Suburban Hospital is a community-based, not-for-profit hospital serving Montgomery County and the surrounding area since 1943. Located in Bethesda, Suburban is the designated trauma center for Montgomery County. Suburban Hospital is affiliated with many local health-care organizations, including the National Institutes of Health; the hospital specializes in surgery, cardiology, oncology, emergency/trauma and a variety of additional clinical services. On June 30, 2009, Suburban Hospital became a member of Johns Hopkins Medicine. On December 13, 1943, Suburban Hospital opened its doors as a 130-bed hospital constructed to accommodate the expanding World War II military population in rural Montgomery County, Maryland. In its first full year, the small facility, consisting of several one story cottages, admitted 3,000 patients and had an operating budget of $13,000. In 1950, the hospital was purchased by the community from the federal government for $125,000. During the late 1950s, the hospital experienced a severe shortage of beds, requiring administrators to enclose sun porches and convert clinic space to accommodate patients.
To alleviate the overflow of patients, the Suburban Hospital Association developed a master facility plan to construct three new wings over the next decade. On February 7, 2008, Suburban Hospital unveiled its plans for the first major upgrade and enhancement of its facilities and campus in nearly 30 years; the last major upgrade to its facilities was in 1979. The proposed improvements will be built on Suburban’s existing campus at 8600 Old Georgetown Road, across from its key clinical partner, the National Institutes of Health. Major features include improved access to the emergency/trauma center. Details include: A new building addition consisting of 300,000 square feet; the building will house a new surgical wing, physician office space and private patient rooms and be four stories in height. A new surgical wing containing 15 state-of-the-art operating rooms to replace existing operating rooms; each operating room measures 700 square feet and is designed to accommodate important technological advancements, such as MRI-guided surgery.
All of the new operating rooms will be located on one floor, near the emergency/trauma center, allowing for greater efficiencies and better patient flow. Improved vehicular and pedestrian circulation, including orientation of traffic to Old Georgetown Road. Improved emergency and trauma access, including a new main entrance that will separate the pedestrian and private vehicle entrance from the helipad and emergency vehicle entrance. A sustainable design that incorporates green building initiatives. Separate elevators for patients and non-patients. Replacement of the existing parking garage with a new 1,200-space parking garage to address the parking needs of the new building and the current parking shortage. A landscape program to include gardens, greenways and paths. Mechanical systems housed below grade to enhance aesthetics. Suburban Hospital Hospital Services A-Z Johns Hopkins Medicine Patient Care Locations
Maryland is a state in the Mid-Atlantic region of the United States, bordering Virginia, West Virginia, the District of Columbia to its south and west. The state's largest city is Baltimore, its capital is Annapolis. Among its occasional nicknames are Old Line State, the Free State, the Chesapeake Bay State, it is named after the English queen Henrietta Maria, known in England as Queen Mary. Sixteen of Maryland's twenty-three counties border the tidal waters of the Chesapeake Bay estuary and its many tributaries, which combined total more than 4,000 miles of shoreline. Although one of the smallest states in the U. S. it features a variety of climates and topographical features that have earned it the moniker of America in Miniature. In a similar vein, Maryland's geography and history combines elements of the Mid-Atlantic and South Atlantic regions of the country. One of the original Thirteen Colonies of Great Britain, Maryland was founded by George Calvert, a Catholic convert who sought to provide a religious haven for Catholics persecuted in England.
In 1632, Charles I of England granted Calvert a colonial charter, naming the colony after his wife, Queen Mary. Unlike the Pilgrims and Puritans, who enforced religious conformity in their settlements, Calvert envisioned a colony where people of different religious sects would coexist under the principle of toleration. Accordingly, in 1649 the Maryland General Assembly passed an Act Concerning Religion, which enshrined this principle by penalizing anyone who "reproached" a fellow Marylander based on religious affiliation. Religious strife was common in the early years, Catholics remained a minority, albeit in greater numbers than in any other English colony. Maryland's early settlements and population centers clustered around rivers and other waterways that empty into the Chesapeake Bay, its economy was plantation-based, centered on the cultivation of tobacco. The need for cheap labor led to a rapid expansion of indentured servants, penal labor, African slaves. In 1760, Maryland's current boundaries took form following the settlement of a long-running border dispute with Pennsylvania.
