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Maryland legislators who supported Adventist HealthCare's plan for a new hospital in Clarksburg say they are hoping the Maryland Health Care Commission still rules in Adventist's favor, but are not dismissing legislative action.

A commission reviewer Dec. 17 recommended that a hospital proposed by Holy Cross Hospital be built in Germantown over the Adventist plan. The full health care commission is expected to vote Jan. 20 on a hospital that would serve the growing population in northern Montgomery County and southern Frederick County.

On Thursday, Adventist HealthCare officials filed a 105-page response, seeking to reopen the review because of flaws in the recommendation.

Adventist officials say the recommendation was based, in part, on evidence that was not in the official record and that it highlighted negative financial information about the Clarksburg project while overlooking similar findings on Holy Cross' project, as well as factors.

Del. Brian J. Feldman (D-Dist. 15) of Potomac, one of 11 of 12 upcounty Montgomery legislators to endorse Adventist HealthCare's plan for a Clarksburg hospital, said he was disappointed by the recommendation in favor of Holy Cross and that he plans to talk to delegation colleagues and "explore whatever options might be available to us."

"This has been a contentious issue for us for some time," he added.

Feldman, who recently returned from a trip out of the country, said it was too early to comment on possible action.

But in 2005, after the Maryland Health Care Commission denied a certificate of need for Shady Grove Adventist Hospital's plans to build a stand-alone emergency center in Germantown, state lawmakers passed legislation that bypassed the commission's decision so the emergency center could be built. Feldman said the 2005 legislation was difficult to pass, however.

His e-mail inbox has been filled with comments about the 260-page recommendation, drafted by Maryland Health Care Commission Chairwoman Marilyn Moon, Feldman said.

Another Adventist HealthCare supporter, Del. Kirill Reznik (D-Dist. 39) of Germantown, who was not in office in 2005 when the legislature overrode the commission's decision, said he does not know if lawmakers would want to pursue that route again.

"It's something of a dramatic step," Reznik said. "We set up the commission to be a regulatory agency to make decisions. To countermand that every time we get a decision we find we disagree with undermines the commission and takes away our ability to properly regulate."

Reznik said he is keeping his "powder dry" on the issue. "Further conversations with Adventist and Holy Cross are probably the prudent way to go," he said.

But he is not entirely ruling out legislation to support Adventist's proposal.

"At this point I don't have any plans to submit legislation. That could change after various conversations," Reznik said.

Outgoing Del. Saqib Ali (D-Dist. 39) of Gaithersburg, the lone upcounty legislator to not sign the letter in support of Adventist, said the Adventist plan never made sense to him for Germantown.

"The arguments in favor of Adventist over Holy Cross were wholly unconvincing," Ali said. "The argument they told me is, ‘We've reached out to the community' and such, which to me were nonsensical. That's not the basis for why a hospital should be located anywhere in Montgomery County."

In her report, Moon cited Holy Cross' overall financial picture, the population and demographics in Germantown compared with Clarksburg's and other factors.

"I have concluded that Adventist HealthCare's priority over the next few years must be assuring the long-term viability of Washington Adventist Hospital," Moon said. "This task, critical to restoring Adventist HealthCare to robust financial health, is large enough that it should not be put at risk by simultaneously attempting to establish a new hospital."

William G. "Bill" Robertson, president and CEO of Adventist HealthCare, called the recommendation "flawed" and disagreed with Moon's assertion about Adventist's fiscal health, saying the firm had a "solid financial plan" for the Clarksburg hospital.

Holy Cross Hospital is seeking to build a $202 million, 93-bed hospital on Montgomery College's Germantown campus, while Adventist's plan calls for a $177 million, 86-bed hospital as part of a large health care campus in Clarksburg.

Adventist HealthCare's Robert Jepson, vice president of government relations and public policy, said Adventist is busy working on its response to Moon's report and is focused on the commission's upcoming meeting. The report gave "little consideration" to the impact that a new Holy Cross hospital in Germantown would have on the Shady Grove Adventist Hospital Germantown Emergency Center, Jepson said.

But the Adventist HealthCare's Facebook page for the Clarksburg hospital urged supporters to contact their state legislators to state their continued support for the Clarksburg plan.

"We continue to firmly believe the best plan for upper Montgomery County is the Clarksburg hospital and the continued operation of the Germantown Emergency Center," Jepson said.

A Holy Cross Hospital representative declined to comment about possible future actions by Adventist HealthCare.

Sen. Robert J. Garagiola (D-Dist. 15) of Germantown said that it was too early to say what, if any, action he would back on a hospital because he has not had a chance to read the report and the full commission hasn't made a decision.

"I want to take a look at the reasoning behind the recommendation," Garagiola said. "What I know of the two projects and what I see in the future, demographically, I still strongly believe that it makes more sense to have a hospital in the Clarksburg community. Right now, where we're at is let's see what the commission does."

Under Maryland law, the 15-member Maryland Health Care Commission is required to approve a certificate of need before a new hospital can be constructed. At the Jan. 20 meeting, the commission can vote to accept the recommendation as is, modify it or reject it entirely, said Pamela Barclay, director of the Maryland Health Care Commission's Center for Hospital Services. Concerned parties are expected to make presentations, she said.

If approved, a new hospital would be the first in Montgomery County since Shady Grove Adventist Hospital opened in 1979. The last new hospital in Maryland was Atlantic General, which opened in 1993 in Worcester County.

The last time a recommendation was not accepted by the full health care commission was unknown, although it has happened in the past, Barclay said.

Adventist officials said they had long planned a hospital for the Clarksburg area since purchasing land in 2001 and would not be deterred by the recommendation.

Adventist's Robertson said in an e-mailed statement, "We will urge the full commission to study all of the relevant information in this case, which clearly shows that our vision is the strongest plan for the region and the only one that has the approval of the Montgomery County Planning Board."

In her report, Moon wrote that a Clarksburg hospital would improve access for upper Montgomery County, but "is a riskier project, given the lower population density that exists in the Clarksburg area. I also note the weaker financial position of its sponsor when compared to the HCH-SS proposal for Germantown."

Both hospitals have other multimillion-dollar projects in the works. Adventist HealthCare plans to spend more than $400 million on its new Washington Adventist Hospital when it moves from Takoma Park to White Oak. Holy Cross is planning a $295 million renovation of its Silver Spring hospital.

On the day Holy Cross received the prized recommendation, hospital CEO Kevin Sexton said, "It makes for a terrific day for us and we think a terrific day for the county."

The long review process began in September 2008, after Holy Cross submitted its proposal; Adventist submitted its plan in April 2009.

Holy Cross has moved forward with land-use approval for the site on the college campus, Sexton said. When ground might be broken would depend on obtaining county approval, he said.

"It has been a long process, but I'd have to say a thorough process," Sexton said. "To come through that amount of scrutiny and to be selected ... certainly makes us feel that work was worthwhile."

cford@gazette.net