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HCA: BRMC is the right hospital in the right place
Mark Foust is the HCA Capital Division vice president for communications. Tracey White is the HCA Capital Division vice president for community and government affairs. Broadlands Regional Medical Center, they argue, will benefit the county, the community and the region, and should be built in Ashburn.
Is there an immediate need for a second hospital in Loudoun County?
Mark Foust: Absolutely. I think the people who live and work in Loudoun County simply do not have access to the same kind of health-care resources or options that the neighboring counties enjoy. That's why one out of every two patients from Loudoun County is forced to leave the county to find care. That needs to change. Building Broadlands Regional Medical Center in Ashburn will certainly improve access to care, but even more important, it will improve the quality of life for county residents.
What's the downside to locating this hospital on your U.S. 50 property and having some of the users drive 5 or 6 miles south, and others come 4 or 5 miles north?
Mark Foust: In addition to the fact that we have a COPN [state-issued Certificate of Public Need] for Ashburn and not for Route 50, again, however you slice it – current population, projected population, place of origin of EMS calls – Ashburn is the more accessible site for the county. Eight out of every 10 county residents now and in the future, out to 2020, I believe, will live closer to Ashburn than they will to Route 50. Ashburn is by far the better site in terms of accessibility.
The COPN was awarded for Ashburn, and at least two hospitals [Fauquier and Prince William] have expressed grave concerns if another hospital is built on Route 50. You can try to pick and choose -- this site, that site -- but we have a site selected. It's a wonderful site for every reason and this is where Loudoun's next hospital needs to be built.
Tracey White: As we always talk about, minutes count in an emergency, and having that accessibility for those EMS providers is very important. Even with the growth, in 2013 the numbers are still 10 times higher. Population is going to grow on Route 50 and we're well prepared to go there in the future, with our land at Route 50 and Gum Spring Road, with an emergency department in the short term and then the medical center on Gum Spring Road. Our intentions are to serve that population. But the time for BRMC is now in Ashburn, and the future will come with Gum Spring.
[White referred to Loudoun County data, which show 70.47 percent of the 21,636 EMS calls in 2007 were from Sterling, Leesburg and Ashburn, while 8 percent were for rescue stations in Aldie, Arcola and the Dulles Safety Center. The county's projection for 2013 is for 73 percent of 25,957 EMS calls to come from Sterling, Leesburg and Ashburn. Calls for Aldie, Arcola and the Dulles Safety Center are projected to be 7.3 percent of the total.]
What is the profit at Reston Hospital, where did the money go and do the investors have any say in the financial medical decisions?
Mark Foust: Last year, Reston had a profit of $11.3 million on a net patient revenue of $192 million – about 5.9 percent.
A significant amount of that money is returned to the community – purchasing new technology, for example, improving physical plants – all on behalf of our patients. Profits from our hospitals will also be used to build new hospitals, such as BRMC, and the Spotsylvania Regional Medical Center, which we are currently building between Richmond and Washington, to open in 2010.
BRMC, like Reston and all our others, will be locally managed – the board of trustees, the physician leadership, the administrative team will be the ones who drive the clinical decisions at BRMC, and all of them will be local. The investors will have no say in clinical decisions.
I think there's a bigger issue here – the pending financial impact of BRMC, and in this case it's a very positive story for the county. BRMC will pay taxes that are used to fund vital community services. BRMC will provide uncompensated care, including free care to uninsured patients at all income levels. BRMC will – we have already done so – support a lot of local nonprofit organizations, because we recognize their importance in the community.
A recent Virginia Health Information report shows that 40 of the 187 beds at Reston Hospital are not staffed. Are you prepared financially to start building as soon as the Board of Supervisors gives you approval?
Mark Foust: We are not retrenching at Reston or anywhere else. Adjusting staffing levels to patient volumes is something hospitals do all the time. We staff as many beds as we have patients.
We are totally committed to building BRMC in a timely basis. It will take at least nine months to get the county site approvals once we get approval from the supervisors, then the construction timeline is at least three years. At the earliest, we are looking at 2011, maybe 2012. The sooner we get approval, the better for the county and its residents.
Will two hospitals in close proximity, competing for the same patients, prevent BRMC from adding tertiary-care services – brain and heart surgeries, organ transplants, third-degree burn care?
Tracey White: It is early to say exactly what tertiary-care services BRMC will bring. That will be determined by our patients' needs. With advances in medicine, it has become much more standard to deliver many tertiary-care services in community hospitals, not just in large medical centers. It is important to note that although these services are important, they are accessed by a small number of residents. In 2007, 121 patients from Loudoun received these services at a hospital somewhere in Northern Virginia. Most residents need access to the standard hospital care that BRMC will also bring: obstetrics, emergency services, surgical care, pediatrics and more. One thing is clear, however: The county stands a much better chance of gaining tertiary services if two hospitals, rather than one, are exploring their development.
Finally, you only have to look to Reston Hospital to see that HCA does invest in tertiary care even when a competitor [Inova] dominates the market. The competitive marketplace keeps each health-care facility constantly striving to be better and more patient- and quality-oriented.
Is there anything you would like to add?
Mark Foust: When we were invited to the county by Loudoun officials several years ago, we considered it quite an honor. This is not about HCA, this is about a hospital county residents want and need and are asking to be built. We are very hopeful we will get approval very soon so we can begin that process.
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