Maryland was an active participant in the events leading up to the American Revolution, by 1776 its delegates signed the Declaration of Independence. Many of its citizens subsequently played key military roles in the war. In 1790, the state ceded land for the establishment of the U. S. capital of Washington, D. C. Although a slave state, Maryland remained in the Union during the U. S. Civil War, its strategic location giving it a significant role in the conflict. After the war, Maryland took part in the Industrial Revolution, driven by its seaports, railroad networks, mass immigration from Europe. Since the Second World War, the state's population has grown to six million residents, it is among the most densely populated states in the nation; as of 2015, Maryland had the highest median household income of any state, owing in large part to its close proximity to Washington, D. C. and a diversified economy spanning manufacturing, higher education, biotechnology. Maryland has been ranked as one of the best governed states in the country.
The state's central role in American history is reflected by its hosting of some of the highest numbers of historic landmarks per capita. Maryland is comparable in overall area with Belgium, it is the 42nd largest and 9th smallest state and is closest in size to the state of Hawaii, the next smaller state. The next larger state, its neighbor West Virginia, is twice the size of Maryland. Maryland possesses a variety of topography within its borders, contributing to its nickname America in Miniature, it ranges from sandy dunes dotted with seagrass in the east, to low marshlands teeming with wildlife and large bald cypress near the Chesapeake Bay, to rolling hills of oak forests in the Piedmont Region, pine groves in the Maryland mountains to the west. Maryland is bounded on its north by Pennsylvania, on its west by West Virginia, on its east by Delaware and the Atlantic Ocean, on its south, across the Potomac River, by West Virginia and Virginia; the mid-portion of this border is interrupted by District of Columbia, which sits on land, part of Montgomery and Prince George's counties and including the town of Georgetown, Maryland.
This land was ceded to the United States Federal Government in 1790 to form the District of Columbia.. The Chesapeake Bay nearly bisects the state and the counties east of the bay are known collectively as the Eastern Shore. Most of the state's waterways are part of the Chesapeake Bay watershed, with the exceptions of a tiny portion of extreme western Garrett County, the eastern half of Worcester County, a small portion of the state's northeast corner. So prominent is the Chesapeake in Maryland's geography and economic life that there has been periodic agitation to change the state's official nickname to the "Bay State", a nickname, used by Massachusetts for decades; the highest point in Maryland, with an elevation of 3,360 feet, is Hoye Crest on Backbone Mountain, in the southwest corner of Garrett County, near the bo
University of Maryland Medical Center
The University of Maryland Medical Center is a teaching hospital with 757 beds based in Baltimore, that provides the full range of health care to people throughout Maryland and the Mid-Atlantic region. It gets 165,000 outpatient visits each year. UMMC has 6,500 employees as well as 1,000 attending physicians, provides training for about half of Maryland's physicians and other health care professionals. All members of the medical staff are on the faculty of the University of Maryland School of Medicine; the University of Maryland Medical Center was named one of the nation's best acute-care hospitals in patient safety and quality of care in 2006 and 2007 by the Leapfrog group. It is part of the University of Maryland Medical System, a private, not-for-profit health system that includes nine acute care and rehabilitation hospitals as well as outpatient facilities throughout Maryland; the University of Maryland Medical Center is one of the nation’s oldest teaching hospitals. It was created in 1823 as the Baltimore Infirmary, located on the same site as today’s medical center, on the West side of downtown Baltimore.
First in Maryland to perform combined heart and liver transplant: 2007 First in Maryland to offer a newly approved artificial cervical disc to patients with degenerative disc disease in the neck: 2007 First in the Mid-Atlantic region to perform minimally invasive, beating heart, multiple-vessel coronary artery bypass surgery with the assistance of a surgical robot: 2006 First in U. S. to have performed 1,000 minimally invasive kidney removals from living kidney donors: 2005 First in Maryland to offer SIR-Spheres, microscopic beads infused with radiation to treat cancerous tumors in the liver: 2004 Maryland's first accredited Primary Stroke Center: 2004 First in the U. S. to use Statscan, a low-dose X-ray scanner that provides full body images for trauma patients in 13 seconds: 2003 First in Mid-Atlantic region to perform cryosurgery for prostate cancer: 1993 Maryland's first single-lung transplant: 1992 First in Mid-Atlantic region to use a Gamma Knife to destroy brain tumors and vascular malformations without surgery: 1992 First in Mid-Atlantic region to develop and open Accredited Simulation Center: 2007 First laparoscopic gall bladder removal in the Northeastern U.
