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The Maryland Health Care Commission is likely to decide Thursday whether a new hospital will be built in either Germantown, Clarksburg, both communities or neither.

The vote by the commission, which is scheduled to meet at noon in Baltimore, has been highly anticipated by advocates of competing hospital proposals.

Holy Cross Hospital, which is seeking to build a hospital in Germantown, applied for approval of its plan in October 2008, followed in April 2009 by Adventist HealthCare, which wants to build a hospital in Clarksburg.

In December, a reviewer for the commission called Holy Cross' plan the "superior" proposal and recommended approval, but Adventist HealthCare officials have continued to lobby for a Clarksburg facility.

A Holy Cross hospital would be built on the grounds of Montgomery College's Germantown campus.

Meanwhile, 12 upcounty state legislators have written the commission, which is likely to choose just one hospital, saying they continue to support the Adventist HealthCare plan despite the lengthy review and report from the commission's chairwoman, Marilyn Moon, who recommended the Holy Cross plan.

"However, we continue to urge, as we have done in the past, support for Adventist HealthCare's proposal for a comprehensive medical campus and hospital along 1-270 in Clarksburg to meet the future health care needs of Montgomery County residents," according to the letter.

In the letter, the legislators said they were concerned about the impact of the proposed Germantown hospital on the Germantown Emergency Center, operated by Adventist HealthCare, about a mile from where the new hospital would be located.

"We want to ensure that the placement of health care services occurs in a manner that enhances access and avoids duplication by ensuring health care services are complementary to existing infrastructure," according to the letter.

While the commission does not have to accept the recommendation from the reviewer, it would be unusual for the full body to dismiss it entirely, said Pamela Barclay, director of hospital services for the commission.

Adventist HealthCare officials filed a 105-page response to the Holy Cross recommendation, seeking to open up the entire review process because of what Adventist officials called flaws in the report.

Adventist officials said the reviewer highlighted negative financial reports by Robert Murray, executive director of the Health Services Cost Review Commission, about their Clarksburg proposal, while ignoring a negative report, also by Murray, regarding Holy Cross' proposal.

In a follow-up letter, Adventist officials said that a Holy Cross financial report also was not sent to them and was filed with the commission after the official record had closed.

Holy Cross CEO Kevin J. Sexton defended Moon's review, saying the years-long process had been thorough and fair to both sides. In its response to the recommendation, Holy Cross said Adventist's plan did not meet the criteria for a certificate of need in several categories.

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."

cford@gazette.net