In less than 30 days Richmond Circuit Court Judge Theodore J. Markow is expected to make a ruling in Inova Loudoun Hospital's latest effort to overturn the state health commissioner's site approval of the Hospital Association of America's (HCA) proposed Broadlands Regional Medical Center.
Friday, April 7, Inova argued in Loudoun County Circuit Court that the only reason State Health Commissioner Robert B. Stroube approved HCA's Certificate of Public Need (COPN) was because of political pressure. Stroube had originally rejected HCA's approval, but reversed his decision more than a year later.
"This was approved because of the outside influence of HCA," Inova's attorney Mark S. Hedberg said. "I think the court heard us and is taking our arguments into account."
"There has been irregular communication between various parties of the state government that should not have been involved in the [the application]," Tony Raker, director of community relations for Inova Loudoun Hospital, said.
THE CURRENT ACTION awaiting Markow's ruling is only the latest in an ongoing battle between Inova and HCA to block the building of the 164-bed Broadlands Regional Medical Center. The proposed site plan locates the medical center along the west side of Belmont Ridge Road and south of the Dulles Greenway in Ashburn. The location is less than five miles from the existing Inova Loudoun Hospital in Lansdowne, which was the reason for Inova's initial concern.
"When you have got a county [this large] it doesn't make sense to put the second hospital on top of the existing one," Hedberg said. "And the site certainly doesn't seem to be improving geographical access."
However, Megan Descutner, spokesperson for HCA, said that the company did extensive research when looking for a site for the hospital and found that the Ashburn location was the best option.
"People are constantly moving from the west to the east," she said. "The choices are Route 7, Route 50 and the Greenway. Every year we have re-evaluated the piece of property that was the best and every year the data confirmed that was the best."
Recently, Inova put forward an application for 16 additional beds in its facility, something HCA has opposed.
Raker said that if the Broadlands Regional Medical Center was built that Loudoun Hospital would take the additional beds out of its plans.
THE COUNTY'S constantly changing population is the argument being used by both sides to both support and oppose the creation of the second hospital.
HCA says that the proposed Ashburn site is where most of Loudoun's population is focused. Descutner said that western Loudoun was considered for the site of the county's second hospital but it was determined that the population could not sustain a hospital.
"Where we proposed to put our hospital is smack dab in the middle of the county's population," Descutner said. "When looking at beds and planning a hospital, a district's [distance] minutes [away] do not necessarily equal miles."
Inova's main concern is the effect the Broadlands Regional Medical Center would have on its Loudoun Hospital, stating that it would lose money if HCA's hospital was built.
"There is not enough population to support both facilities," Raker said. "How can we grow to meet the growing population if there is another identical facility right next to us? If the approval goes through the entire structure of the hospital would need to be looked at."
HCA has used Fairfax County as an example of how two similar hospitals can exist closely to one another, something Raker says is "not an apples to apples comparison."
"Fairfax County is much more dense than Loudoun is," he said.
HCA, however, believes that it has been clearly demonstrated that the population in eastern Loudoun will sustain a second hospital, pointing to the approval by Stroube.
"This population is unique in that it has a high birth rate, a large aging population and a large number of people moving into the area," HCA attorney Tom Hancock said. "We drew a radius around the Ashburn and Broadlands area and it showed that 80 percent of the population was within 15 minutes of Broadlands."
WHILE ASHBURN is the most densely populated area in Loudoun County, there are other areas that will soon need a hospital to support their residents, the most prevalent of which is South Riding along Route 50.
"There is a belief that the hospital should be built on Route 50," Descutner said, "but Ashburn has the most immediate needs. We are committed to building a third hospital in South Riding no matter who actually builds it, Inova or us."
Inova suggested a South Riding site to HCA three years ago, Raker said.
"We pointed out what we thought were areas that could sustain a hospital and HCA rejected the Dulles South location," he said. "If you wanted to be competitive why not go where health care is needed?"
Since Loudoun Hospital's merger with Inova last year, the hospital has the money to build a hospital in Dulles South, Raker said, and it is something they are planning on doing.
"We have purchased 54 acres in Dulles South and we are going to step forward and do it," he said.
Raker added that HCA already has a COPN from the state, something Inova does not yet have for its Dulles South acreage.
"They have the COPN, which is something," he said. "It has just come under a cloud now."
However, a COPN is only granted for a specific site and to move to Dulles South, HCA would need to apply for a new COPN. Changes to the current plan could result in major timeline set backs for HCA.
"The process is very specific," Descutner said. "Unless you want to start all over you have to go forward with your plans. Turning down a hospital that costs no tax dollars and will in fact pay tax dollars is not a good idea."
No matter what their conflicts are right now, both hospitals are able to put aside their differences and do what is needed for the people that need the hospitals' services. Recently, a Reston HCA hospital was having problems with some of its equipment and it called on Inova Loudoun Hospital to take over the patient load until the problem could be fixed.
"In the trenches we all have to help each other," Raker said. "We all have to do our job to serve the community."