Things change.

Last February, when the Board of Supervisors turned down his company’s plans to build a hospital in Broadlands, HCA Vice President Mark Foust said moving the project to U.S. 50 was not even a remote possibility.

On Aug. 19, HCA applied to the state to move its already approved hospital beds 7 miles south from the Broadlands property to a site HCA owns at the corner of Gum Spring Road and the future Stone Spring Boulevard.

The change came, Foust said, because “Loudoun needs another hospital and needs another hospital system. We changed our plans to best serve Loudoun’s interests.”

StoneSpring Medical Center

The proposed StoneSpring Medical Center will include a 337,000-square-foot four-story hospital building, helipad, a four-story medical office building and a six-level parking garage. The hospital will include 124 acute care beds, 40 child and adolescent psychiatric care beds, diagnostic services, a cardiac catheterization lab and seven operating rooms. Cost is projected to be $195 million, with a planned opening in December 2015 “barring unexpected delays,” according to HCA’s Foust.

HCA earlier had announced plans to build a freestanding emergency department on the U.S. 50 property. County and state regulators have approved that plan. HCA will now proceed with the full-service hospital instead, which includes a 24/7 emergency department, Foust said.

Effect on other plans

Foust said the new plan to build the 164-bed hospital on the U.S. 50 will not affect HCA’s application to expand its Reston Hospital Center by 152 beds. HCA announced the Reston expansion one week after the Board of Supervisors denied the Broadlands plan last February.

The Reston application is working its way through Fairfax County’s land-use process. If and when the county approves the expansion, HCA will have to apply to the state for permission to add that many beds to the Northern Virginia health planning district. State regulators last year approved additional obstetric beds at Reston, but turned down a request for additional medical-surgical beds, citing a lack of demand.

HCA’s 24 acres on U.S. 50 are adjacent to a 95-acre parcel owned by Inova Loudoun Hospital. When HCA earlier this year insisted the population in the U.S. 50 corridor will not support a hospital – its land was for a third hospital in the far future – Inova applied to the state to build an 80-bed hospital on its land.

If State Health Commissioner Karen Remley approves the HCA request to move its beds to a new Loudoun location, the Inova application has little prospect of success. Inova executives said they are standing by their pledge not to oppose HCA’s move to U.S. 50, but will reserve judgment on their own application until after they study the 300-plus page HCA application.

What comes next

The Health Services Agency of Northern Virginia must review the HCA application within 30 days. Remley must rule on the application five days after that. An extension of the review period could be allowed with HCA’s concurrence.

The HCA application appears to ask that approval for the relocated beds be extended through late 2015, and for exemption from the need to seek yearly reapproval. Erik Bodin, chief of the Certificate of Public Need division at the Department of Health, said he reads the request rather as a way for HCA to extend its construction schedule. He cannot recall, he wrote, a multi-year approval for any other project.

The HCA application is for a "significant change" to existing approved COPN for Broadlands, not a request for new beds. Some, including Bodin a year ago, have questioned whether a significant change is the correct route for moving the project to U.S. 50 or whether HCA should be submitting an entirely new request for hospital beds in the planning district.

In October 2008, in the run-up to the second Board of Supervisors consideration, and ultimately rejection, of the Broadlands project, Bodin advised HCA that the process called a significant change application would not be a “viable option” for moving the Broadlands beds to a new location. “Much of the review that led to the original site-specific approval would need to be repeated looking at the new site,” he wrote in 2008.

That has changed.

“HCA has applied for a change of site significant change to the original certificate authorizing the project,” Bodin wrote Aug. 25. “The way they have made the request is an allowable approach to the proposed change.”