S.: 1989 First in Maryland to use supported angioplasty to open blocked arteries: 1987 First to develop a microwave scalpel which inhibits bleeding during operations: 1983 The world's first Shock Trauma Center: 1968 The University of Maryland Medical Center is a referral center for trauma, cancer care, cardiac care and heart surgery, women's and children's health and organ transplants. It has one of the nation's largest kidney transplant programs and is known for developing and performing minimally invasive surgical procedures; the major components of the University of Maryland Medical Center include: The R Adams Cowley Shock Trauma Center is the world's first center dedicated to saving lives of people with severe, life-threatening injuries sustained in motor vehicle collisions, violent crimes and other traumatic incidents. Shock Trauma has more than 100 inpatient beds dedicated to emergency surgery, intensive care, acute surgical care; the trauma staff treat more than 7,500 critically injured patients each year who arrive by helicopter or ambulance.
It is named after its founder, R Adams Cowley, M. D. who came up with the concept of the "golden hour" — that lives can be saved when trauma patients receive appropriate care within one hour of their injury. Shock Trauma trains physicians and medical personnel from locations overseas and throughout the United States The University of Maryland Greenebaum Comprehensive Cancer Center is designated by the National Cancer Institute as one of the top cancer centers in the country UMGCC is known for providing coordinated care from teams of specialists—medical oncologists, radiation oncologists, surgical oncologists, pathologists and other team members who have expertise in particular types of cancer—who consult on each patient's case and develop a joint treatment plan. UMGCC is known as a center with expertise in laboratory and clinical research. UMGCC researchers particate in new drug development, the center offers more than 100 clinical trials; the University of Maryland Children's Hospital provides care for serious and complex health problems in patients ranging from newborns to young adults.
UMCH has its own pediatric pharmacy and emergency room, is very active in children's health care research. Special programs and services include a headache clinic, asthma program, AIDS program, pediatric surgery and neonatal intensive care unit. Infants born prematurely are transported from around the region to be cared for in the 52-bed NICU — the largest in the state; the University of Maryland Heart Center was recognized as one of the 100 Top Cardiovascular Hospitals by Thomson Healthcare for 2007. The Heart Center is recognized for its expertise in robotic heart surgery, minimally invasive heart bypass and valve surgery, heart transplants and heart pumps; the Heart Center's cardiologists and cardiac surgeons treat a full range of heart problems, including heart failure, coronary artery disease, heart rhythm abnormalities and mitral valve disorders and cardiomyopathy. The Heart Center emphasizes heart disease prevention by educating patients about lifestyle factors, including proper nutrition and exercise.
The University of Maryland Division of Transplantation is one of the nation's largest kidney and pancreas transplant programs with a reputation for its expertise in treating patients who need kidney, pancreas or liver transplants. It is known for its la
Kennedy Krieger Institute
The Kennedy Krieger Institute is a nonprofit, 501 tax-exempt, Johns Hopkins affiliate located in Baltimore, Maryland that provides inpatient and outpatient medical care, community services, school based programs for children and adolescents with learning disabilities, as well as disorders of the brain, spinal cord, musculoskeletal system. The Institute provides services for children with developmental concerns mild to severe, is involved in research into various disorders, including new interventions and earlier diagnosis. Kennedy Krieger Institute opened its doors in 1937 when Winthrop Phelps, M. D. an orthopedic surgeon from Baltimore, responded to a dire need for treatment for individuals with cerebral palsy. Dr. Phelps founded the Children's Rehabilitation Institute, the first treatment facility in the country dedicated to children with cerebral palsy; the Institute was renamed the Kennedy Institute in 1968 in memory of President John F. Kennedy who enacted the Medical Training Act during his administration, to protect the rights and improve the lives of persons with disabilities.
