Kaiser plans new 14-story San Francisco hospital on Geary Street

Kaiser Permanente’s planned 14-story hospital at Geary Boulevard and Divisadero Street would replace a 1954-era San Francisco institution with a much larger footprint, one that nearby residents are likely to feel first in traffic, shadows and years of construction disruption. The new building would rise about 266 feet and grow to roughly 623,000 square feet, up from the current hospital’s 367,000 square feet, while adding beds from 239 to about 300.

The project would be built at the corner of Geary and Divisadero in Anza Vista, across from Kaiser’s existing San Francisco Medical Center at 2425 Geary Boulevard. If approved, the old hospital would be converted into medical office buildings while the new tower becomes the inpatient hospital. Kaiser also plans a medical office building and two parking garages as part of the broader redevelopment, and the current hospital would keep operating during construction.

The scale is a sharp shift for a site that already anchors care for the Western Addition and the Lower Richmond edge of the city. Kaiser says the new hospital would be all-electric, and it would be the health system’s third all-electric hospital after projects in Sacramento and San Jose. The design is by Perkins & Will, and Kaiser is aiming to start construction in late 2028 and finish around 2033, pending city and state approvals.

At a neighborhood meeting, reactions split along familiar lines. Some residents warned that a 14-story tower could bring long shadows, more wind, heavier traffic and less greenery. Others argued the corner should be put to better use. Kaiser’s senior vice president and Golden Gate Service Area manager, Abhishek Dosi, told neighbors the project was at “the beginning of the beginning,” a reminder that the most contentious phase may still be ahead.

The proposal also reaches deep into San Francisco’s medical history. Kaiser’s first hospital in the city was a 35-bed facility on Potrero Hill that opened in 1948. The system moved to Geary Boulevard in 1954, onto land that had once been Calvary Cemetery, and Kaiser facilities now dominate both sides of Geary in the area. More than 70 years later, this would be the company’s first new hospital in San Francisco, arriving as another major hospital cycle unfolds on Van Ness Avenue and as Kaiser weighs how to modernize a campus that serves about 245,000 local patients.

Any formal review will move through the city’s Institutional Master Plan process, which requires public notice for future medical development and gives the Planning Commission an early, informational role. For San Francisco, the stakes are bigger than a single tower: the project would reshape one of the city’s most visible health care corridors for a generation.