Rt. 50 Healthcare - HCA Perspective

Dear Commissioner Chaloux –

I am pleased to offer you additional detail about HCA Virginia’s health care plans within Loudoun County as well as an overview of the health care services that are in action for the Rt. 50 corridor.

HCA Virginia has a phased approach to providing health care in Loudoun County that's based on the County's known healthcare needs of today and the belief of further need in the future. First, with the development of BRMC, residents will have much-needed access to hospital care closer to home. Your constituents in South Riding, Stone Ridge, Aldie, Brambleton and Broadlands, among others, will have better access to heath care services with less time on the road – and they will
have a better road to travel with our proffered Rt. 659 improvements.

Beyond BRMC, HCA Virginia will additionally serve the residents along the Rt. 50 corridor with the freestanding StoneSpring Emergency Department (ED ). This project includes a CT scanner which has already been approved by the State Health Commissioner and is expected to be complete by late 2009 - early 2010. The opening of the ED will have a positive impact families in southern Loudoun County by providing them with access to emergency and other outpatient services. The ED initially will originally be affiliated with Reston Hospital Center and later will transition to work directly with BRMC once it opens. It also will offer the pediatric expertise of Children's National Medical Center.

A HCA Virginia hospital and outpatient facility, collectively called Stone Spring Medical Center, are planned for a second phase of development on the land that we own at the corner of Rt. 50 and Gum Spring Road. This hospital, which is focused on meeting long-term community needs, does not have a definitive timeline for completion, but would come online as the already planned for population growth in the corridor occurs and the County warrants a third full-service hospital. Notably, because COPNs are considered and awarded based on local and regional needs, proposals to add hospital beds at existing facilities, such as Inova Fairfax Hospital or Prince William Hospital, can affect the timing for construction of new
hospitals in Loudoun County. The Health Commissioner is the ultimate determining factor for the construction of the next hospital in Loudoun County based on health care needs. Her analysis of population and need will lead to the ultimate awarding of the Certificate of Public Need and dictate the timing to proceed.

Beyond HCA Virginia’s plans for the phased development of StoneSpring, other health care providers are progressing on their plans for medical services in the corridor as well. Within just a small radius, Rt. 50 residents will have access to Inova’s Urgent Care Center at Avonlea ( already open), HCA’s StoneSpring Emergency Department ( site plan in process), HealthSouth’s 40-bed Rehabilitation Hospital ( COPN approved, pending Special Exception approval from Loudoun County) and Capital Hospice’s 20-bed hospice care facility (planned). These near-term projects, along with BRMC, will provide access to a spectrum of medical care to serve all life stages while being poised to meet the region’s future hospital needs with StoneSpring Medical Center .

HCA’s commitment to Loudoun County is strong and we look forward to providing residents with the services, access and choice that the want and deserve now and in the future.

Thank you and please let me know if you have any questions.

Sincerely,

Tracey White
VP of Community & Government Relations
HCA Capital Division

Rt. 50 Healthcare - INOVA perspective

Commissioner Chaloux and members of the Loudoun County Planning Commission:

Please note below my response to the questions posed to me in an e-mail dated Friday, October 24 from Commissioner Chaloux.

1. Does INOVA currently own the property on Route 50 where the County granted INOVA approval for a SPEX application to build a hospital in 2007? I received a constituent call. This constituent indicated that INOVA never completed the final closing papers on this property.

We closed on this real estate transaction in early 2006; the property is owned by Loudoun Healthcare, Inc. and would be operated by Inova Health Care Services. We were granted our special exception by the Board of Supervisors in March of 2008.

2. Has INOVA pursued a COPN for a hospital at the Route 50 location? If not, why not?

We have not pursued a COPN and advised the Board of Supervisors of this before our Special Exception was approved. In fact our planning experts believe that no new hospital beds will be approved by the State anywhere in Loudoun County for decades to come if BRMC is approved. As long as the BRMC issue remains unresolved, there will be no application for hospital beds for this site.

In fact, should BRMC open in Broadlands Inova Loudoun Hospital must surrender 16 beds recently put into service at our Lansdowne campus because of a condition that was imposed by the State Health Commissioner when those beds received COPN approval.

3. What population numbers, geographic radius, and other criteria must exist to make a hospital viable on Route 50? Would the current population support a hospital on Route 50?

We believe a Route 50 hospital is viable, necessary for the population living on Route 50 corridor and consistent with the goals of the County's comprehensive plan. A hospital on Route 50 would be as viable as a hospital at Broadlands (and would not have the detrimental effects). This is based on a study that our health planning experts are just completing and which I will forward to you. The current population that would be served by a Route 50 hospital would be sufficient to sustain a hospital there (if there is no BRMC). If BRMC is built, a hospital on Route 50 will not be viable.

As I have previously informed the Board of Supervisors at numerous public comment sessions, should BRMC NOT be approved and if HCA elects not to seek a COPN change in location, Inova would immediately file a COPN application for a hospital on Route 50.

Meanwhile I will point out that a hospital on Route 50 will have the opportunity to serve all the same patients that a hospital at Broadlands would serve plus more from the south and west. Patients leaving the County now for care should not hesitate to drive to Route 50 if they are now driving even longer distances outside the County. Remember it is this population HCA says it wants to capture rather than taking patients away from Loudoun Hospital. Furthermore, a hospital on Route 50 is less likely to divide patients with Loudon Hospital and Reston Hospital, which would reduce a new hospital's use at the Broadlands location.

4. What are Inova’s plans for providing emergency medical services in the Route 50 corridor if the BRMC SPEX application is approved and if it is not approved? What is the anticipated timeframe in both cases?

We have completed the engineering work required to submit a site plan for our first phase of construction on our Route 50 property. This facility would include a full-service 24 hour/day emergency department along with other outpatient services and medical offices. (This planned facility would replace our leased facility already operating on Route 50.) We are prepared to move forward with this facility immediately if the BRMC application for Broadlands is denied.

If the BRMC facility is approved in Broadlands, all of our planned expansion throughout Loudoun County will be at risk and will be subject to further review and curtailment.

Randy Kelley, CEO
Inova
Loudoun Hospital

Dulles South Healthcare

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