While institutional uses within Urban Neighborhoods such as churches, schools and hospitals provide community stability, their expansion can be controversial, especially if the area is a historic neighborhood. Sometimes the use, scale, setback or height of new institutional structures are considered incompatible with the adjoining neighborhood, other times expanding parking into the neighborhood is the issue. Because of the unique nature of institutions, Area Plans do not always designate land specifically for expansion, but instead set out policies to guide growth. When institutional expansion occurs, good communication between the neighborhood and the institution is essential. A positive example is the work the Citizens’ Advisory Committee (CAC) for the Southwest Area Plan (Ardmore area) accomplished through the Area Plan process. Wake Forest Baptist Health was represented on the CAC along with neighbors. Through listening and hard work, a consensus was reached on limitations for hospital expansion on the current campus.