In 1992, the name was changed again to Kennedy Krieger to honor original board member and long-time supporter, Zanvyl Krieger. Since it opened, Kennedy Krieger Institute has evolved into an international resource for children with diverse brain-related disorders, from mild learning disabilities to rare genetic disorders. Kennedy Krieger provides schooling, in addition to its involvement in research. Kennedy Krieger treats more than 19,000 children annually; the Institute practices early identification and treatment of disabilities to maximize potential and to prevent major problems throughout a child's life. Kennedy Krieger brings all the disciplines to bear-science, therapy- on the problems and injuries that affect a child's development; the Institute's interdisciplinary approach brings together a team of professionals from various fields and departments to create treatment plans tailored to the special needs of each child throughout all stages of care. Kennedy Krieger scientists research to prevent and cure pediatric neurological disorders, spinal cord injuries and developmental disabilities.
The Institute's work has yielded answers that are improving the treatment and care of children with conditions such as autism, cerebral palsy and spina bifida. A team of international scientists and investigators at Kennedy Krieger is working to isolate culprit genes and develop new treatment models and therapies; the institute has a swift transfer of research to patient care. The institute received a $1.5 million grant in early 2010 to perform brain cancer research. The Kennedy Krieger School is a nationally recognized Blue Ribbon School of Excellence and a leader in providing model programs of innovative education for children ages 6 to 21 with a wide range of learning, physical and developmental disabilities. Education occurs in a variety of day-school settings and in partnership settings within public schools; the goal of Kennedy Krieger Institute's Department of Special Education is to provide a number of special education and related services to children with disabilities in a variety of school-based, hospital-based and recreational settings.
At Kennedy Krieger, the faculty and staff advance the treatment of developmental disabilities only by sharing knowledge with individuals and organizations throughout the local communities, across the country, around the world. In order to help all individuals with developmental disabilities achieve their full potential, Kennedy Krieger works to increase the community's knowledge and understanding; the cornerstone of these efforts is the Maryland Center for Developmental Disabilities at Kennedy Krieger Institute. The Center focuses on professional training, community service and information dissemination. In addition to the other core areas of focus, Kennedy Krieger provides training opportunities to increase the number of qualified specialists in the field of neurological and developmental disabilities; each year, more than 400 individuals come to Kennedy Krieger to train with renowned experts in many fields from audiology to pediatrics, nursing to occupational and physical therapy. The Institute funds the training of the next generation of researchers.
Adrenoleukodystrophy is a rare genetic disorder of the brain. The fatal condition destroys the nervous system leaving the victim unable to walk, talk normally. For many years ALD continues to do so today. In 1987, Augusto and Michaela Odone, parents of a child affected by ALD, invented Lorenzo's oil as a treatment for the disease, their story was in the 1992 Universal Studios motion picture, Lorenzo's Oil, starring Nick Nolte and Susan Sarandon. Dr. Hugo Moser, a renowned scientist at Kennedy Krieger Institute, joined forces with the Odone's proving that their treatment, Lorenzo's oil, can prevent the onset of ALD if begun before neurological symptoms appear. Moser and colleagues created the first diagnostic test for ALD, as well as a newborn screening test that can detect the disease from birth. On January 20, 2007 Dr. Hugo Moser died of complications from surgery to treat pancreatic cancer. Today, Dr. Moser's wife Ann B. Moser, continues this important work at Kennedy Krieger. In 2008, she helped to launch a pilot study to screen for ALD in 5000 newborns born in local Baltimore hospitals, the results of which will be used to advocate for nationwide newborn screening for this devastating disorder.
Autism spectrum disorders are a large focus of clinical programs. Autism is diagnosed by age three, however the Institute's research is focused on detecting signs of the disorde
Adventist HealthCare Shady Grove Medical Center
Adventist HealthCare Shady Grove Medical Center is a 266-licensed bed acute care facility located in Rockville, Maryland. Shady Grove Medical Center provides a range of health services to the community such as high-risk obstetrical care and vascular care, oncology services, orthopedic care, surgical services and pediatric care. Opened in 1979 as Shady Grove Adventist Hospital, Shady Grove Medical Center operates as part of Adventist HealthCare, a health-care delivery system that includes hospitals, home health agencies and other health-care services. Adventist HealthCare is headquartered in Maryland. John Sackett joined Shady Grove Medical Center as president in April 2013. Shady Grove Medical Center is located within a 600-acre Life Sciences Center, which has Montgomery County's largest concentration of advanced technology companies including the hospital, Johns Hopkins University-Montgomery County Campus, the Universities at Shady Grove and biotechnology companies; as part of the Shady Grove Life Sciences Campus, the hospital established a partnership in 2008 with the Universities at Shady Grove and Salisbury University to offer a bachelor's degree in respiratory therapy at the USG campus in Rockville.
