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Rapid growth at community’s new ‘third hospital’

STORY BY STEVEN M. THOMAS (Week of June 23, 2022)

Vero Orthopaedics and Neurology’s gleaming modernist facility on Indian River Boulevard is fast gaining a reputation as the community’s “third hospital,” treating hundreds of patients a day.

The $22 million building houses 15 fellowship trained doctors, 68 exam rooms, three radiology suites, four procedure rooms and three brand new operating rooms with a full anesthesia team.

“We have every sub-specialty of orthopedics, including spine surgery, total joint replacement, hand surgery, foot and ankle, osteoporosis and bone health, and sports medicine,” said Vero Ortho CEO Jennifer Davison.

Just this week, Vero Ortho began conscious sedation, the “twilight anesthesia” used for operations that don’t require general anesthesia, further expanding its range of patient care.

There are even two overnight-stay rooms for post-op patients who need continued care for 23 hours or less.

The two-story building is about the same size as the Health and Wellness Center at Cleveland Clinic Indian River and more than two-thirds as large as the 90,000-square-foot expansion that added 48 patient rooms and six operating rooms at Sebastian River Medical Center in 2020.

Co-developed by Vero Orthopaedics and Optimal Outcomes, a major healthcare real estate development company, the facility employs 135 people, from X-ray and MRI technicians to physical therapists who help patients recover after treatment so they can “get back out on the golf course or tennis court.”

“We wanted it to be a ‘one-stop shop’ for patients, where they can be diagnosed, treated and receive aftercare,” said Davison.

Besides offering a complete spectrum of care, Davison’s goal as she managed the design and development process was to increase patient access.

And it seems to be working.

“If you call us by 4 p.m. [with an injury or other urgent need for treatment], you will see a doctor that same day,” Davison said, noting that the practice sees 600 patients a day, on average, up 40 percent since 2019.

“Our motto is ‘hurt today, treated today.’”

“A woman came in last week with a dislocated elbow,” said Dr. Seth Coren, president of Vero Ortho. “It had been dislocated before and reinjured and one of our doctors sent the patient upstairs to the surgery center, put the elbow back in place, and was back at her office in 20 minutes to keep her afternoon appointments.

“At the same time, the patient was saved from going through a time-consuming and expensive hospital admission to get treatment.”

Davison, who colleagues credit with being a driving force behind the new building and business expansion, served as interior designer on the project, picking finishes and furnishings aimed at creating a bright “coastal ambiance,” in her words, with “extensive use of blues and natural earth tones to promote a healing environment.”

She said Vero Ortho was “very fortunate” in the partners it picked for the project.

Design was by Array Architects, a firm with five offices from Boston to Boca Raton that specializes in healthcare architecture whose work is well known in Vero. In recent years, Array designed Cleveland Clinic Indian River’s Health and Wellness Center and Scully Welsh Cancer Center.

“This is all we do. We are experts in healthcare,” said Leo Salomon, principal and studio leader at the Boca Raton office.

Array’s signature can be seen in the sleek, modern design, which includes a vast glass curtain wall that covers half the front of the new building, flooding the expansive foyer and waiting area with light and letting in the green view.

“Natural light is critical in a healthcare setting,” Salomon told Vero Beach 32963. “It is one of the main things we emphasize. It has been proven by scientific research that natural light reinforces the healing process.”

Infection control was another crucial consideration as the design came together, resulting in a touchless entry, hard, high-tech surfaces that are easy to keep clean and carefully arranged seating areas.

“Everything we design in this era of viruses is aimed at [reducing contagion],” Salomon said.

Developer and building co-owner Optimal Outcomes is another major player in healthcare development. The company was in the news last summer when it sold a two-building medical office park in Port St. Lucie that it helped develop to Cleveland Clinic Tradition Hospital for $52 million.

The company has completed more than 100 medical building projects totaling 2.5 million square feet – most in Florida – since it was founded in the late 1990s, and has a dozen projects currently underway, according to its website.

