A proposed new hospital on the southeast corner of State Road 60 and 66th Avenue likely would not open until 2032 or even 2034, but earlier phases of the project could serve the community with emergency care by 2029 if approved by the county commission.

A team representing the owner of 75 acres along 66th Avenue abutting Indian River State College Mueller Campus was set for a discussion with the public and commissioners this Tuesday. But the only thing that was expected to be decided was whether or not to proceed with future public workshops about zoning and land use changes that would be required to accommodate a proposed five-story hospital.

Only the main hospital building, which would likely be slated for a final phase, would require height and size variances from the county to build a five-story, 260,000-square-foot structure with 108 beds.

Former County Commissioner Tim Zorc, who assembled a local technical and legal team for the Miami property owner, said the construction company involved in the project, which builds hospitals and other medical buildings, advised three phases of construction.

"First would be the standalone emergency room. That would be in years one and two," Zorc said. "Then the surgery center would be years three and four, and then the vertical hospital portion would be years five through seven."

Florida-based Sphere Investments will design the hospital in consultation with the operator and build the buildings," Zorc said. "They build a lot of medical facilities all around the country. They have a platform for healthcare real estate and private investment in healthcare facilities. And they buy and own healthcare facilities."

Sphere would work with three yet-unnamed hospital operators interested in the Vero market to develop proposals and the property owner would then choose the one to move forward with to construction.

Zorc's team has hammered out language with the county's planning and legal staff that would limit any height and size variances to the specific 66th Avenue site, referred to by the county as the "Preferred Location Area." Variances would apply only to a hospital use. The legal team includes beachside attorney Bruce Barkett, former county attorney Dylan Reingold, now in private practice in Indian River Shores, and the property owner's family attorney, Roy Lustig, of Coral Gables.

"We only want to get this right. We don't want to leave the door open accidentally [for another project to make use of the variances]. We're very selective and specific, and if somebody else comes along, it's not going to work," Zorc said.

If all required zoning, land use and site plan approvals can be obtained by the end of 2027, the development team said the hospital would be completed between 2032 and 2034.

By then, the just-completed Oslo Road interchange will increase traffic flow and development near the proposed hospital site. Also by then, county commissioners and county staff likely will have decided how to expand the Urban Service Area in the middle-western parts of the county, which will generate even more growth.

The Florida Department of Economic Research predicts Indian River County will grow by nearly 30,000 people by 2040, nearing or even exceeding the 200,000 resident mark. That does not count snowbirds and tourists.

Proponents of the new hospital point to that upcoming growth as one reason a third hospital is needed in the county.

A 2024 Kaiser Family Foundation report put the national average of hospital beds at 2.3 per 1,000 people. Older populations using healthcare facilities more intensely need 4.8 beds per 1,000 people, researchers suggest.

Based upon the 200,000 resident figure projected by 2040 and the 2.3 beds per 1,000 people for a non-senior population, the county needs about 460 beds. The ideal for Indian River County's older population and elderly snowbirds would be closer to the 4.8 beds per 1,000 residents or 960 total hospital beds.

Cleveland Clinic Indian River Hospital has 332 beds. Orlando Health Sebastian River Hospital, which also serves 16,000 residents of Barefoot Bay, Micco and Grant-Valkaria in Brevard County, has 145 beds. That's a total of 477 beds between the two hospitals.

A new hospital with 108 beds, based upon 2040 population projections, would bring Indian River County up to 2.9 beds per 1,000 people.

None of these numbers matter if the County Commission opposes the needed height and size variances.

County staff in a memo noted the leeway given to Vero's existing hospital, which was built on residentially zoned land, initially 80 feet for five stories, but that was revised upward later.

"Cleveland Clinic Indian River Hospital previously received a site-specific variance allowing a maximum building height of 134 feet, with an additional 16 feet permitted for an elevator structure, resulting in a maximum authorized height of 150 feet for that specific site," Sweeney said.

Zorc said one of his team's engineers will present graphics showing how densely developed the 66th Avenue site could be with commercial buildings if the hospital plan is voted down.

His clients own 45 acres east of 66th Avenue, and 28 acres west of 66th Avenue that they assembled over nearly 30 years. Current zoning would allow the acres to be filled with new retail strip malls, big-box type stores and chain restaurants, similar to nearby stretches of Route 60, if the hospital is not built.

Zorc said he hopes the illustrations will enable his team to show "what's actually allowed to be built on this corner if we don't change anything.

"If it was a big shopping center, what would that look like?" Zorc said, responding to potential objections to having a five-story hospital building on the corner.

Should commissioners allow the plan to move forward, there will be multiple public hearings, and perhaps a workshop or two on the proposed development before any final approval.