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Dan Kegley/Somewhere behind this sign, Smyth County Community Hospital officials hope to build a new hospital.

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SCCH moves ahead with relocation plans

By DAN KEGLEY/Staff

Smyth County Community Hospital took its first public step toward relocating Thursday as it gained the county planning commission’s unanimous support for rezoning its proposed site from Agricultural/Rural to Commercial. The commission and the county supervisors held a joint public hearing on the requested rezoning in which speakers voiced no opposition to the hospital’s proposed location.
Citizens did express universal concern to the commission and board that the development’s impact on an adjacent residential area be minimized both during and after construction.
SCCH has an option on 40 acres north of U.S. 11 near Exit 47, west of the town’s water treatment plant, and east of the Panorama Drive/Althea Street neighborhood in Marion. The land, owned by Judith Shulz and Kenneth Greer, straddles the town’s corporate limits, with eight acres in town and 32 acres in the county.
According to SCCH CEO Lindy White, the hospital is planning to replace its current 40-year-old, 170-bed facility with a 50-bed hospital. An executive summary filed with the planning commission by Hank Carr, a commercial real estate consultant retained by SCCH, showed the new building would be 120,000 square feet. A 30,000 to 40,000 square-foot medical office building would be part of the site’s initial development.
“The goal is to create a health care campus that will serve Smyth County for the next 40 to 50 years,” Carr told the commissioners and supervisors during the hearing. Rebuilding on site, he said, introduced concerns about the interruption of the hospital’s critical water, sewer and electrical service during construction.
Carr said there was enough land on which to build facilities as well as create buffers around them. “We have more than enough land to do what we have to do.”
The current building itself cannot be feasibly renovated, Carr and White said. Architecturally, the building “cannot be added to or altered due to current code requirements,” and the plumbing and electrical wiring “do not meet today’s codes and would not be cost effective to upgrade,” Carr’s written summary said.
Carr said he and hospital officials “looked up and down the interstate, all through Marion and Smyth County, even land on Callan [Drive],” in considering new hospital sites, but all presented issues that the Shulz-Greer site does not, even with its “challenging,” sloping topography. The proposed site has access to water, sewer and electricity, and easy storm water management, Carr said.
The officials also considered the south side of Exit 47 where a retail shopping center is planned. “Exit 47 is still a possibility,” but he called the Shulz-Greer property “the best possible location.”
Carr said rezoning was appropriate for the site because it lies both adjacent to and across U.S. 11 from existing commercial districts.
The hospital’s initial two buildings would sit on about 12 acres, Carr said, and eventual related development would encompass perhaps a dozen more acres. Within the 40-acre site, the proposed use will allow buffers between the medical buildings and residential neighborhoods, he said.
The hospital will ask Marion to rezone the eight acres in the town as a Medical Arts district.
Supervisor Mike Roberts asked Carr if other areas outside Marion had been considered, specifically Seven Mile Ford, Chilhowie and Saltville. Saltville previously had hospitals, Roberts said.
“This is a Smyth County Community project, but this is also a Marion project,” Carr said. He said hospitals are competitive and have service areas, and noted Thursday’s announcement by Johnson Memorial Hospital in Abingdon that it would relocate to the site outside that town where its new cancer center recently opened. That relocation moves JMH “even farther north,” referencing the interstate’s orientation toward Smyth County.
“Interstate visibility was a primary consideration,” Carr said, as was an “interchange with full access.”
Supervisor Marvin Perry questioned the relatively small size of the proposed hospital, with less than a third the number of patient beds of the current facility. White said the number was dictated by the state that, although it has not approved a certificate of need for the proposed hospital, sets the number of beds that can be licensed in hospitals.
“The state pulls census information – we call it peak census – for the last 48 months that shows how many beds were used to determine how many beds will be licensed in the new facility,” White said. “We are limited by the state with regard to how many beds, but we can go back.”
White said the four-year figures showed an average daily census of 25 to 35 patients. Each year the hospital admits 2,600 patients, but sees 90,000 annually on an outpatient basis. “The facility is not built for that,” she said.
Currently the hospital has “staffing for 59 beds,” White said, and the reduction in the number of licensed beds “will have no affect on the number of team members relocating to the new site.”
