When it was built more than 100 years ago, Washington Adventist Hospital had plenty of space to serve the once small, suburban population in and around Takoma Park.

But times have changed. Now in a bustling urban area, the hospital has been looking for growing room and six years ago announced that it wanted to relocate elsewhere in Montgomery County.

Beginning today, the hospital’s parent company, Adventist HealthCare, will go before state regulators to present its proposal to move the 281-bed hospital to a 48-acre site near White Oak.

The hearing before the Maryland Health Care Commission is one of the final hurdles for Adventist, which received approval from the Montgomery County Planning Board in 2008.

“The issue is that we face significant challenges at our current campus,” said Robert Jepson, an Adventist vice president. “We’ve got to be able to effectively serve the community long term.”

But other hospitals in the area oppose the move, which they say would hurt their own growth and hurt care for some of the region’s poorer people.

Washington Adventist serves many people from lower-income communities, including Langley Park in Prince George’s, and the absence of a full-service hospital in the area is a concern of some officials, including Prince George’s County Executive Rushern L. Baker III.

Jepson said Adventist will not be abandoning anyone.

“We are seeking to serve the same patients we always have,” he said.

The hospital has plans for a clinic on the Washington Adventist site, which state Sen. Victor R. Ramirez (D-Prince George’s) said has alleviated his concerns about patient care.

“I think they’re taking adequate measures to make sure all the needs and wants are met,” Ramirez said.

Joyce Portela, president of the hospital, said the limitations of the site in Takoma Park have become an obstacle to the hospital’s necessary growth.

One issue is that the only route onto the campus is a narrow, two-lane road offering little space for both cars and emergency vehicles, Portela said. Another issue is the lack of private beds, she said. Most rooms have two beds, which sometimes leaves visitors jostling for space with medical machines and nurses. Beds may also go unused when the room is already occupied by a patient with a contagious illness, she added.

A bigger hospital could solve some of those problems, but Portela said the current location, between Washington Adventist University and the Sligo Creek Parkway, does not allow for expansion.

Adventist’s plans for the new hospital include a 249-bed facility with all private rooms on a lot located about six miles away, near Route 29, on the eastern edge of the Montgomery County border and not far from the Prince George’s community of Calverton.

The site, purchased by Adventist four years ago for $11 million, would be part of a larger health-sciences corridor envisioned by county leaders.

Adventist has plans for a new faith center at the location, as well as utilizing a lake on the property to provide a “natural setting” for healing, Portela said.

Some key local officials support the proposal, including Montgomery County Executive Isiah Leggett and the members of the Montgomery County Council, according to letters from each that were submitted to the state health commission.

The Prince George’s County Council endorsed the move last year and Council member Mary Lehman (D-Laurel), whose district includes Laurel Regional Hospital and is near the proposed Adventist site, said she supports the plan.

When it comes to health care, “more access is better than less,” Lehman said.

While Lehman said she sees no downsides to the move, the operators ofLaurel Regional are worried about how the new hospital will affect their patient population.

Representatives of Dimensions Healthcare, which owns Laurel Regional as well as Bowie Health Campus and Prince George’s Hospital Center in Cheverly, assert that the new hospital would attract some wealthy, insured patients that Laurel would normally receive and leave behind poorer, uninsured patients.

“You abandon your urban population and go to a suburban population,” said Kurt Fischer, an attorney for Dimensions. “That’s not good health-care planning.”

The result, said Fischer, is millions of dollars in losses for Laurel once the new hospital is up and running.

Jepson said Adventist is not seeking to change its mix of patients.

Baker has said that the proposed move by Adventist is fraught with risk for Prince George’s. The county is in the early stages of an effort to strengthen its public hospital system, which is operated by Dimensions.

Regulators weighing the proposal, Baker said in a letter to the County Council and to Adventist and Dimensions, “must recognize that the building of a new hospital near Laurel Regional Hospital may negatively impact the financial sustainability of the county’s hospital system.”

The county executive called on Adventist and Dimensions to “work cooperatively to achieve our overriding goal of providing . . . accessible health care to our citizens.”

Dimensions is not the only hospital operator lining up against the Adventist proposal. Montgomery General Hospital, which is in Olney and is owned by MedStar Health, completed a new state-of-the-art emergency department last year and is constructing an additional floor on its west tower to house 25 private rooms. Fischer, who is also representing Montgomery General, said the hospital’s improvements will be “substantially undercut” by Adventist’s move.

Holy Cross Hospital in Silver Spring, which is also opposing the move, has submitted testimony to support its position that there is no need for a new Adventist campus. The hospital asserts that it is financially viable for Adventist to simply renovate the Takoma Park campus and keep it a full-service hospital.

Montgomery General, Dimensions and Holy Cross will be presenting their own testimony at the hearings, which are scheduled to run through the end of the week in Baltimore.