Indian River County Hospital District

Our next hospital: Site and financing among questions

Vero Beach 32963

February 22, 2024

By: Lisa Zahner, Staff Writer

Where will Indian River County’s next hospital be located? Out west, is presumably the answer as the county continues to expand in that direction. But exactly where, and when, is a third hospital likely to join Cleveland Clinic and Sebastian River Medical Center?

Since the pandemic, not only have developers resumed construction in developments stalled during the Great Recession, but new homes, communities, apartment complexes and businesses are coming

That’s not likely to stop as the County Commission mulls whether or not to expand the westward boundaries of the county’s Urban Services Area. In time, an additional hospital almost certainly will be needed.

The Indian River County Hospital District began to scratch the surface of the issue at last week’s Board of Trustees meeting, but the brief discussion closed leaving a great deal more questions than answers.

The timeliness in planning for the county’s next hospital is twofold — the need to designate existing land holdings in west-central Indian River County for a medical center, or to secure a significant piece of land for a new hospital campus and ancillary medical offices before all the available, appropriate land is developed into housing or commercial buildings.

There are also the questions of how to finance a new hospital to serve the growing community, and who would take that project on. Would Cleveland Clinic design and build it? Would the Indian River County
Hospital District build it and then lease it back to Cleveland Clinic on a long-term lease? Would it be some sort of public-private partnership?

The current hospital on 37th Avenue is owned by the hospital district but governed by a complex 75-year lease agreement, so the district and Cleveland Clinic are enmeshed financially for virtually this entire century.

The hospital district owns 45 acres of vacant land on 82nd Avenue, between the Heron Cay manufactured home community and Pointe West. Plus an adjacent 45 vacant acres are owned privately by an LLC. But that land does not have frontage on State Road 60, meaning the substantial traffic to and from a
hospital would run through a residential area.

The western parcels were purchased decades ago to place a territorial claim on that geographic sector of the hospital market, to prevent another competing hospital or hospital chain from locating
in that area. Due to Certificate of Need (or CON) laws, the construction of new hospitals must be approved by state regulators.

As explained by the National Conference of State Legislatures, these CON programs are in effect in 35 states and “primarily aim to control healthcare costs by restricting duplicative services and determining whether new capital expenditures meet a community need.”

The two parcels the district owns on 82nd Avenue have a combined market value of just less than $2 million, according to the Indian River County Property Appraiser, but values stated by the county, due to the time lag of the assessment process, can run 12 to 18 months behind the market so a private appraisal would likely be higher.

Hospital district Trustee Paul Westcott said he’s spoken to some reputable Realtors who told him that land could sell at a price between $4 million and $6 million. Should the district put the land up for sale and get a viable offer, the way the deed is written, Westcott said, Cleveland Clinic would then have the right to match that and purchase the land.

“Our assessment of the viability and use of the property should probably incorporate some long-term planning, that we discuss, too, where’s our next medical campus going to be?” Westcott said.

“I’d just like for us to take steps to explore that as an option for us,” he said.

Trustee Karen Deigl questioned what the hospital district’s role might be in planning for the next hospital that Cleveland Clinic might or might not want to open and operate in Indian
River County.

“Is that really our format?” she asked. “We’re not the ones. If they’ve got that land, got the first right of refusal on it, it’s them,” referring to Cleveland Clinic.

District Chairwoman Marybeth Cunningham said they could have the conversation “in the spirit as partners.”

“If we’re going to commit that property for medical use, we’d be well advised to take a 30,000-foot look and coordinate with and plan where’s the ideal location, and not let the tail wag
the dog,” Westcott said. “If the better location is out at the intersection of I-95 and State Road 60, and the County Commission believes so, or for planning purposes that’s the better location as opposed to a mile and a half south of State Road 60, I think we need to know

“The question then begs, are we an organization that only disperses money and we’re not thinking strategically, or are we an organization that the public reasonably expects that we’re going to be engaged in strategic planning? I think we’re the latter, and that’s what I’m advocating for,” Westcott said.

