The Sisters of Mercy took care of the sick and poor from the earliest days of Monroe. In September of 1892 they advised Snohomish County they were no longer able to do so.
Consequently, in June of 1893, the county built a two-story home for the ill, aged and indigent on land the county owned, and called it The County Farm and Hospital. The 40-acre tract was crossed diagonally by the Great Northern railroad tracks. The building faced north on the southern triangular portion of the tract near where EvergreenHealth Monroe now stands. The wood-frame building had 20 beds and cost $4,500 to build. The larger northern portion was the farm with a barn for cows and for the two horses used for plowing. This area is where the Evergreen State Fairgrounds is now located. Mr. M.L. Mahoney was hired to run the county home, care for, and furnish medicine to the residents and patients. The County Farm and Hospital did not handle patients with contagious diseases. Patients who were able, worked at the farm tending livestock or raising crops. The farm produced and sold milk and ice cream and raised potatoes, hogs and chickens. The cast-iron bell from the original building is in the Monroe Historical Museum.
In 1909, a second two-story building, the hospital annex, was built in front of the 1893 building. A staff of about seven or eight was employed to operate the facilities. In 1925, a new county hospital, a larger two-story stucco structure was built at a cost of $90,275 to replace the two aging wooden buildings. This hospital had 100 beds and fronted on Valley View Road (now 179th Ave. SE) and was just west of the old buildings. The first floor was for patients and the second floor was for the hospital and working staff. Although occupancy was usually much less, during one month during the Depression, 148 were cared for there. The original wooden buildings were demolished in the spring of 1929. The County Farm and Hospital, was often referred to as the 'poor farm" and operated until 1940. After the Social Security Act of 1935 was passed by Congress and the elderly started receiving small pensions, the farm operation was discontinued. Beginning in 1941, the building was used only as a hospital and was called Valley View Hospital.
In 1949, the county leased the building as a private hospital and nursing home and it was renamed Monroe General Hospital. In May of 1960, Snohomish County Public Hospital District No. l was formed and in November of that year a bond issue for $385,000 was passed to purchase and renovate the old hospital. On February 1, 1961, the name was changed from Monroe General Hospital to Valley General Hospital (VGH). The last trace of the old stucco hospital building was torn down in 1992. Beginning in the mid-90s, Valley General Hospital offered "timeshare" space for non-Monroe based physician specialists to see patients on a part-time basis in Monroe. Historically, VGH has also leased out space on its second floor to Virginia Mason and Group Health.
In 2002, several Monroe specialists formed an LLC that purchased land from VGH and constructed a medical office building. The resulting 48,000 square foot building on the southwest corner of the VGH parking lot was named the Sky River Medical Building. The building's ownership was shared among a number of local and regional physicians, an optometrist, an ophthalmologist and an outside investor. When the building opened, the hospital leased approximately 20,000 square feet of space for several of its outpatient services, including MRI, mammography, ultrasound, a primary care clinic and physical rehabilitation and therapy. As part of the Sky River Medical Building project, Valley General Hospital also "pre-invested" in several site improvements to allow for future hospital expansion, including current and future parking capacity requirements, road and intersection improvements, and on-site surface water retention requirements.
In 2011, Valley General Hospital closed its obstetrics and psychiatric units and began discussions with larger hospitals and health systems regarding a possible affiliation. Eventually the board of commissioners signed an affiliation agreement with Kirkland-based EvergreenHealth in late 2012. As part of the affiliation agreement, EvergreenHealth sub-leased space in the Sky River Medical Building from Valley General and opened EvergreenHealth Primary Care Monroe
The hospital also placed on the ballot a proposal for an increase in its maintenance and operations levy. In April 2013, the voters of the Snohomish County Public Hospital District No. 1 approved a $2.7 million increase in the hospital’s annual operating levy.
Negotiations between Valley General and EvergreenHealth in 2014 led to a new strategic alliance agreement effective March 1, 2015. As part of that agreement Valley General Hospital became EvergreenHealth Monroe. Also in 2015, EvergreenHealth Monroe entered into a lease agreement with Fairfax Behavioral Health that culminated with the opening of Fairfax’s Monroe psychiatric hospital within EvergreenHealth Monroe’s facility in January of 2016.
In 2018, the Sky River Medical Building was renamed EvergreenHealth Pavilion.