SIOUX FALLS, S.D. (KELO) — Sanford Health’s planned $209 million in projects over the next three years is more than the organization has invested in projects in Sioux Falls from 2015 to 2019.

Although investments from 2015 to 2019 didn’t reach $209 million, the health organization has invested at least $69.4 million in Sioux Falls projects during that time frame, according to top value permits compiled each year by the city of Sioux Falls. The city lists top projects for each year with values of more than $1 million.

Sanford announced Tuesday that it plans to build a new clinic in Harrisburg and a new orthopedic hospital. Sanford will also add 16 rooms to its heart hospital and expand the Van Demark Building by 23 exam rooms, rooms for eight more surgeons and advanced practice providers.

The $209 million investment over three years is one of the largest in the organization’s history, according to the Sanford Health history on the organization’s website.

It’s also about half of what Denny Sanford donated in 2007 to Sioux Valley Hospitals and Health System. Sioux Valley changed its name to Sanford Health after Sanford donated $400 million.

Sanford Health opened the $500 million Sanford Fargo Medical Center in 2017.

Sanford Health’s website lists other highlights from the organization’s history.

The $77 million Sanford Heart Hospital was completed in 2012.

The then Sioux Valley Hospitals and Health System had a $55 million expansion to its surgical center in 2006.

In 2004, a $16 million gift from Denny Sanford to Sioux Valley was used to start the construction of a children’s hospital.

When the $77 million, $55 million and $16 million are combined, they don’t reach $209 million but $134 million.

Sanford may not have been as busy in the Sioux Falls area from 2015 to 2019 as it plans to be from 2020-to 2023, but there was a lot of construction happening.

The map below shows the sites of top Sanford permits received from 2015-2019. The permits are only those that made the top value list for each year, based on the city’s list. The top value permits do not necessarily indicate the full scope of projects.

Sanford built its Sanford Medical Center Imagenetics Medical Building and on top permit was valued at $22.7 million in 2015. The organization also received a top valued permit for the Edith Sanford Cancer Center addition valued at $14.5 million in 2015.

In 2016, Sanford received a top valued permit for the new facility, the Sanford West Center, valued at $12 million.

Sanford received a top valued permit in 2016 for a $6 million for Ava’s House Hospice.

Building permits received by Sanford Health and Avera Health in Sioux Falls often make the top value list in the city. The top valued individual permits do not indicate the full scope of projects but rather permits for which top values have been indicated by the city.

In 2017, Avera Health received a permit for $25.5 million for the Avera On Louise Specialty Campus at 6100 S. Louise Ave. Cale Feller of Avera’s public relations said Wednesday the Avera on Louise permit was part of a $130 million total investment.

One of Avera’s largest facilities in Sioux Falls, at 1325 S. Cliff Ave., received a $12 million permit for an operating room remodel in 2019. Feller said it was part of a $40 million investment over the past few years.

Prior to 2019, Avera received a permit applied to building a new medical building at 2100 S. Marion Road. The permit was valued at $15.5 million in 2016.