Hospital project divides neighbors

When she was growing up in Country Club Estates, Martha John played on the stone pillars that mark the main entry to the Columbia Country Club, flanked by wide expanses of grass.

The scene, including the vacant lots, has remained unchanged for more than half a century, although Old Highway 63 has been relegated to a minor arterial city street since then. The family that owns the frontage along the north and south entrance roads has been in no hurry to develop the property, zoned single-family residential.

But after a public hearing on Monday, the City Council will decide whether to rezone the northernmost tract of frontage commercial and allow construction of a 42-bed acute-care hospital.

“We would prefer that it remain grassland,” said John, an architect like her father, the late Hurst John. “But if it has to develop, we want it to be single-family homes.” The land has been zoned that way since it was annexed by the city in 1935 and has been labeled accordingly in the city master plan since 1957.

John and her neighbors are concerned that the “spot” zoning for the 4.7-acre vacant tract and the hospital construction would open the entire stretch of frontage on the east side of Old Highway 63 to office and commercial development.

But representatives of the neighborhood across the road, Benton-Stephens, support the development, as do leaders of the local medical industry and the business community, which is eager for an economic boost that the new hospital, with 120 jobs, would provide. The Planning and Zoning Commission voted 5-3 in favor of the ordinance allowing the development, which is also endorsed by the city staff.

Landmark Hospitals of Cape Girardeau already has secured a state certificate of need for the hospital and has chosen the location on land owned by the Berry McAlester trust.

Berry McAlester was a local builder and son of Dr. A.W. McAlester, who was the first dean of the University of Missouri-Columbia School of Medicine in 1890 and owned a 160-acre farm that largely became the Columbia Country Club and the adjacent neighborhood. The property is held in trust for his heirs, Elizabeth and Mark Crawford.

A long-term acute care hospital, known as an LTAC, is a new concept for Columbia. An average patient stays at a short-term acute care hospital such as Boone Hospital Center for three days. But the average stay for an LTAC hospital like Landmark’s is 25 days, because the patients are generally chronically ill and often need ventilators for extended periods. Residents of Columbia who need such care now often must seek help in St. Louis, Kansas City or Springfield, despite the advanced development of medical units here.

The 32,000-square-foot hospital would focus on rehabilitation and therapy. It would receive patients directly from other hospitals and would not have hospital fixtures such as an emergency room. Planners even intend to purchase meals from other institutions—either hospitals or university facilities.

The state certificate of need envisions the hospital serving a 50-mile radius, and the addition would substantially enlarge the growing medical community around Boone Hospital Center.

Rajiv Dhand, director of University Hospital’s pulmonary and critical care division, wrote in a letter sent to the Columbia City Council, “In order to manage and treat the ever-increasing intensive care unit patient population and to relieve some of the ongoing congestion in our ICUs, we have an important need for a long-term, acute-care facility in the Columbia area.”

Jay Burchfield, a project consultant, said during a P&Z public hearing in March that the hospital management anticipates hiring an upscale, skilled workforce of 120 full-time and 30 part-time employees with a payroll of $7.4 million a year. The hospital indirectly would create another 85 jobs locally that pay $2.2 million annually.

The facility would buy a projected $1.2 million a year in services when it reaches full occupancy, Burchfield said.

George Crawford Construction Co.—owned by the McAlester Trust heirs—would build the facility.

Virtually everyone welcomes the facility, but some are unhappy about the location.

Country Club Estates have residents helped defeat two previous commercial zoning attempts in the frontage area since 1990, and a lopsided majority opposes the pending proposal. At a March meeting, the membership voted 42 to 4 against the rezoning. Benton-Stephens Neighborhood Association members, representing residents and landowners located across Old 63 from the site, voted by a narrower margin to support it while the East Walnut Neighborhood Association decided to follow the lead of Country Club Estates.

Bob Hutton, a Columbia College official and former councilman who represented the Country Club Estates neighborhood at the P&Z hearing, was blunt when asked about any modifications that would make the hospital acceptable to the residents. “Only if it was moved,” he responded.

