Planning commission members focused many of their questions on the adequacy of local roads and when they will be improved, but also asked about sewer service, parking and possible future expansion.
Commission members Terry Reiber, James F. Kercheval, Bernard Moser, Linda Parrish and George Anikis voted in favor of approving the site plan.
Commission member R. Ben Clopper chaired the meeting in place of Don Ardinger, who was absent.
Clopper did not vote. The chairman of the meeting only votes to break a tie.
The new hospital - replacing one on East Antietam Street - is expected to be about 500,000 square feet.
The last cost estimate was $235 million, but that estimate probably is outdated, James Hamill, the Health System's president and chief executive officer, has said.
Washington County Health System and county officials are working on a "fast track" review of the hospital project. Thompson said that means parts of the review process are happening simultaneously instead of sequentially.
The Washington Board of Zoning Appeals in December granted two variances in December 2005 that allowed the hospital project to move ahead. The vote on each variance was 4-1.
One variance waived setback requirements, so the new hospital could be connected to the existing Robinwood Medical Center.
The second variance permits a helicopter pad and ambulances at the new hospital. It also lets the building be taller than the zoning ordinance allows.
In January, members of a citizens' group known as Citizens for Responsible Health Care filed appeals to the zoning board's two approvals in Washington County Circuit Court.
The appeals will not halt the county's review process of the proposed hospital or its construction, unless a judge rules that the project should stop.