Seattle Grace Hospital and Mercy West Medical Center were originally two separate medical facilities but in 2009, due to the economic climate, they merged to form one medical facility. Due to the merger and large amount of staff between the sites, many employees were fired due to "budgetary constraints" both before and after the merger (notably Dr. Isobel Stevens and Dr. April Kepner). Seattle Grace Hospital was used as the location for the new Seattle Grace Mercy West Hospital.