It hosts nursing students from surrounding community colleges such as Montgomery College. When Shady Grove Adventist Hospital admitted its first patient in December 1979, it was located in a "rural" part of Montgomery County, surrounded by fields. With some 2,100 employees, 1,200 Medical Staff and Allied Health Professionals, 350 to 380 volunteers per month, Shady Grove Adventist delivers more than 5,000 babies, treats more than 108,000 emergency patients at its main Rockville and Germantown emergency locations, cares for more than 60,000 inpatients each year. In 2009, the hospital completed a four-year $100 million expansion and renovation project with an expanded NICU and new Pediatric Emergency Department and an expanded state-of-the-art Surgical Services area. In October 2014, the hospital's name changed from Shady Grove Adventist Hospital to Adventist HealthCare Shady Grove Medical Center; the change was part of a branding initiative to emphasize the Adventist HealthCare system name and better reflect the facility's broad range of services.
The medical center provides medical and non-medical services for men and children. Medical services include pediatrics, bariatric surgery, vascular, oncology, wound care, surgical services, special care services and emergency services; the Birth Center has private labor and delivery suites, private Mother-Baby suites, a Level IIIB Neonatal Intensive Care Unit. A Level III-B Neonatal Intensive Care Unit provides pediatric medical subspecialists and surgical specialists who perform major surgeries for patients with congenital malformations or acquired conditions. A Level III-B NICU is designated for newborns with extreme prematurity, 28 weeks' gestation or less, or low birth weight or severe or complex illness, it is staffed by neonatal nurses. In October 2008, Shady Grove Medical Center became the first hospital in the Washington D. C. metropolitan area to offer a Birth Advisor to aid expectant mothers in preparing for their upcoming birth experience. This free appointment with Kathy Schaaf, RN, Birth Advisor, allows expectant mothers a one-on-one discussion with an experienced Labor and Delivery nurse about their individual needs and expectations for their hospital stay.
Shady Grove Medical Center operates the first Pediatric Emergency Department in Montgomery County staffed with fellowship-trained, Pediatric Emergency Physicians and Pediatric Intensivists 24 hours a day, 7 days a week. The hospital's heart care outcomes have earned it recognitions from across the state of Maryland and the nation by leading organizations that grant accreditations and awards based on quality; these include Designated Cardiac Interventional Center by the Maryland Institute for Emergency Medical Services Systems, Primary PCI Waiver grantee by the Maryland Healthcare Commission, National Cardiovascular Data Registry ACTION Registry Get with the Guidelines Gold Performance Achievement Award and Mission: Lifeline Silver Performance Achievement Award by the American Heart Association. In 2009, Shady Grove Medical Center was designated as a Cycle II Chest Pain Center, the only one in Montgomery County to earn this accreditation. In 2012, Shady Grove Medical Center obtained its Cycle III Chest Pain designation, one of only four hospitals in Maryland to achieve this.
Shady Grove Medical Center's board certified cardiologists, electrophysiologists, interventional radiologists and vascular surgeons provide the following cardiac and vascular care. ECG, holter monitoring, stress testing Vascular ultrasound Nuclear medicine Magnetic resonance anteriography CT imaging Angiography Emergency and routine abdominal aortic aneurysm stent graft Carotid stenting Arterial embolization Full spectrum of vascular surgery Comprehensive electrophysiology service Catheter ablation Pacemaker and defibrillator implants Enhanced external counterpulsation, the only hospital-based EECP Center in Montgomery County Monitored Cardiac Rehabilitation Unmonitored cardiac rehabilitation in the community Cardiac and Vascular Center for Research Percutaneous coronary intervention Primary PCI- an early life-saving medical procedure for heart attack patients since 1996 Elective PCI- waiver from Maryland Healthcare Commission Annually performing on average, 100 PCI's with mean door-to-balloon times in 75% nationwide The oncology program at Shady Grove Medical Center is one of 1,400 oncology programs in the country approved as a Community Hospital Comprehensi
Greektown is a neighborhood located in Baltimore, United States. The neighborhood is bounded by Lombard Street to the north, O'Donnell Street to the south, South Haven to the west, I-895 to the east. A long stretch of Eastern Avenue runs through the neighborhood. In 2014 Greektown was home to around 600 families. During the neighborhood's peak there were around 1,000 families. Greektown has been home to a thriving Greek American community since the 1930s. Once known as The Hill, during the 1980s its residents petitioned the Baltimore City Council to change the name of the neighborhood to Greektown. A bridge shot in the Barry Levinson movie, "Diner", at 21:51 in the movie used Fleet Street at S Newkirk St with the Crown Cork and Seal building in the background. Greektown underwent a revitalization effort beginning in 2001 As of 2010, Greektown is about 50.9% white, 22% Hispanic, 17.8% African American, 6.3% Asian, about 3% all other. A thriving self-contained residential and business community consisting of single family town houses, Greektown is noted for its many restaurants, authentic Greek coffee houses and small businesses of many types.