“Optimal was a fantastic partner on this project,” said Davison. “They were superb throughout, a huge help with all the nuances of timelines, material selection, making sure the move went smoothly.”

Optimal earned that rave review despite some formidable challenges.

“This project had some complicated site conditions and the entitlement process with the county was by far the most challenging we have encountered in more than 25 years,” Patrick Marston, a former banker and company co-founder, told Vero Beach 32963. “Additionally, during construction the rain in Vero was excessive – seemingly incessant – and more than double the average rainfall for the area historically.”

And there was covid to contend with, too.

Davison and the doctors who own Vero Ortho started planning the project and purchased the 9-acre site in 2019. They broke ground in 2020, as the pernicious virus was first wreaking havoc.

Built by Precise Construction, a Tampa company that works frequently with Optimal Outcomes, the project was completed in July 2021, just as another covid wave was developing.

Despite the difficulties, the timing turned out to be favorable, with materials ordered and subcontractors signed up before supply-chain snarls and inflation hobbled the construction industry and pushed labor and material prices through the roof.

Marston estimated that if the project had been started a year later, costs would have been “20 percent to 40 percent higher,” and the job likely would have taken much longer.

“We were all exceptionally fortunate in the timing of the project ... and we could not be more pleased with the facility, which has won design awards locally and nationally,” Marston said.

“I can say without caveat that the physician partners and the entire administrative team at Vero Ortho were a pleasure to work with. They knew what they wanted and were professional and positive throughout the process.

“Jennifer Davison, the chief executive officer, in particular was a champion of the project and was fully committed to making it a success. We wish every project was similar to this one – even with the site work challenges and the issues caused by covid!”

For Vero Ortho, the timing of the new building allowed them to ride the wave of covid immigrants arriving in Indian River County from around the country, continuing to expand and add new services and facilities.

Asked how the new building is better than the old one, Coren smiled and said, “We don’t have enough time to fully cover that.”

“Our old place was only 20,000 square feet and our waiting room was standing room only some days,” Davison said. “Here we have much more room and have grown our patient count by 100 patients per day in just the past year.”

Vero Ortho has hired two new doctors since its move and another hand surgeon is slated to start in August, which will raise the physician count to 16.

The Advanced Center for Surgery opened on the building’s second floor in March. It has the three operating rooms, two of the four procedure rooms, 10 pre-op bays, 12 post-op bays and the two-overnight stay rooms.

“We have two physical medicine rehab docs and a neurologist. We have four ultrasound machines and can do full-body X-rays. Our MRI machines are going 12 hours a day, six days a week. Our [9,000-square-foot] rehabilitation suite with a staff of 20, including Ph.D. physical therapists, is full all week long,” Davison said.

Things are so busy, in fact, that Davison is considering further expansion. There is a 7,000-square-foot unfinished space on the second floor adjacent to the surgery center that was slated to be leased out but that now may end up being filled by the growing practice.

“We are getting close to capacity downstairs, and with a 17th doctor possibly coming by the end of the year, it is time to start thinking about it,” Davison said. “I’d like to get a CT scanner for upstairs and that could be something that goes in the extra space.”

There are several businesses involved in Vero’s “third hospital.”

Vero Orthopaedics and Neurology is owned by the 10 doctors who are partners in the practice.

The award-winning building that continues to turn heads as people pass by on Indian River Boulevard is co-owned by Vero Ortho and Optimal Outcomes, which also manages the building.

The Advanced Center for Surgery is co-owned by several of the Vero Ortho doctors and United Surgical Partners International (USPI), part of Tenet Healthcare Corporation. USPI Tenet operates more than 400 surgical facilities across the country.

Vero Ortho has a second office in Sebastian. Its physicians operate at Cleveland Clinic and Sebastian  Medical Center as well as in-house, and Davison said one of the spine surgeons will begin seeing patients at Melbourne Regional Medical Center one day a week in the near future.