic surges have meant serious financial strain for hospitals — even as they operate at near capacity caring for people sick with the virus. What’s more, temporary suspension of non-emergency procedures — a major revenue source for hospitals — early in the pandemic and again as omicron surged created budget shortfalls from which hospitals are struggling to recover.

Children’s hospitals have in many cases been able to avoid the financial woes of general medical centers because they offer specialized care that families are willing to travel great distances to access, and they have less local competition, Blumenthal said.

“The children’s market is a pretty special market. There are very few dedicated children’s hospitals, and CHOP is one of the very best in the country,” Blumenthal said. “Children do not get hospitalized very often, unless they’re very sick. It’s hard to generate demand for a hospital that doesn’t already exist.”

Most general hospitals can treat children, but they are designed for adults. Hospitals that cater to children feature spaces that better meet children’s physical and emotional needs.

Some of those features at CHOP’s new facility include:

  • Smaller operating tables and child-sized armchairs in waiting areas.

  • Dedicated space in each patient room for families or guardians because pediatric patients are more likely to be accompanied throughout their stay.

  • Large windows in patient rooms, hallways and lounge areas to help children feel they’re “still part of the outside world,” Ballantine said.

  • Photo murals of Philadelphia-area scenes decorating every patient, exam, and operating room, in an attempt to bring calm and comfort — and maybe distraction — to young patients. For instance, a field of purple and pink tulips sprawls across the wall in the room where children are taken for X-rays.

CHOP announced the project in 2018, well before the COVID-19 pandemic, but it features design elements that will be useful in the event of another pandemic — and for the duration of this one:

  • Private patient rooms limit contact between families.

  • Individual nurse stations with windows into patient rooms bring nurses closer to patients than the traditional nurses station, centered in the middle of a patient floor. Blinds embedded in the windows enable nurses to check on patients without having to go into the room.

  • Green lights embedded in operating-room ceilings turn to purple sanitizing lights when the rooms are empty. During surgery, green light helps doctors better see red.

“COVID brought to the forefront the risk of infections between patients, families, clinicians,” Ballantine said.

When deciding where to open a new hospital and what services to offer, CHOP leaders considered where its current patients live and what specialties they use most. Orthopedics and an emergency department that’s open 24 hours a day were among the services administrators found were most used. The new hospital, which is about a mile from the King of Prussia Mall, connects to CHOP’s popular specialty care center.

The King of Prussia location is expected to draw some patients from CHOP’s West Philadelphia hospital, which is routinely more than 90% full, by offering many families a more convenient alternative to driving into the city. But the new location isn’t as easily accessible by public transit.

Some specialties, including the cleft palate program, will move entirely to King of Prussia, freeing up resources at the West Philadelphia campus.

Located on South Goddard Road, with easy access to the area’s major highways, the hospital could also draw families who may have previously traveled to Penn State Health Children’s Hospital in Hershey, Nemours Children’s Hospital in Delaware, or even UPMC Children’s Hospital of Pittsburgh.

Though the King of Prussia hospital was built in the image of CHOP’s internationally recognized Philadelphia medical center, to provide cutting-edge specialty care, administrators envision a separate identity and mission for the new hospital, said Jan Boswinkel, senior vice president and chief operating officer at Children’s Hospital of Philadelphia in King of Prussia.

“We have an opportunity to do things a little differently ... to really become part of the community,” Boswinkel said. “We hope that it will feel like a community hospital version of CHOP. The atmosphere of a community hospital, with CHOP-quality care.”