Arlington Hosp…..er, sorry, Virginia Hospital Center, is scrambling daily to find space for its patient overflow.

The medical nerve center of our county built in 1944 (whose name was delocalized in 2001) has 394 beds, but commonly needs more than 421 per day, said Adrian Stanton, vice president and chief marketing officer of Arlington’s only hospital.

Stanton, plus an experienced county planner and a friendly critic representing wary neighbors, spoke March 14 to the Arlington Committee of 100 to update impatient Arlingtonians on when the long-discussed land swap between the county and the hospital will be consummated.

But the hospital’s hoped-for expansion won’t occur before a bit of community relations triage.

The hospital at N. George Mason Dr. and 16th St. is ranked highly for patient satisfaction and gets an A for safety, its marketer says. It has prestigious partnerships with Georgetown University Medical School and the Mayo Clinic. Its 3,400 employees and 1,200 doctors provide care to 77 percent of Arlingtonians (delivering 83 percent of our babies). It treats 120,000 outpatients yearly.

But it has struggled to accommodate 37 percent growth since 2009, Stanton stressed, growth that’s projected to continue. When wards are full, managers sometimes keep patients in the emergency room or intensive care longer than normal. “If the doctors see there are no beds, they will send patients to other hospitals, and that’s what we don’t want for Arlington.”

So the hospital’s strategists eyed aging county-owned structures on 5.8 acres on Edison St. abutting their campus. For decades they housed behavioral health services, but they now stand empty since the providers moved to Sequoia Plaza near Lyon Park.

The pending deal is for the hospital to trade 11 acres on Carlin Springs Rd. (its urgent care center) for the Edison St. land. It would then build a pavilion, with parking garage, to house outpatient services – radiology, imaging, physical therapy and the pharmacy, plus physician offices. The cancer, surgical and mental health units would stay put, but two current floors of the main building would be freed for 88 new beds.

Sounds healthy. But Tracy Greiner, chair of a task force of three nearby civic associations, said the hospital has “failed to effectively address three years of homeowner feedback.” Neighbors — some who’ve been in Halls Hill for three generations, others who just bought in — worry about traffic, nighttime lights and construction.

Neighbors call the planned pavilion “The Wall.” They want larger setbacks surrounding the 90-foot garage, plus more trees, sidewalks and pedestrian crossings. “Some feel the county is going to rubber-stamp it, so why should we care?” he said.

In Arlington “there are no easy sites,” said Nancy Iacomini, who chairs the hospital expansion Site Plan Review Committee. Its Arlingtonian thoroughness involves monthly meetings with transportation and parks staff, and specialists in aging and disabilities. The group should arrive at consensus, with some compromises, soon, she said. “You get to a point where, if you’re still talking about it, you’re not going to change it.”

The hospital wants county board approval by June, at which point it will cut a deal to close the gap between the $12 million assessed value of the Edison St. grounds and the $10 million facility on Carlin Springs Rd. Then expect 24-30-months construction time.

The county needs land for schools and transport. The neighbors want planning — with surgical precision.

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Affluent Arlington for next year is planning an austerity budget. The proposal released in February contained no tax rate increase but scrapes away funds from at least three projects I’ve profiled.

It would reduce Arlington Independent Media funding by 20 percent, or $90.852. It would cut the Lee Highway reimagining process by $500,000 and trim neighborhood colleges by $40,000, or 80 percent.

The budget is currently the subject of hearings and heads to a final county board vote April 21.