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New Hospitals in Loudoun: If Built, Will Patients Come?

While two vie for hospital building rights in the county, residents worry about accessibility to health care.

When it comes to hospitals in Loudoun County, there's only one thing that everyone can agree on: the county desperately needs more facilities to keep up with the exploding population. How this will come about — who will build the facilities, where they will be located and what services they will offer — is the debate.

WHAT LOUDOUN HEALTHCARE WANTS.

"All we are asking for is that we are allowed to grow to our potential," said Tony Raker, community relations director for Loudoun Healthcare. Raker contends, and a report commissioned by the Board of Supervisors from the Health Systems Agency of Northern Virginia corroborates, that the existence of a hospital in close proximity to Loudoun Hospital Center (LHC) could siphon away patients and jeopardize LHC's viability — all without significantly improving in-county health care accessibility for citizens.

According to Raker, Loudoun Healthcare has three things in mind. First: making quality healthcare available for all citizens. Second: placing treatment facilities throughout the county to ensure access for all citizens. Third: spacious placement of facilities would allow each to grow and be able to support "sophisticated, specialized services," he said, such as open heart surgery.

"In order to achieve that level of service, you have to have a hospital of 300-400 beds," Raker said. In other words, if another moderately-sized hospital served the same population as LHC, neither hospital could grow to maximum efficiency and service.

According to Raker, the board at Loudoun Healthcare is "perplexed" by the state health commissioner's decision to simultaneously deny the additional beds at Cornwall and approve the 164-bed Broadlands facility.

"We've wracked our brains and we can't come up with an answer," Raker said. He acknowledged that is it not uncommon to apply more than once to the state for hospital site approval, and said that Loudoun Heathcare plans to reapply for the Cornwall beds.

By handing the decision over to the Planning Commission, which will make a recommendation to the supervisors, "everyone's being put on an even playing field, and that's all we ask for," Raker said.

"LHC may not be capable of building a third hospital," Raker said. But without a competing facility just minutes away, LHC could grow and improve. "Any hospital system would appreciate having that."

A criticism of LHC's urgent distaste for Broadlands Regional Medical Center (BRMC) is that LHC wants to preserve what detractors call its "monopoly" in the county. Raker pointed out that LHC serves 49 percent of the population and competes with Reston Hospital Center, Inova Fairfax and Inova Fair Oaks. "I don't see how anyone can call that a monopoly."

WHAT HOSPITAL CORPORATION OF AMERICA WANTS.

"We truly didn't try to find a site that was close to LHC," said Bryan Dearing, CEO for Broadlands Regional Medical Center. "We had to pick a site along the [Dulles] Greenway."

When HCA, which owns more than 200 hospitals, initiated plans to build a hospital in Loudoun two years ago, a survey supported building along the area that was both adjacent to the only major highway in the county and central to population growth. In the summer of 2003, HCA purchased a 57.8 acre tract between Belmont Ridge Road and Broadlands Boulevard. It was as far west as public utility availability would allow, and a little over five miles from Loudoun Hospital Center.

Just as LHC has the Health Systems Agency of Northern Virginia report suggesting the Broadlands site would hurt LHC, BRMC has a report of its own stating otherwise by Dr. Louis Rossiter, former state Secretary of Health and Human Resources. While the report will not be available in full until mid-July, supervisors got a preview from Rossiter at the June 15 board business meeting.

Rossiter laid it out: BRMC would not threaten LHC's "exaggerated" financial concerns because population growth supports a second hospital and specialized services at BRMC would not only be distinct from LHC's but would also attract quality physicians who would practice out of both facilities. Residents would benefit because the hospital would help the tax base, provide more in-county health services and help the county cope with "acute overwhelming emergencies" — in other words, terrorist attacks.

To Dearing, LHC's objection to Broadlands comes down to one thing.

"They've got a monopoly here in the county and they don't want to lose it," Dearing said. He pointed out that the Reston and Inova Fair Oaks hospitals are only about six miles apart and that the population density along the Broadlands area denotes the area as the prime spot for a second hospital.

BRMC's application for a certificate of public need was denied by the state two years ago. HCA adjusted the number of beds from 180 to 164, and State Health Commissioner Stroube accepted it.

"The population growth that continued so significantly was what caused him to change his mind," Dearing said.

HCA hopes for a quick rezoning, with groundbreaking for the hospital next spring.

WHAT THE PUBLIC WANTS.

It seems simple: accessible health care for everyone, no matter where they live in the county. Janet Warren spoke in support of Loudoun Healthcare-submitted comprehensive plan amendment at a public meeting held by the Planning Commission in South Riding on June 29. Like the amendment on the table, she supported Loudoun Healthcare's three-hospital proposal for the county.

"It makes sense to spread the medical services around the county," Warren said. A couple dozen Dulles south residents echoed Warren's sentiments at the public meeting, all voicing their concern that the population growth and parallel traffic woes in the area would make hospital accessibility, already a tricky thing, even more complicated.

With only a single pediatrician and a single dentist in South Riding, Warren takes her family to doctors on the far side of Herndon, 45 minutes away. When it comes to emergency services, well, Warren has already experienced the dearth of easy availability once.

When her son Matthew was in kindergarten, another child pushed him down and he blacked out. Because Warren had to drive from work at Tyson's Corner to the kindergarten in Arcola and then take the unconscious child to Cornwall, Matthew was out for three hours.

Supervisor Stephen Snow (R-Dulles) pointed out to the commissioners that the projected growth for the area was enormous. "Here's the question," he said. "Health care: if not now, when?"

Broadlands Homeowners Association vice president Cliff Keirce was relieved that the Broadlands site went to a hospital instead of an office park. In terms of environmental impact and traffic patterns, "it's a no-brainer," he said.

"First and foremost, we need more medical care, more hospital beds," he said. Broadlands is an ideal site, he said, because within a four-mile radius there are 40,000 home units built or on the way.

As for a third hospital in the Dulles south area, Keirce is skeptical. "They want health care that's closer. I don't blame them," he said. "They think that if they defeat Broadlands, they'll get a hospital down there." That's not necessarily the case, and Board of Supervisors chairman Scott York agreed.

"If Broadlands gets blocked, that won't build a hospital in Dulles south any sooner," he said. The population and infrastructure needed to support a hospital there won't be in place for 15 to 20 years, he added.

MONTHS COULD LAPSE between now and the final approval of an amendment to the comprehensive plan to include a heath care facilities policy — and certainly a few years will pass before any new facilities welcome their first patients.

In the meantime, Loudoun Healthcare will reapply for a certificate of public need from the state to add beds to the Cornwall facility in Leesburg. Additionally, HCA will apply to the Board of Supervisors for a land use permit on the Broadlands site.

The Planning Commission will hold a pair of work sessions on Aug. 30 and Sept. 13 as well as a public hearing on Oct. 18 on the comprehensive plan amendment. The commission will then make a recommendation to the Board of Supervisors, followed by a public hearing tentatively scheduled for November.