The Cleveland Clinic is defending its plan to build a Level I trauma center after criticism from MetroHealth. The hospital argues that hundreds of critically injured patients are transferred out of its system every year due to lack of facilities for treatment. The proposed center is scheduled to open in 2028 and has been criticized by MetroHealth, which operates one of the city's existing Level I hospitals. The expansion of the hospital's main campus has sparked controversy, with CEO Christine Alexander-Rager warning that it could increase costs and decrease expertise.