Adventist HealthCare and Holy Cross Hospital have filed their final applications to build hospitals in northern Montgomery County.

The health care providers each filed a modified application for their respective proposed hospitals with the Maryland Health Care Commission on Wednesday, clearing the way for the final stages of the review process to begin, said Pamela Barclay, director of the commission's Center for Hospital Services.

Holy Cross announced in August 2008 a plan to build a 93-bed hospital on the Montgomery College campus in Germantown. Adventist HealthCare announced in April a plan to build a hospital as part of a health care campus in Clarksburg. The state requires new hospitals to receive a certificate of need before they are built and is unlikely to approve both proposals.

Adventist made some minor changes to its proposal, which has been in the works for several years and has many of the required land-use approvals from the county, said Robert Jepson, vice president of government relations and public policy for Adventist HealthCare of Rockville. Proposed hospital beds were reduced from 100 to 86 after looking at projections for need and to avoid affecting existing health care providers, he said, and cut the expected cost from about $202 million to roughly $177 million due to softening of the construction market.

"We feel very confident that we have a good project in the fastest growing part of the county," Jepson said. "We think it's the right project in the right place at the right time."

Holy Cross' modified application states that changes to its initial application arose from a change in the proposed facility's design, additional analysis required for comparative reviews and new bed need analysis. Spokeswoman Yolanda Gaskins said she could not describe what the design changes were.

The hospital will be designed with a six-level diagnostic and treatment wing with private rooms and a separate three-level clinical support wing, according to the application.

A public comment period of 10 business days will begin after the modified applications are reviewed for completeness and posted on the commission's Web site in the next several days, Barclay said. The reviewer will then determine whether a hearing is needed to address unresolved issues before the reviewer takes a comparative look at which hospital, if either, should be built.

A decision could be made as early as the spring, Barclay said.