The years-long debate about where to put the next hospital in Loudoun County will come to a head June 22, when a public hearing on Hospital Corporation of America's Broadlands Regional Medical Center will be held.
Healthcare giant HCA's proposal to put a 164-bed, for-profit hospital in Broadlands has been under fire from Loudoun Healthcare, now a part of Inova Health System, since it was first presented three years ago.
A series of legal tussles between HCA and Loudoun Healthcare resulted in the Broadlands' center's certificate of public need, or COPN, being revoked last year and then reissued this year by state Health Commissioner Robert Stroube. Loudoun Healthcare still has the issue under appeal.
The hospital debate has also cleaved the county in two places: first, in Broadlands, where both HCA supporters and detractors sit on the homeowner's association board, and second, in the Dulles district, where Dulles south residents clamor for their own hospital to serve South Riding.
Broadlands resident Eric Steenstra has a daughter with asthma and supports bringing a hospital to his neighborhood. "I know how important it is to have a hospital close to home," he said.
But one of the claims Loudoun Healthcare has made against the Broadlands site is that it's too close Ñ too close to its own main campus at Lansdowne, just five miles away. Meanwhile, western and southern Loudoun won't have a hospital of its own.
County population projections, however, show that the Ashburn area will continue to outstrip Dulles south and the west for years to come.
And from his many trips to visit his mother in Leisure World, Steenstra thinks that Lansdowne's not as close as it looks.
"I think that the case is pretty clear," Steenstra said.
BUT DONNA Fortier, a member of the Broadlands homeowners association board, says she has the support of the community behind her and against HCA.
"It doesn't go with the aesthetics of the community," Fortier said. "We've got nature, bike traffic, kids playing. It's not harmonious with the neighborhood we purchased into."
Fortier moved to Broadlands three years ago, just prior to HCA's announcement of its intentions to build a hospital there. As soon as she heard, she began going door-to-door to drum up opposition.
Fortier wants to see HCA's 58-acre site built as it's currently zoned: for office buildings.
"If it's an office building, you only are open Monday to Friday, nine to five," she said. "A hospital is open 24 hours a day, seven days a week, 365 days a year. It never closes."
Fortier, a Loudoun Healthcare employee, has faced criticism from HCA for being Loudoun Healthcare's physician relations liaison.
"That [criticism] I don't think holds water," she said. "I had been fighting them" for two years before being hired by Loudoun Healthcare.
Broadlands homeowners association vice president Cliff Keirce, however, thinks the community is still deeply divided on the issue. A survey from two years ago sent to 2,000 Broadlands homes came back with only a 30-vote difference between those for and against the hospital.
Keirce, a vocal proponent for HCA, said that a hospital would be "far less obtrusive" on the neighborhood than an office park Ñ not to mention the huge amounts of property taxes the county would garner and the hundreds of high-paying jobs for residents at Broadlands Regional Medical Center.
"All this is a huge plus for the taxpayer," Keirce said.
The Broadlands homeowners association's previous board passed a resolution in favor of the hospital, but the current board is evenly divided. Ashburn Farm, which is adjacent to Broadlands, passed a resolution of support last week.
PLANNING for hospitals in the county got underway in 2003. A little over half of the county's population goes outside Loudoun for health care. With only one inpatient facility, Loudoun Healthcare's 155-bed Lansdowne campus, and a rapidly growing population, the need for a healthcare plan was clear.
But just as a county-appointed healthcare commission was taking shape, a new Board of Supervisors took office and shuttered the nascent commission.
"They slashed and burned it," said Chairman Scott York (I-At Large).
HCA had joined the commission Ñ but Loudoun Healthcare had not.
Just months later, Loudoun Healthcare presented its version of how the county should plan health care. Its plan included a hospital for Dulles south plus community health centers in Loudoun's incorporated western towns.
It did not include a planned hospital for HCA's Broadlands site.
The Planning Commission reworked Loudoun Healthcare's plan amendment, eliminating its proposed map of future healthcare sites and language stating a preference for Loudoun's next hospital to be in the Route 50 corridor.
Planning Commission Chairman Larry Beerman is a member of Loudoun Healthcare's board of directors. He recused himself from votes on the plan.
YORK called the Planning Commission's reworked healthcare plan a "reasonable proposal," but voted against it when it came before the Board of Supervisors.
York could not support it because the board reinstated the language stating a preference for a new hospital in the Dulles south area.
"No hospital's going to go to Route 50 right now," York said. "If they did, it'd already be there. They'd be in the process."
Supervisor Stephen Snow (R-Dulles), whose district covers both the Broadlands site and the Route 50 corridor, disagrees about the viability of a hospital near South Riding.
He plans to meet with Broadlands Regional Medical Center CEO Bryan Dearing in the coming weeks to discuss relocating to Dulles south.
"It's location, location, location," Snow said. "They've got the wrong location."
BEFORE merging with Inova Health System, Loudoun Healthcare CEO Rod Huebbers had said his local, nonprofit community hospital could not survive with another similarly-sized hospital nearby.
Today, despite Loudoun Healthcare's merger with Northern Virginia's largest healthcare provider, Huebbers still thinks HCA will siphon away patients and doctors from Inova Loudoun Hospital.
"Why does Burger King build across from McDonald's?" Huebbers said. "They know where the market is."
But Broadlands' Dearing said HCA's intention is not to put Loudoun Healthcare out of business.
"We chose the Greenway site because we thought it was going to give the best access for the east, west, north and south," Dearing said. As for Route 50, "it simply doesn't make much sense because the population base isn't there and won't be there for 10 to 15 years."
Huebbers has said Loudoun Healthcare is looking at putting a hospital in the Route 50 corridor, but it does not yet own land. An initial deal to work with developer Greenvest LC, which is submitting a plan to put 14,800 homes in the area, to gain a piece of land went nowhere. Huebbers didn't want to get the hospital wrapped up in Greenvest's increasingly polemicizing proposal, which has caused outcries among slow-growth residents and officials.
BOTH HCA and Loudoun Healthcare have sunk millions of dollars into the legal fight on the Broadlands certificate of public need. They've also both embarked on outreach campaigns, meeting with citizens and officials as well as taking out full-page ads in local papers and sending mailers to homes.
Last month, HCA sweetened its deal by offering to pay $8 million for improvements on Belmont Ridge Road, which would provide better access to the hospital for residents in Dulles south.
While the legal wrangling is still going on Ñ Loudoun Healthcare's appeal with additional information on the certificate of public need process will be made public in July Ñ right now, Broadlands Regional Medical Center has the state approval it needs.
Now it needs a special-exception rezoning from the Board of Supervisors to begin construction. If the rezoning is granted this summer, the hospital will be completed in three years.
If the board doesn't grant the special exception, Dearing said more legal action could be taken.
"We don't want to go that route," he said.
York, HCA's most vocal proponent on the board, said he hopes his colleagues will support its application.
"I would hope that the board will do the right thing, but after a year and a half with them, they're susceptible to doing anything but the right thing," he said.
The Planning Commission recommended the board deny the Broadlands special exception, citing the hospital's incompatibility with the residential neighborhood.