The District's health advisory council dealt a blow last night to Mayor Sharon Pratt Dixon, voting 7 to 6 to transform Capitol Hill Hospital from an acute care facility into a nursing home.

Dixon submitted testimony to the council last week expressing strong support for keeping the hospital open. Its owner, Medlantic Healthcare Group, wants to shut its emergency room and convert 130 medical-surgical beds into nursing home beds.

"The city needs Capitol Hill Hospital to remain an acute care facility," Dixon said in her testimony.

But some council members said they believed they should do their jobs as health care planners without political pressure. "The mayor's feelings should have no bearing on what we do tonight," one said.

Carolyn Graham, chairman of the D.C. State Health Planning and Development Agency, has the authority to decide what happens to Capitol Hill Hospital, one of the city's smallest. The hospital is at 700 Constitution Ave. NE, near low-income neighborhoods that depend on the hospital rather than private doctors for primary care.

Graham has indicated that she will make a decision by Feb. 20 after considering the Medlantic application for conversion, the council recommendation, the staff report and other advisory opinions.

At one point during last night's meeting, Graham described the Capitol Hill Hospital case as an "administrative nightmare." She said that she had been assured by the D.C. corporation counsel that the advisory council could legally proceed on Medlantic's request to convert the hospital.

But Constance Spheris, a representative of the mayor's office, told the council that the D.C. corporation counsel was still studying the court order to determine its impact on the certificate of need application for conversion.

Spheris said Dixon believes Medlantic should obtain a certificate of need to close the hospital before obtaining a certificate of need to convert it. She said the mayor also believes that permitting the conversion certificate to be processed first would nullify the court order.

Medlantic spokesman Philip Schneider applauded the advisory council's decision. "We are appreciative of the council's recognition of how this project will fulfill its own objectives," he said.

But coalition leader Rick Ehrmann said that the council's decision was "awful" and represented a slap in the mayor's face. "We aren't saying they should do what the mayor says, but we have a situation here where Carolyn Graham has acted as Medlantic's cheerleader, shepherding it through the process as though it were her pet project. It is not a fair due process taking place here."