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For second time, supervisors decline HCA hospital plan
The Board of Supervisors took a second look at the Broadlands Regional Medical Center Feb. 17.
The answer was the same. By the identical 5-4 vote that denied the HCA application Feb. 3, the board declined to discuss the matter again.
Stevens Miller (D-Dulles) had gotten the application back on the agenda for Tuesday, and asked his colleagues to delay a final vote until April. That would allow time, Miller said, for the Federal Trade Commission to analyze health care in Loudoun and to make a recommendation that takes competition into account.
"This board settled litigation a year ago so this board, not a court, could make a local land-use decision," said Supervisor Susan Klimek Buckley (D-Sugarland Run).
That decision, Buckley said, belongs not in Richmond and not in Washington, D.C. "This decision belongs right here in Loudoun County and it was made two weeks ago."
Mark Foust, at HCA, called the vote "highly unfortunate.”
He said, “The FTC is in a unique position to explain how competition, specifically BRMC, would bring lower prices, better quality and more choice to Loudoun."
Hospitals consider options
A lot has happened since the Feb. 3 vote to deny the Broadlands Regional Medical Center application. HCA has announced plans to turn its attention to Fairfax County and expand its Reston Hospital Center by 152 beds. Inova Health System made its first move to put an 80-bed hospital on U.S. 50, where many have maintained that the county's second hospital belongs. And the Federal Trade Commission contacted Supervisor Stevens Miller (D-Dulles) and offered to come out to Loudoun and discuss competition in health care.
According to Miller's e-mail to his constituents, the FTC contacted county government a day before the scheduled Feb. 3 vote on the Broadlands application. Miller then contacted James Cooper at the Federal Trade Commission's Office of Policy Planning. Cooper wrote to Miller Feb. 11, offering his services to discuss "the role of competition in our health care delivery system." A 2003 FTC report, Cooper continued, concluded that "vigorous competition among health care providers 'promotes the delivery of high quality, cost-effective health care.'"
At the Feb. 3 meeting, the application failed by one vote (5-4). Supervisors Buckley, Sally Kurtz (D-Catoctin), Lori Waters (R-Broad Run), Kelly Burk (D-Leesburg) and Eugene Delgaudio (R-Sterling) said they were convinced that the negative effects of a 24/7 hospital adjacent to a residential neighborhood could not be mitigated.
Board of Supervisors Chairman Scott York (I-at large) championed the project from the beginning. He invited HCA to look for a home in Loudoun County more than seven years ago and worked hard to get the project through the previous board, which opposed it 6-3.
Supervisors in support of the Broadlands application pointed to the jobs the hospital would bring, the taxes it would generate and the need for competition. The 183-bed Inova Loudoun Hospital currently serves the entire county, and 50 percent of Loudoun residents head east to Reston Hospital or to Inova facilities in Fairfax, or west to Winchester Medical Center.
The Reston scenario
Shortly after the Feb. 3 denial, HCA's Mark Foust said the hospital corporation would keep all its options on the table, including going back to court to challenge the vote. Moving its operation to land HCA owns on U.S. 50, Foust said, is not an option.
Within a week, HCA proposed to add 152 beds to Reston Hospital's existing 187 beds, and to expand the campus by 345,000 square feet. The expansion would include a six-story medical office building and the addition of 650 parking spaces.
HCA submitted a rezoning request to Fairfax County to get the process started. How it will deal with getting the state's approval remains unclear. The current state approval of the 164 beds for Broadlands, first issued in March 2004, involved moving already-approved hospital beds from Northern Virginia Community Hospital in Arlington and from Dominion Hospital in Falls Church to the proposed Broadlands facility.
HCA could ask the state to shift those approved beds to Reston, but it would have to ask for more beds – the 40 adolescent psychiatric beds approved for Broadlands will stay at Dominion Hospital in Falls Church. Or HCA could ask the state to extend the approval for the 164 Broadlands beds for a year, possibly anticipating a legal challenge to the Loudoun board's denial, and apply to create 152 new beds at Reston.
HCA will have to prove to the state that the additional beds are needed. The health commissioner late last year approved Reston's request to add 18 obstetrical beds but did not approve the addition of 12 more medical-surgical beds.
At about the same time, the health commissioner approved the addition of 40 obstetrical beds and 37 neonatal beds at Inova Fairfax Hospital.
According to the nonprofit Virginia Health Information, 40 of Reston's 187 beds were not staffed during 2007. For the same time period, Virginia Health Information showed all of Loudoun's 155 beds, all of Inova Fair Oaks' 182 beds, all of Inova Fairfax's 833 beds and all of Winchester's 411 beds were staffed.
Expanding the Reston campus, Foust said, "will serve many Loudoun patients who otherwise would have received care at BRMC."
Foust noted that Fairfax in 1984 approved the original application to build Reston Hospital, and has allowed expansion of the campus five times since then, "to help the hospital grow with the community."
The 15-acre Reston campus today houses 600,000 square feet of hospital and medical office space.
The U.S. 50 plan
The same day HCA announced plans to shift its attention to its Reston campus, Inova notified the state of its "intent to file a Certificate of Public Need application" for a hospital on U.S. 50 by the June 1 deadline to be considered this year.
Inova Loudoun Hospital CEO Randall Kelley said Inova is seeking a Certificate of Public Need for a full-service hospital with 80 beds, up to eight emergency rooms, a 24/7 emergency department and a helipad for transporting trauma patients.
Inova will start work immediately on a healthplex on the property, Kelley said. Inova's Avonlea healthplex on U.S. 50 includes outpatient urgent care, primary and specialty physicians on duty, physical therapy, pharmacy, laboratory and radiology. All those services will be shifted to the new healthplex, which will grow into the full-service hospital, Kelley said.
The healthplex does not require approval from the state, and Loudoun has already approved the property for a hospital.
"We are fulfilling the promises we made to the people of Loudoun," Kelley said. "HCA chose to leave the county, even though they own property on Route 50 and have an application [for hospital use there] in the process."
Kelley took exception to the charge that Inova is trying to stifle competition. "I would remind everyone that half the people in Loudoun County leave the county for health care. It's hard to make a credible argument for choice when people are exercising that choice every day."
Foust, at HCA, had doubts. "Believing Loudoun will magically gain a hospital on [U.S.] 50 ignores market, competitive and regulatory realities. This filing will surely invite competing applications, including those from outside the county. Another Inova hospital at any location in Loudoun will continue its monopoly and have a detrimental impact on health care delivery."
Well Sally Kurtz, I hope when you are voted out next time you don't wonder too hard why! Same with you Lori Waters...I hope your district sees you for what you really are.
Posted by NovaDifferenceMaker
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Why can't people find the courage within themselves to stand up and do the right thing? These supervisors, under the guise of land use planning, caved in to the bullying threats of Inova to shut down services had the new hospital been approved. It will be a long time before Loudoun County sees any new hospital - and - let's say Inova does get one built in five years or so -- is allowing Inova to have a monopoly on healthcare services in the county really the best move for the public? How does a lack of competition increase quality of care, service and cost for everyone? It doesn't. I think this BOS really let the county down -- and it won't be forgotten at election time.
Posted by Phantom
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