This story has been updated to include a comment from Barton Health.

The promise “You, only better” was erected on a billboard at the former site of the Lakeside Inn and Casino and has left the community divided over the proposed Barton Hospital site in Stateline, Nevada. Oliver Park General Improvement District, the residents of Douglas and El Dorado Counties, nor the governing agencies are in agreement on the details of the move, the proposed height, or the accompanying helipad.

In 2021, Barton was forced to make the decision to tear down and rebuild their existing hospital to meet new California seismic regulations or move a short distance to Nevada and build a new location. After extensive financial assessments, Barton chose to purchase the Lakeside property for $13 million.

Yet, many residents think the negatives far outweigh the positives, describing the project as a “black hole of a project” that looked like a “back door deal” during the Douglas County Planning Commission meeting on August 13.

In an interview with the Nevada Globe, Tobi Tyler, Vice Chair of the Sierra Club Tahoe Area Group, pointed out that the proposed building site is awaiting approval and Barton is preparing to build on land in an area the Tahoe Regional Planning Agency (TRPA) considers a “D” on the SEZ Assessment Unit“.

The Stream Environment Zone (SEZ) includes perennial, intermittent, and ephemeral streams; wet meadows, marshes, and other wetlands; riparian areas, beaches, and other areas with groundwater bubbling to the surface. The areas are protected because they provide many positive services: maintaining water quality by encouraging nutrient cycling and sediment retention, flood attenuation, wildlife habitat, and wildfire abatement.

To note, development within riparian corridors was commonplace throughout the Tahoe Basin before TRPA regulations. “Significant resources continue to be invested in removing development from these sensitive areas,” per the Baseline Condition Assessment provided by TRPA and funded through an Environmental Protection Agency Wetland Development Grant published in December of 2020.

According to TRPA’s Public Information Officer Jeff Cowen, even TRPA finds Barton’s “plan” unusual. “Not many developers would have done the demolition first without a sure plan,” Cowen explained. “They don’t want to make that kind of investment unless they have approval. We don’t really know what Barton’s idea was with [demolition prior to approval], others might have waited,” Cowen added.

Additionally, if the Barton site remains empty for an extended period, it may fall under what the Nevada Supreme Court calls a “Prescriptive Easement.” While a prescriptive easement ruling by the Nevada Supreme Court may be far-fetched, the ruling would prohibit Barton from developing the now empty lot. People get use to driving by this new open space,” Cowen mentioned.

“We don’t know if 80 foot buildings will be allowed there, or not,” Cowen said. “Douglas County has agreed that certain things about hospitals require additional height per floor for medical equipment to achieve the desired infrastructure.”

Currently, the height allowable is 56 feet even though the previous Lakeside casino was about 4 feet over that from the lowest point of natural grade, according to Cowen.

“The height, scenic, and transportation requirements are different than anything around the Basin. We’re still 900 yards from the finish line,” Cowen stated.

“Tahoe should have been a National Park and unfortunately it’s not,” 52-year resident of Douglas County Sharon Skinner remarked. “When I think of issues like the hospital moving from South Lake Tahoe to Stateline Nevada, I think of the environment. The Lam Wahtah Nature Trail is one of the most beautiful trails in our area. It has streams, grasses, and marshes. There are beavers, coyotes, bears, many ducks, and birds including bald eagles.”

Employees and potential patients of the hospital are equally concerned that if the hospital is built on the Nevada side it will no longer retain its “world’s best” healthcare reputation.

“My main concern is the quality of care that is going to be provided in this hospital. California has state-mandated nurse-to-patient ratios,” ER nurse Dorothy Dean said during the August meeting. “Barton has flatly refused to provide any patient-to-nurse ratios,” she added. “I should mention, they didn’t start winning awards before we unionized. Anyone with eyes can see you’ll spend longer in the car or back of an ambulance,” Dean said.

“I understand we’ve been referred to as NIMBY’s (Not In My Back Yard)” resident Dana Tibbitts stated, “but we are simply residents insisting on the work of preservation, which is Douglas County and TRPA’s work to do in the first place.”

Tibbets has been actively working with the Tahoe East Shore Alliance to ensure the evacuation route along Highway 50 is maintained through each process of project approval for what she calls “half-baked plans”.

“An Environmental Impact Statement is foundational,” Tibbitts added.“ From our perspective, things are done with a check of a box and a handshake. It frankly defies the imagination that there is no plan for massive big projects for which foundation work is well underway, massive trenches already dug and a big new billboard touting the arrival of a new hospital- one of the world’s best.”

The “potential timeline” would be for Douglas County to submit an area plan amendment to allow for additional height at the next meeting on September 25th. The TRPA would be presented with the timeline two days prior.

“All that does is allow them to put in an application for a building at the height allowable in the district.” Cowen clarified, “That’s when we start looking at habitat, noise, scenic quality, etc.”

In an emailed statement to The Globe, Barton Health replied, “As the only comprehensive health system in the Lake Tahoe Basin, our priority is to provide high quality, exceptional healthcare to our community. Due to aging infrastructure and growing health needs, Barton plans to rebuild the hospital to meet today’s health needs. We will continue to work with the community to ensure exceptional healthcare is accessible and available in the basin. Barton will follow environmental regulations from the TRPA and Douglas County. The parcel is rated Class 7 land capability, meaning the least sensitive of developable parcels.”