Boomers Drive Hospital Growth
New Technology, Demands Addressed

By Lori Aratani
Washington Post Staff Writer
Sunday, August 10, 2008

Holy Cross Hospital's announcement last week that it hopes to build a hospital in Germantown is just the latest example of a baby boomer-fueled building frenzy sweeping the health-care industry in Montgomery County and other parts of the country.

Over the past several years, all five of Montgomery's major medical centers have decided to expand, upgrade their facilities or build new ones. The changes sometimes pit hospitals against each other as they vie for patients. Holy Cross's announcement has prompted Rockville-based Adventist HealthCare to urge greater regulatory scrutiny of its rival's plans.

Medical centers in some nearby counties are also growing.

Howard County General Hospital broke ground in September on a $105 million expansion that will increase the number of beds from 219 to 261. Kaiser Permanente of the Mid-Atlantic States, which has 29 medical centers in Maryland, the District and Virginia, plans to open a medical center in Fredericksburg early next year. In 2006, Potomac Hospital in Woodbridge opened a four-story, 180,000-square-foot patient care building that added 30 private rooms.

"You're seeing this all over," said Charlene Wilkins, spokeswoman for Potomac Hospital.

What's happening locally mirrors a national trend, fueled by concerns that aging baby boomers will put new demands on the health-care system and that old hospital buildings can no longer accommodate changing and complex medical technologies, said Mary E. Stefl, chairwoman of Trinity University's Department of Health Care Administration.

"It's the most significant [hospital building boom] since after World War II," said Rick Wade, senior vice president of the American Hospital Association.

According to an annual survey by Modern Healthcare magazine, 2007 was a banner year for hospital construction. Last year, 3,552 health-care construction projects were completed, compared with 3,441 the year before.

Amid the boom, however, D.C. area hospitals in less affluent areas have struggled to stay afloat. In the District, officials hope new ownership will prevent Greater Southeast Community Hospital from having to close. In Prince George's County, state and county officials are working to keep the publicly owned Prince George's Hospital Center open until a buyer can be found.

Although some say the economic downturn will slow the trend in more affluent areas, the boom continues in Montgomery. In addition to Holy Cross's plans for a new hospital and renovations at its Silver Spring campus:

· Montgomery General Hospital in Olney will break ground in a few weeks on an addition that will double the size of its emergency room.

· Washington Adventist Hospital is laying the groundwork for a move to a site in White Oak/Calverton that's almost quadruple the size of its 13-acre campus in Takoma Park. It is also in the midst of a $99 million expansion that will add about 45 beds to its Rockville campus.

· Suburban Hospital in Bethesda is in the planning stages of a renovation that will upgrade and expand its operating rooms.

"Montgomery County's health-care infrastructure clearly has not kept up with the needs of a growing and aging population," said Ronna Borenstein-Levy, spokeswoman for Suburban. "Each hospital is trying to serve the community the best way it can, which is why you see these various initiatives being proposed."

Montgomery County Council member George L. Leventhal (D-At Large) added: "We've had the same infrastructure we had 30 years ago, but we have a dramatically larger population."

In addition to changes at its Takoma Park and Rockville campuses, Adventist HealthCare opened the Shady Grove Adventist Emergency Center in Germantown in 2006 to help meet the demand for emergency room services. Spokesman Thomas Grant said the center, the only emergency facility in the 30 miles between its campus in Rockville and Frederick Memorial Hospital, is expected to have about 33,000 patients this year. Holy Cross's plan for a hospital in Germantown has been greeted with enthusiasm from elected officials, who have long heard complaints from residents about access to medical facilities.

"I'm very excited," said Montgomery Council President Michael Knapp (D-Upcounty) about Holy Cross's plan. "To look at where we were 10 years ago [in terms of medical facilities] and look where we'll be in five years, it's a great turnaround."

But Kathie Hulley, a Clarksburg resident, said she's worried about the effect the Holy Cross project will have on Adventist HealthCare's earlier plan to build in Clarksburg.

In 2001, Adventist HealthCare purchased a parcel in Clarksburg with the intention of building an additional medical campus, officials said.

"This would be the nail in the coffin to that plan," Hulley said.

Officials at Adventist also have concerns.

"There needs to be more public and regulatory scrutiny over various aspects of [Holy Cross's plan]," said Robert Jepson, Adventist HealthCare's associate vice president of government relations and public policy. Jepson noted that several years ago, when Adventist HealthCare sought to increase the number of beds as part of a renovation at its Shady Grove Adventist campus in Rockville, Holy Cross officials were among those who argued fewer beds were needed.

"There's a very energetic rivalry going on between two hospitals, Holy Cross and Adventist," said Leventhal, who chairs the council's health and human services committee. "I don't know what to make of it. They're both nonprofits. They ought to be working together, but they're clearly very competitive."

Although it established its first hospital in Takoma Park, Adventist HealthCare has slowly carved out a presence in the western part of the county with Shady Grove Adventist in Rockville and the emergency center in Germantown, as well as the Clarksburg land purchase.

Holy Cross is based in Silver Spring. The Germantown site would be its first major push into the western portion of the county, though it plans to open a primary care clinic in Gaithersburg this year, said Holy Cross's president and chief executive, Kevin J. Sexton. Its proposed hospital would be about a mile from Adventist HealthCare's emergency center, Jepson noted.

More details about Holy Cross's plans will come in October when it must submit a Certificate of Need with the Maryland Health Care Commission. But a letter to the commission notes that plans might involve a transfer of beds from Silver Spring to Germantown, something officials at Adventist HealthCare said should be examined closely.

Sexton said research shows that there is a need for a full-service hospital in the Germantown area. He said moving some beds to Germantown would not mean a loss of services for Silver Spring residents, since the project is designed to serve the 28 percent of Holy Cross patients who come from the Upcounty region.

Holy Cross's proposal will probably face scrutiny from the state's health-care commission, the state agency that will determine whether it can move forward. Among the commission's duties: regulating the number of hospital beds that can be added when hospitals choose to expand or build.

No matter the outcome, expansion advocates say Washington area patients will benefit from the construction boom. Many of the building projects are focused on making hospitals more user-friendly and less institutional with amenities such as valet parking and private rooms with pullout beds for family members to stay overnight.

Said William G. Robertson, president and chief executive of Adventist HealthCare, "Certainly there are good hospitals all over this region."

Staff researcher Meg Smith contributed to this report.