The matter came up as part of a discussion about purchasing property for a future sober living center, and how selling other land the district might offset the investment in the drug and alcohol rehabilitation center. Westcott first raised the issue in December and wanted to make sure it remained fairly high on the trustees’ agenda.

Westcott pointed out that the county’s next hospital location would not just be a standalone hospital building, but an entire medical community, as doctors, imaging centers, diagnostic labs, physical therapy, pharmacies and other services would want to be near the new hospital.

The State Road 60 corridor near I-95 is home to about 5,000 manufactured homes in age 55-plus communities, a local resident told the trustees in public comment. Indian River Estates’ 100-acre senior community with assisted-living, memory care and skilled nursing care is also about two miles from I-95 on State Road 60, but a full 7.2 miles or roughly a 20-minute drive in heavy traffic from Cleveland Clinic
Indian River Hospital.

District Trustee Dr. William Cooney reminded the trustees of the need for emergent medical care in the western portion of the county. Cleveland Clinic Vice President Dr. David Peter told the district trustees last fall that the hospital’s top fundraising priority right now is a total revamp of the main campus Emergency Department. The I-95 area only has a Cleveland Clinic Urgent Care center at Pointe West, where patients are evaluated and then transported across town to the hospital if needed.

“Every hospital organization has a facilities plan, and we haven’t seen it,” said hospital district Treasurer Michael Kint. “I’d be interested to see if they’ve got to the point where they’re projecting 10, 20 years out.”

“If part of that decision from their perspective, Cleveland’s perspective is location at this juncture, that land exists. I’d kind of be interested to see what they say would be the best location, so that would play a factor,” Kint said.

District Executive Director Frank Isele agreed with Kint that Cleveland Clinic should have a Master Facilities Plan.

“They are not going to make an investment in expansion without doing a lot of work on needs analysis and all that. It’s going to be very thoughtfully done, so I think a good place to start would be to get that Master Facilities Plan from Cleveland Clinic Indian River.”

Cunningham said she would “feel better about Cleveland’s plan than I would the county commissioners saying where the best spot (would be), personally.”

“So I don’t know that it (the 82nd Avenue property) is off the table. I think there are uses and at this point and time the sale of that property would be something that I would even want to consider until we do understand what their vision is, and the whole housing situation is,” Cunningham said. “There’s a lot of community impact. I would hate to get rid of an asset that would have a huge impact.”

Cunningham also noted that some representatives from an affordable housing coalition had asked about the hospital district’s parcel on 82nd Avenue.

District legal counsel Jennifer Peshke said Cleveland Clinic holds a first right of refusal on many of the district’s properties and any property offered for sale would need to be declared as surplus.



William P Cooney MD is an orthopedic surgeon (retired) who has been a resident of Vero Beach since 2004. He practiced orthopedic surgery at Indian River Medical Center from 2006-2015 within the orthopedic practice of Prosports. He served on the IRMC Foundation for four years. Prior to this, he was a Professor of Orthopedics at Mayo Clinic in Rochester Minnesota, Chair of the Division of Hand Surgery and Vice president of the Department of Orthopedic Surgery. He served as the Vice Chairman of the Mayo Clinic Development Department. He has been President of the American Society for Surgery of the Hand, Orthopedic Research and Education Foundation, Consultant at Shrine Hospital systems. He was editor in chief of the Journal of Orthopedic Surgery and co-editor of the Journal of Hand Surgery. He held grants in hand and wrist surgery sponsored by National Institute of Health (NIH) and Stryker Orthopedics and has over 250 publications in the field of orthopedic surgery, hand, wrist and elbow surgery and microsurgery- free tissue transfers. Within Indian River County, he has served as Chairman of the Board and President of the Hope for Families Homeless Center, Board of the Indian River Hospital Foundation, We Care and Whole Family Health Center medical practices.

