William Robertson, Adventist's president and chief executive officer, said in a statement: "We are deeply disappointed in today's ruling, especially for the thousands of upcounty residents and community leaders, many of whom spent almost a decade working with us to expand access to health care in the region and create jobs with the Clarksburg Hospital."
Adventist said it will evaluate options for appeal to the commission and also consider a court challenge.
Advocacy groups were concerned that Maryland would set a bad precedent if it chose a hospital with religiously mandated restrictions to be built on publicly owned land.
Beth Corbin, national field director for Americans United for Separation of Church and State, said her organization was considering possible legal action. The group was among several advocacy groups that filed a lawsuit under similar circumstances in Florida a decade ago over the operation of a public hospital under Catholic religious doctrines. The case was settled out of court; the hospital no longer operates under Catholic directives.
Adventist had sought to delay the vote, citing Moon's lack of evidence to support her conclusions about the availability of reproductive health services in Montgomery.
Holy Cross said it provides emergency contraception for victims of sexual assault. A spokeswoman said the largest access problem in Montgomery is prenatal and primary care services for uninsured women. Holy Cross is the largest provider of such care, she said.
Adventist had long planned to build a hospital in Clarksburg to complement Shady Grove Adventist Hospital in Rockville and its emergency center in Germantown. Adventist purchased the land in Clarksburg in 2001 and received the necessary county land, traffic and environmental approvals before Holy Cross offered its rival proposal in August 2008.
Adventist proposed a Clarksburg hospital along Interstate 270 between Shady Grove Adventist and Frederick Memorial hospitals. It would have been part of a medical complex with office buildings for doctors and a nursing home.
Holy Cross's proposal for Montgomery College's Germantown campus would provide on-the-job training for nursing students.
In a recent letter to the commission, 12 upcounty state legislators said they continued to support Adventist and were concerned about possible duplication of health-care services at the Adventist-operated Germantown Emergency Center, which is about a mile from the proposed Holy Cross site.