The CEO said the hospital is “significantly challenged” by its infrastructure. “It’s very hard for us to compete in this facility we’re in. The facility is designed poorly if we’re going to compete in this market and if we’re going to grow long term.”
White said the hospital will spend $2 million on renovations immediately, including a “dedicated outpatient entrance,” to allow SCCH to remain competitive for the four or five years new construction will be under way. Much of that money will go toward equipment that could be relocated to a new hospital, as will the celebrated MRI already installed at SCCH.
Roberts said the hospital had done much in its year of affiliation with Mountain States Health Alliance. Later, SCCH board of directors chairman Gary Peacock said, “This has not just been a one-year project. It’s a five-year project. Most of the board is still there.” Previous to the MSHA affiliation, the board decided “we couldn’t do what we needed to, and we wouldn’t be here without Mountain States. We’re very satisfied with this project.”
Seven residents and adjacent landowners spoke along common themes of protecting Althea Street and its neighborhood from heavy traffic use during construction and when the new hospital is operational, separating the hospital from neighbors by buffers, installing downward-directed lighting outside the facility to reduce light pollution, and loss of the rural environment the area offers to current residents.
All favored the general idea of a new hospital and building it on the proposed property.
Property owner Judith Shulz said her parents built the first house on Althea and as an heir she had previous commercial offers for the property. “We were never too excited about commercial, we wanted something good for the whole town,” she said. “We’re very sympathetic to having it as beautiful as possible.”
Charlie Wassum asked for a reversion in the zoning should SCCH not follow through with the development. Previously Carr acknowledged that concern when he said, “This is the best site for us based on the information we have today. We’ve worked on this the better part of a year and we’re serious about this.”
Zoning Administrator Clegg Williams said if the hospital does not follow up on its plans, rezoning back to Agricultural/Commercial can be requested by the landowner, by the planning commission or enacted by the supervisors.
Tina Graham said she was concerned about the four or five years of construction, and where the hospital would be built within the property and “how it will affect my sight lines to the mountains.”
Jim Gates of Holly Street spoke as a resident concerned about tractor-trailers unable to make turns on residential streets during the water plant renovation and the larger volume of big trucks during hospital construction. Gates is a member of Marion’s town council and said that body denied applications for medical facilities west of the hospital because the intended use was not specific enough.
Althea Street resident Tom Burkett asked the planning commission to postpone any recommendation until a SCCH could file a site plan that would address concerns like buffers and traffic. Alice Freeman, who owns lots on Althea, echoed the site plan request so she could know whether her lots can still be sold residentially. “Marion needs residential,” she said.
Mary Martin asked SCCH and the property owners to proffer conditional zoning to require screening or buffering from adjoining residential areas.
According to Williams, Thursday’s hearing was on a matter separate from approving a site plan. “This is the first step,” he said, and the county zoning ordinance does not require a site plan at this stage. The hearing was to determine, he said, “does it make sense to be commercial?”
Williams said the special use permit, required as the second step in development, will require a site plan with specifics about the buildings’ use, buffers, and entrances. In considering the special use permit, the planning commission can recommend conditions and the supervisors can impose them, he said.
Williams said state law prohibits conditional zoning—“We’ll rezone if you do this, this and this. You can’t do it,” he said. “Smyth County Community Hospital can ask for it, but this is straight-up rezoning.”
Williams said anyone requesting rezoning can offer to include features such as buffers to “sweeten the pot” and raise the chances of getting rezoning approved.
Commissioner Karl Kalber said he understood the concerns about traffic through the residential area. The majority of traffic will be off of U.S. 11, he said. “It’s the logical thing.” But ingress and egress from the west should be expected, according to Kalber. “I can’t believe there will not be some kind of entrance to the rear.”
Commissioner Don Medley told the residents the “main entrance should not affect you. There are a couple of places where they can make an outlet. When the time comes, we’ll address that.”
Without a site plan to consider, Burkett said he was opposed to the rezoning. “If we’re being asked to accept a pig in a poke, I’d say absolutely not.”
“Don’t forget the current hospital sits right in the middle of a residential neighborhood and there are no complaints as far as I know,” Peacock said. “We part of the community, too.”