Boone Hospital officials and Stephens College President Wendy Libby wrote letters in favor of the site with indications of support from University of Missouri medical officials. The lineup of backers led Warren Prost, a local builder and vice chair of the estates neighborhood group, to ask that city officials “not allow the powerful medical-business interests in this community to force this 30,000-square-foot, four-and-a-half-acre development upon our residential neighborhood.”

Jay Burchfield

Opponents of the rezoning maintain that spot zoning of the one site—at Old 63 and Alfred Street—would set up domino effects that would transform the east side of the highway.

Neighbors said they are convinced that the McAlester Trust wants all of the frontage land rezoned to office or commercial and have repeatedly rejected proposals to sell land for the construction of single-family homes.

“We don’t want to see a string of strip malls down to Broadway on the east side” of old 63, said Russell Still, a former school board president and an attorney who lives in a 1910 home in the estates.

The hospital will set a far-reaching precedent because it “is a 24-hour-a-day, 365-day-a-year business,” Still said. “The lights will be on all the time. You’ll have people coming and going. You have 100 parking places in the parking lot. You have a large staff, ordering things, things being delivered there. You have Dumpsters. Nobody makes more trash than a hospital. It’s a very intrusive development, much more intrusive” than the one the city rejected in the early 1990s for the area.

All the property adjoining the proposed hospital site is zoned residential, although land across old 63 is set aside for multifamily structures, which has led opponents to deride the “spot zoning” character of the proposed change..

The city has acted on parcel-by-parcel rezoning requests but has not had an overall development plan for the Old Highway 63 corridor for the past half-century. The highway decades ago served as the city’s treacherous north-south link to the world. Once the border of Columbia, the area haphazardly sprouted development that mixed gas stations, bicycle shops, assorted stores, farmland and residential neighborhoods like the upscale estates and less expensive ones.

What had been the outskirts of town now has become almost the city center, although zoning reflects the historic patterns.

Planning and Zoning Commissioner Ann Peters wanted to set aside the rezoning request and work with landowners in the area on a revised master plan when the group voted 5 to 3 to recommend that the council approve the project.

Burchfield said almost every city in Missouri is struggling with the issues created by such sprawling growth, the relocation of major highway projects and the need to create “in-fill” development that would gracefully mix residential and commercial uses into a livable environment.

He said he understands the frustrations of landowners who are worried about the broader land-use implications of the decision, although he maintains that the Landmark owners have cooperated on a broad range of issues, including the appearance of buildings, stormwater management and lighting. For example, they changed the roof design to make it blend-in with the nearby Stephens College stables. The owners have no control over the decisions by other owners and the city about how to develop neighboring property, he said.

What has complicated the land-use dispute is the question of whether the hospital actually could relocate to another site or if a zoning rejection would doom the building, along with the medical opportunities and the economic impact.

“It is a real possibility” that denying the zoning would kill the project, Burchfield said. State approval of the application was based on the site, he said, even though existing zoning did not permit the construction. “Theoretically, it would be a dead deal.”

But later in the conversation, Burchfield said he could not speak for the owners on whether a rejection of the rezoning would cause them to scuttle the project. “I’ve never once maintained that it would not happen” if the city council deep-sixed the old 63 site. “It could happen although there would have to be administrative changes in the certificate of need.”

State Department of Health and Senior Services officials confirmed that the approval was based on the site, but said that after relatively manageable resubmission of paperwork, the owners likely could switch to a different location in the same service area.

Burchfield emphasized that the owners had checked about 20 potential sites for the hospital, which they want to locate close to one of the Columbia acute-care facilities. All the sites near the University Hospital and Clinics were university-owned or not available.

He said the owners had looked closely at a site on Old 63 farther north that is occupied by a landscaping business. But Burchfield said that after making land allowances to accommodate stormwater needs for development, the site was too small.

Opponents of the proposed site mention a much longer list of properties that could host the hospital. Said Still: “Real estate developers, being very inventive people, I’m sure they’ll figure out a way to place the building someplace that’s properly zoned.”

The residents, however, face much the same problem dealing with the issue as they encountered in trying to convince the McAlester heirs to sell land and allow construction of single-family homes along Old 63: they don’t own it and control its direction.