It is a diverse community of blue-collar people of numerous ethnic derivations. Greektown is Greek and other European descendants, but includes large numbers of people of Native American, African-American and Hispanic ancestry living in a low crime environment; the Greektown Community Development Corporation was formed to revitalize Greek town by The St Nicholas Church. The 1000 member church parish council unanimously voted to appoint Col John E Gavrilis as its first Executive Director. Under his leadership a strategic plan to revitalize the community was published; the plan was near completed to include the revitalization if the Pemco property. The neighborhood is home to the Saint Nicholas Greek Orthodox Church, it is home to Parade. Continuing the consecutive-alphabet scheme that originates in Highlandtown to the west, the north–south streets in this area are: Lehigh, Newkirk, Ponca, Rappolla, Savage and Umbra. History of the Greeks in Baltimore Greektown Community Development Corp. Greektown strategic plan, Baltimore, Md.: Greektown Community Development Corp.
2002. Morgan State University, Community Development Resource Center. Bayview-Greektown, Baltimore, MD: The Center, 1997. Live in Baltimore - Greektown Greektown Community Development Corporation USA Today Television on the evolving nature of Greektown
Howard County General Hospital
Howard County General Hospital is a 267-bed, not-for-profit health care provider located in Columbia, Maryland. Prior to the construction of Howard County General, most emergency services were provided outside Howard County. In Baltimore and Montgomery General Hospital opened in 1920. With the rapid increase in population anticipated from the Rouse Company development he approved, County Commissioner Charles E. Miller attempted to redevelop his family's Historic Gray Rock farm in Ellicott City to build a 200-bed Lutheran Hospital and housing development. Despite multiple attempts, the zoning for the hospital was not approved as competition for the proposed Howard County General project. In addition, the State declined another 1973 proposal to build a 200-bed unit in Ellicott City by Bon Secours for refusing to service abortions as a Catholic hospital. Howard County General Hospital: A Member of Johns Hopkins Medicine is a not-for-profit health care provider with 264 licensed beds located in Columbia, Maryland.
A comprehensive, acute-care medical center, Howard County General offers a full range of services specializing in women`s and children`s services, cardiology, orthopedics, psychiatry, emergency services, community health education. The hospital has a professional staff of more than 950 physicians and allied health professionals, representing nearly 100 specialties and subspecialties. In 2009, the hospital opened a $105 million, four-story, five-level patient pavilion with three inpatient floors as well as the Bolduc Family Outpatient Center. In 2014, the Health Care and Surgery Center Building was renamed to the Dr. Sanford A. Berman and Dr. Kay Ota-Berman Pavilion after a $5 million donation; the hospital is situated on a prehistoric Native American settlement settled as farmland. Benjamin F. Bassler exchanged 92 acres of his fathers 400-acre family farm and airfield to The Rouse Company in exchange for a 504-acre farm to create Haysfield Airport. A hospital was proposed for the development as two others sought County approval.
The 59 bed Columbia Hospital and Clinic Foundations Center was opened on July 9, 1973 serving members of the Columbia Medical Plan only. The Columbia Medical Plan was an early HMO created by the Rouse Corporation in conjunction with Columbia's chief backer and financier Connecticut General Life Insurance and Johns Hopkins, which discouraged private practices that would form competition; the hospital was an early adopter. After a year of operations, the facility was opened to residents outside the Columbia Medical Plan, with the new name Howard County General Hospital. Within the first three years, the hospital was rated the second most expensive in the state and faced budget cuts after cost overruns and unpaid debt. Howard County General Hospital Johns Hopkins Medicine