The city's largest hospital is proceeding with plans to build a $1-billion medical center on a site now occupied by a hotel.
California Pacific Medical Center's Cathedral Hill facility would become the hospital's main medical branch.
"Essentially we're looking at a citywide network," said Jim McCaughey, vice president of planning and redevelopment.
A $210-million medical office building is also scheduled to be built across the street.
State law requires hospitals to meet strict seismic safety requirements by 2013.
California Pacific chose to comply with the standards by building the new center.