The two church-affiliated health care companies seeking to build a hospital in northern Montgomery County are being pressed for details about the need, timing and financial plans for the competing projects. A recommendation on whether proposed hospitals in Clarksburg and Germantown should receive state approval is expected by the end of the year.

The companies, Holy Cross Hospital and Adventist HealthCare, began providing testimony to a Maryland Health Care Commission panel this week at hearings in Bethesda. The hearings are expected to conclude early next week at the latest, though it will be several months before a recommendation is made.

Holy Cross Hospital filed for state approval in August 2008 to build a $202 million, 93-bed hospital on Montgomery College's Germantown campus. Adventist HealthCare filed its plans to build a $177 million, 86-bed hospital as part of a health care campus in Clarksburg in April 2009.

New hospitals must receive a certificate of need from the state before they are constructed, and the board reviewing the proposals is unlikely to approve both. The certificate-of-need process is designed to ensure new health care facilities in the state are needed and adequately serve the community.

Adventist officials say they have been developing the proposed Clarksburg Community Hospital — which would be in a relatively small community where future growth is planned — with county officials, residents and other health care providers since early 2002. They believe the medical campus would enhance existing health care services instead of competing with them. Holy Cross officials say Germantown is the ideal location for its proposed teaching hospital because of the community's large population size and growing number of seniors.

The Maryland Health Care Commission panel, led by Dr. Marilyn Moon, the reviewer assigned to both projects, began hearing testimony from witnesses called by the two nonprofit hospital organizations on Monday.

Moon is expected to recommend which hospital, if any, should receive a certificate of need by the end of the year, according to Pamela Barclay, director of the commission's Center for Hospital Services. The 15 health care commissioners will make the final decision at a public meeting.

"We're pleased with the way the hearing is progressing and the way [Moon is] conducting the hearings," Kevin J. Sexton, president and CEO of Holy Cross Hospital, said Tuesday. "We think we have a terrific proposal."

The commissioners will consider six criteria when determining whether to award a certificate of need: conformance with the state health plan; need for the proposed facilities; availability of more cost-effective alternatives; the proposals' viability; compliance with conditions of previous certificates of need; and impact on existing health care providers.

"It's a respectful and thorough process," William G. Robertson, president and CEO of Adventist HealthCare, said Tuesday. "I was very pleased to see that the information that Holy Cross provided shows that the growth is in northern Montgomery County. It's something we all know and it supports the vision we have for Clarksburg."

Testimony in the current hearings is limited to three issues where more information is needed, according to a June 18 letter from Moon: whether there are current or future health care access problems for upcounty residents that require building a new hospital, including how and when the proposed sites were selected and projected travel times; why the hospitals need to be built now and whether more cost-effective alternatives are available; and whether the organizations will be able to simultaneously finance the hospitals and other large projects in the works.

Holy Cross has proposed a $228.8 million expansion and renovation of its Silver Spring location and Adventist has proposed a $468.1 million replacement of its Washington Adventist Hospital in Takoma Park, according to the letter. Both organizations have questioned the other's ability to afford two major projects at the same time.

Robert Murray, executive director of the state Health Services Cost Review Commission, wrote in a May 14 memo that neither organization "can prudently and successfully undertake the financing, construction and successful operation of a new facility at this time" due to uncertainties in the near-term fiscal environment, such as an anticipated decline in Medicare reimbursements to hospitals, according to Moon's June 18 letter. Officials from both Adventist and Holy Cross say they disagree with Murray's conclusions.

mtierney@gazette.net