After nearly a century in Takoma Park, Washington Adventist Hospital will leave its small residential campus for a much bigger home farther north in Montgomery County.

The decision follows several years of sometimes contentious debate with neighbors over the hospital's future. Yesterday, officials described the move to an as-yet-undetermined site as integral to the hospital's "expanded, strategic vision," which in part targets the health needs of the increasingly ethnic and immigrant populations of Takoma Park, Langley Park and Silver Spring.

Initiatives will include construction of an urgent care facility, barely a mile from the current hospital, to provide primary care and minor emergency treatment, as well as reconfiguration of Washington Adventist's board of directors "to better reflect the diversity of the community served."

But it was the announcement that the hospital and its nearly 2,000 employees will pack up after building a new campus that was the vision's big surprise. Officials have been working with residents since 2003 on a plan to add more than 125,000 square feet to the existing facility's emergency department, inpatient floors and clinic and private doctors' offices.

"We thought we had a potential compromise," said Eileen Sobeck, who lives across the street from the hospital. "I never wanted them to leave, and I'm not sure I'm totally happy with their solution."

Bill Robertson, president and chief executive of parent company Adventist HealthCare, said the organization has identified five potential sites in eastern Montgomery. He expects that a move to any one of them would help ensure the hospital's viability, not just for the next 10 to 20 years but for the next 100. Even if neighbors voiced no objections down the line, he said, the current property offered "no opportunity" for development.

The 308-bed Washington Adventist sits on 14 packed acres, compared with the 48 acres of its sister facility, Shady Grove Adventist Hospital in Rockville. When the Takoma Park hospital opened its doors in 1907 as the Washington Sanitarium, those acres were on the remote, bucolic outskirts of the nation's capital. These days, they are surrounded by a dense urban-suburban community and narrow, often clogged roads.

Patients often have trouble reaching the hospital, as do ambulances. The 150 helicopter flights arriving each year with the critically injured do little for community relations. It has all proved "an interesting challenge," Robertson said.

Administrators said the five potential sites fit their board's criteria for size (25 to 30 acres), access (to major transportation routes) and zoning (commercial). Neither Robertson nor hospital president Jere Stocks would disclose locations or price tags; state regulatory approval of those and other particulars would be required for construction.

A target date for completion is 2010.