By Miranda S. Spivack and Mariana Minaya
Washington Post Staff Writers
Sunday, June 17, 2007
Suburban Hospital in Bethesda is planning a $135 million expansion that could close down a neighborhood street and bulldoze more than a dozen homes, a proposal that has alarmed some residents, who fear the hospital could soon overtake the neighborhood.
For Suburban, which has evolved in six decades from a community hospital into a state-designated regional trauma and stroke center, the expansion's first phase would add an office building, more private rooms and more parking.
For residents in the Huntington Terrace neighborhood just west of the hospital's Old Georgetown Road campus, the expansion could mean more noise, reduced light from shadows cast by taller buildings and the potential for more traffic.
"It's a community hospital. It's in a neighborhood. It wants to be a really big regional hospital in a community footprint," said Lesley Hildebrand, a systems analyst for a consulting firm, who lives nearby. "I think they're trying to shoehorn their way on top of us. Some people would say they're getting too big for their britches."
Suburban's next move is to petition Montgomery County this summer to close one block of Lincoln Street, which bisects the property. If that is approved, the hospital will begin to outline to county regulators details of its expansion, which neighbors say would nearly double the size of the facility.
Eventually, the matter will be turned over to a hearing examiner and reviewed by the county Board of Appeals.
Suburban -- which began as a small community hospital founded as World War II was ending -- has emerged in recent years as a pivotal partner of the National Institutes of Health, just across Old Georgetown Road, and the soon-to-expand National Naval Medical Center on nearby Rockville Pike.
Together, the three hospitals are potential sites for critical triage if there is a major regional disaster. They will be able to ramp up a field hospital with an extra 200 beds and care for major trauma victims as well as those who may have been exposed to chemicals or germ warfare, said Brian A. Gragnolati, Suburban's chief executive. Such efforts require that the hospital remain on the cutting edge of medical advances, he said.
More space is needed to accommodate medical imaging equipment and other modern technology. The rise of antibiotic-resistant bacteria, as well as patient preferences, have driven plans to build more private rooms, he said. The new office building could help attract and keep good staff and doctors by minimizing their commuting time and providing a comfortable setting, he said.
When Gragnolati arrived in 2001, he reviewed plans for expansion and later scuttled them as not fitting into his long-term vision. The revamped plans essentially would rebuild the hospital, but in stages.
"As the population grows, our needs grow, and so does our organization," Gragnolati said. The hospital has eight other sites in Montgomery that do outpatient procedures. "We really need to focus in on acute care on this campus," he said.
Neighbors, who said their relations with the hospital under Gragnolati's predecessor were friendlier, have begun alerting local officials about their concerns and are digging in for a long fight.
"They are trying to destabilize the neighborhood," said Huntington Terrace Citizens Association President Lorraine Driscoll. The association voted twice last month to oppose the hospital's plans.
Driscoll said Suburban could accomplish its modernization without closing Lincoln Street or tearing down houses that separate the hospital from the neighborhood.
Suburban officials told neighbors at a recent meeting that they planned to tear down 19 of 27 houses they own, although a hospital spokeswoman said last week those numbers are not firm.
There also are tensions over noise. The decibel level of the hospital's rooftop heating and cooling system recently was found to violate county law. An expert hired by the hospital took measurements that were lower than the county's and that he said did not violate the law. Next week, the regulators and the hospital will measure anew, hospital spokeswoman Ronna Borenstein-Levy said.
Louise Vann, who has lived near the hospital for more than 50 years, said the effects of the expansion will likely not be as dramatic as some of her neighbors fear. She expects that the hospital will surround the facility with greenery and that construction noises won't be any more annoying than others in the neighborhood.
"I do understand some of their problems, but I feel those problems are small in comparison to the good that the hospital will do for us," Vann said.
Gragnolati pointed to a panel of area residents that the hospital used to vet possible expansion plans, and Borenstein-Levy said the hospital has received about 5,000 expressions of support. The panel suggested that the hospital put extra parking next to Old Georgetown Road rather than close to the neighbors. It appears that the hospital has dropped plans for below-ground parking, which many of the neighbors had endorsed.
Bob Deans, a board member of the Huntington Terrace Citizens Association, said the panel was stacked against the neighborhood. The only representative from Huntington Terrace, the hospital's closest neighbors, eventually quit because the panel seemed to be a "very cynical public relations charade," Deans said.
Some residents also accused the hospital of trying to muzzle neighbors by offering $25,000 bonus payments to homeowners willing to sell and keep mum in any fight over expansion. A hospital spokeswoman said it would not be a deal breaker if a homeowner declined to remain silent.
Gragnolati has also tried to persuade the county to limit neighborhoods' clout by changing the way hospital construction projects are reviewed. He has proposed limiting the significance that regulators could attach to neighbors' viewpoints.
That effort has been watched carefully by civic organizations as well as the county's three other hospitals that are in residential neighborhoods.
"We have asked them to please play by the current rules in place to protect neighborhoods," Driscoll said.
County Council member Nancy Floreen (D-At Large) said hospitals have approached her in recent years to change the process.
"There is some feeling in the medical world that hospitals are basically a public utility and they should not have to go through the whole proof that you have to go through" at county hearings, Floreen said, adding that she was undecided on the matter. "If the citizen engagement process is so onerous and has the opportunity to derail or cause a reorganization of the health care system, is that what we really want?"
Judy Daniel, the county planner who oversees Bethesda for the planning department, said the dispute is unlikely to be resolved soon. "It seemed like they had very little common ground, although both sides acknowledged that Suburban is a wonderful community asset," she said. "The future is a much more complex subject."