Loudoun Hospital opened its doors June 5, 1912, in a rented house on West Market Street in Leesburg. For most of its history, the community-based hospital served a small but growing population from its facility on Cornwall Street, which opened in 1918.

The past two decades, however, have marked a turning point for the hospital, as the county’s population grew from 90,000 to more than 325,000. Throughout its 100-year history, Inova Loudoun Hospital has been the only hospital in the county. But as it celebrates its centennial this month, competition is looming in the form of Richmond-based Hospital Corp. of America, which plans to open an emergency medical center on Route 50 in southern Loudoun next year as the first piece of the StoneSpring Medical Campus.

Inova Health System has been preparing for competition since it took over Loudoun Hospital Center in 2005. But the company has mainly focused on adding advanced medical services to serve the growing population, said H. Patrick Walters, who was named the hospital’s chief executive this month.

Before it merged with Inova, Loudoun Hospital was a “good community hospital,” Walters said. But it lacked surgical specialties, advanced emergency services and medical services for cardiac or cancer patients, Walters said.

“It takes hundreds of thousands of people in order to support advanced services,” Walters said, adding that a smaller population base cannot supply enough patients for the hospital to maintain the expertise, qualifications or accreditations necessary to provide advanced levels of medical services.

When the hospital opened its Lansdowne campus in 1997, officials made a strategic decision to keep the Leesburg facility for future expansion. Over the past decade, as the county’s population surged past 300,000, the hospital has added what Walters called the “first tier” of advanced services.

“There’s a brand-new cancer center, state-of-the-art radiation therapy equipment [and] an exceptionally trained radiation oncologist who came from Johns Hopkins,” Walters said. “We added services to build on that medical staff, and they, in turn, brought other great doctors.”

The hospital has also added advanced cardiac and vascular labs; doubled the size of the emergency room, including a new pediatric emergency center; and expanded obstetrical services for women with high-risk pregnancies.

The need for a population base to support these advanced services led Inova to wage a lengthy fight against HCA Virginia’s plans to build a for-profit hospital in Broadlands, about five miles from Inova Loudoun Hospital in Lansdowne. Over the past decade, the Loudoun County Board of Supervisors twice turned down HCA’s land-use applications to build its hospital in Broadlands, most recently in 2009.

“Our main concern with [HCA] was over . . . how large services have to be, to be viable,” Walters said.

He said that Inova did not object to HCA’s proposal to build its hospital in the Dulles South area.

“A hospital at the south end of the county, a hospital at the north end of the county, with outpatient ambulatory services in the middle for both of us . . . then it’s okay,” he said. “There’s going to be a lot of growth in that area. There’s going to be growth up here, and that makes sense to us.”

Today, Inova has its flagship hospital campus in Lansdowne and is renovating and expanding its Leesburg facility — the old Loudoun Hospital campus. Inova has an urgent-care center in Purcellville and an imaging center in Sterling. The company is also developing plans for urgent-care and imaging centers in Brambleton and Dulles South, near HCA’s planned medical center.

Walters said that Inova Loudoun Hospital has faced competition for years, particularly in outpatient services, such as imaging, which are relatively profitable. But, he said, there is less competition for other services.

A nonprofit community hospital, Inova Loudoun provides services to patients who lack insurance or who are unable to pay the full costs of their care. The hospital provides obstetrical services to more than 500 uninsured women a year, which the hospital subsidizes at a net cost of $1.6 million. “For those kinds of services, we haven’t seen a lot of competition,” Walters said.

The hospital also competes with hospitals in the District and Fairfax County. Walters said that many Loudoun residents continue to go outside the county for advanced medical services and that the hospital is working to draw more of them.

“Growing those kinds of programs in Loudoun County is the next real iteration of what we’ll be doing,” he said.

Celebrating 100 years of service to Loudoun

Inova Loudoun Hospital will celebrate its 100th anniversary Saturday with an afternoon of free, family-oriented activities at Ida Lee Park in Leesburg.

The event, which will be from noon to 4 p.m. at the park’s Festival Field, will include face-painting, jugglers, a health clinic and a rock climbing wall. Food will be sold. There will also be exhibits, a photo booth and giveaways. Ida Lee Park is at 60 Ida Lee Dr. NW, Leesburg. For information, call 703-858-8935 or visit www.inova.org .