Inova laying the groundwork to renege on a promise

Well, that didn’t take long. Not even a week after I last posted on a positive development in the ongoing saga of Loudoun’s abysmally-behind medical facilities we are now seeing Inova’s management starting to waver on their commitment to support the building of an HCA hospital in southern Loudoun. Via The Loudoun Scoop you can find this story over at the Loudoun Times-Mirror:

Inova Health System, parent of Inova Loudoun Hospital, has notified Health Commissioner Karen Remley that it will stand by its pledge not to block a “genuine relocation” of the 164-bed hospital from Broadlands to U.S. 50. But, the letter goes on, HCA’s real intentions could be to tie the beds up and to use them somewhere else, perhaps in its Reston Hospital Center expansion.

Approving the relocation without requiring the project to be completed on U.S. 50, the letter continues, “would be akin to handing HCA paper beds (and paper ORs and a paper cardiac cath lab, etc.)” and preventing the development of health-care facilities in the entire planning district “until the real plan is unveiled.”

HCA Vice President Mark Foust countered that his company has been trying to build a hospital in Loudoun for the last eight years, “dodging Inova’s roadblocks all that time. The real question is whether Inova will keep its two promises: first, withdrawing its Route 50 application, and second, refraining from challenging ours.”

Aside from self-interested suspicion, is there any evidence whatsoever that HCA is considering such an action? Has there been any proof during this entire 8-year ordeal that HCA has had any aim but to build a hospital in Loudoun County? If there is, Inova needs to pony it up and I mean right now, today. To make such a blanket accusation with no proof smells like Inova’s not too keen on keeping its promise, a promise it reiterated just a week ago today.

They’ve even got a list of demands in there and the list is built in such a way as to give themselves a supposed rationale for bailing out of their promise. One of those items, a demand that the State “[r]equire HCA to notify all other hospitals in the planning district of any filings with the Department of Health” is just arrogance of amazing proportion. Filings with State institutions are held to the exact same specifications for all applicants. Inova wants special treatment where their competitors are concerned. Are they not able to avail themselves of the public record on who has filed what with the State agency, just like any other hospital. What is it, precisely, that gives them the impression that they are owed notifications that they, themselves, do not provide anyone else?

So, here we go again. Inova clearly does not want any other medical firm to be present in Loudoun. They like their monopoly and they’re doing what they can to seal it in. The Loudoun Board of Supervisors should weigh in on this demand with the State agency in the strong negative and they should do so quickly. HCA should be held to exactly the same requirements as any other provider and Inova should be told to mind their own damned business. Such as keeping their freely-given word.



  1. Ric, given HCA’s years of rhetoric against Route 50, I see nothing wrong with this. They were given right of first refusal on Inova’s already-zoned land on 50 when their application was turned down again, and spurned it with a lawsuit and statements that they would move to Reston.

    Given that HCA has already had remarkable extensions over the years (one even before the comment period closed), yes they should be held to be serious if this is what they really want to do(now that Inova filed a COPN), before Inova even considers dropping their own plans (which they only moved forward on after HCA turned down the land, and made their statements about suits and expanding Reston).

    Somehow it seems for some that “not opposing” HCA’s plans is synonymous with dropping their own entirely. They have voluntarily held their own in abeyance until after the commissioner rules. That is not opposing.

    Expecting HCA to mean it (which I certainly do!) is a pretty low threshhold if not opposing is going to mean withdrawing, and one they should yes be required to meet before Inova folds up any tents down here.

  2. Barbara, you are making the same error Inova is: do you have evidence that HCA isn’t serious about building a hospital at the proposed location? Do you have proof that they are even considering the action you and Inova are claiming they might pull? If you do, spit it out. If you don’t, then it’s just your suspicion and that’s not a threshold to require additional efforts on their part beyond what is required of all applicants to the State agency.

    So, do you have evidence or not?

  3. No Ric. Perhaps no more than you do that Inova will parlay this into actual opposition?

    I will continue to hold my OPINION that as yet refusing to withdraw their application is not the same as OPPOSING HCA’s.

    The application that is currently on hold, while yet another decision is made on extension and renewal, with a change of venue that could have been sought any time during those eight years its land use was being turned down by two very different administrations.

    The application that they did not even file until HCA had not only turned down land already zoned for a hospital, saying AGAIN that route 50 was not the place for one, saying that they would be refiling suit, and saying that the beds would be moved to Reston.

    I am not “claiming” anything WITH Inova.

    I’m just hesitant to correlate a stated lack of opposition with a need to drop their own plans, simply because of a sudden, surprising and welcome turnaround by an entity that was, until quite recently, adamant that they would NOT be going to 50.

  4. You don’t call the public demand that HCA be held to a stricter standard when dealing with a public agency to be an action in opposition? They’re suggesting that the State make HCA work harder to get the same consideration.

    And you’re never going to get me to agree with you that HCA should have just knuckled under and moved their earlier application to somewhere that a competitor – who has a vested interest in keeping HCA from offering a service similar to theirs – wanted them to go. My earlier support for the BRMC was based on services provided to the largest population density of Loudoun, something that was consistently ignored by the opposition.

    And for the record, I have never suggested that Inova drop their plans and I don’t expect them to do so before the COPN adjustment is ruled upon, so please take that accusation elsewhere. I have no issue with Inova proposing another hospital. I have an issue with them not keeping their word. And I have an issue with their demands, which is exactly what I wrote in this post. *MY* opinion is that Inova is preparing the groundwork to break their word, and that is what I have said.

  5. Ric, I don’t recall accusing you personally of anything.

    I think that after the first denial, HCA could certainly have worked with the county to find a place the county was willing to approve, and that offer was made at both the commission and the board level the first time.

    Look up the form that has been filed multiple times, for extension or significant change.

    The six-month checklist is supposed to include having all land use approvals for the project.

    We can certainly disagree that placing BRMC in an already well-served area between two existing competitors was the best place for a hospital–lol!

    I think we can also disagree that asking for a firm commitment to the location before withdrawing anything is not opposition.

    I would like to see either entity build on 50 in as timely a manner as possible.

    I’m not prepared to assume that if Inova just drops their process, HCA will play games.

    But given everything that has occurred in eight years, I would sure hate to see Inova drop everything, and HCA file for another change once their Fairfax land use comes through at Reston.

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