Term:  1/23-12/24

Origination: Elected (2 OC)

Occupation: Retired Surgeon



Kerry Bartlett,  of Vero Beach, has more than 30 years experience in philanthropy, including as vice president of the VNA & Hospice Foundation; VNA chief advancement officer from 2001-2007; and executive director of the Indian River Community Foundation from 2008-2014. Kerry is the founder of The Bartlett Company, which focuses on nonprofit and philanthropic consulting. She also is a managing director for Carter, a Vero Beach company that specializes in advancing philanthropy worldwide. Kerry has spent more than 25 years in the nonprofit sector as a fund development professional and has particular expertise in annual funds, major gifts, endowment campaigns and legacy giving. Kerry is also known for creating and implementing effective donor-centered stewardship programs that build, maintain and strengthen nonprofits’ relationships.

Term:  3/21-12/22   |   1/23-12/26

Origination: Appointed by Governor Ron DeSantis
Elected NOC

Occupation: Philanthropic Consultant/Managing Director



Karen has been President and CEO of Senior Resource Association, where she successfully advocates for older adults and their families, since 2006. In that role, she helps provide activities, education and services benefiting older and disabled adults in Indian River County. In addition, Karen provides oversight of the community mass transit system for residents and visitors of the county. As CEO, Karen is responsible for a $7 million operational annual budget and managing more than 100 employees. She ensures that fiscally sound and responsible solutions are created to provide healthcare and a better quality of life for all Indian River County residents. Karen earned a BS in Health Administration from Florida Atlantic University and an MHA from the University of Florida. She was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO



Paul Westcott has been a Board Certified Workers' Compensation Attorney since 1999. In addition, Paul has earned his certification from the Florida Supreme Court as a Circuit Civil and Family Law Mediator. Receiving his Bachelor of Arts degree in both Economics and Political Science at Florida Southern College, he continued his education at Stetson University College of Law. He graduated from Stetson in 1988, having been a published member of the Stetson Law Review. Paul has been a member of the Florida Bar since 1988.  He began his practice in a combined civil litigation and transactional practice before serving as an Assistant State Attorney.  He began his career in Workers' Compensation with Rissman, Weisberg, Barrett, Hurt, Donahue & McClain P.A., where he handled Workers' Compensation cases at the trial and appellate levels.  In 1997, Paul opened the Ft. Pierce office of Hurley, Rogner, Miller, Cox, Waranch & Westcott P.A. handling workers' compensation cases at all levels throughout central and south Florida, while managing the operations of that office.  During his nearly 25 year career in Workers' Compensation, he lectured on a wide range of industry topics.

1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator



Barbara has practiced physical therapy, specializing in orthopedics and sports medicine, in her hometown of Vero Beach since 1981. She was an integral part of the sports medicine team at Vero Beach High School for 35 years. Barbara completed the reserve police academy training, and served with the Vero Beach Police Department from 1982-1989. Her volunteer involvement in the community includes serving on the City of Vero Beach Recreation Committee, Arthritis Association of Indian River County, and the Senior Good Life Games. She and her husband, Michael, enjoy spending their free time traveling in their RV and training their Labradors, Gunner and Chase, in K-9 performance events, including agility and dock jumping. Barbara is a lifelong resident of Indian River County, and received her degree in physical therapy from Chattanooga State College. Barbara was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected 1 OC

Occupation: Physical Therapist



Born and raised in Illinois, Michael was a Theatre and Speech Instructor at Lincoln College when he moved to Indian River County in 1984. He was the Director of Education for the Riverside Theatre for a decade, helping to build the Riverside Children’s Theatre and directing many productions. Michael is well known in the community for his 25 years of service at the United Way of Indian River County, 16 of those years as the CEO. He is very proud of his work with dozens of nonprofit agencies and his commitment to creating and strengthening community collaboratives. Michael was also an Adjunct Faculty member at Barry University for 20 years. He has served on many boards and committees over the years, including: Children’s Services Advisory Committee Needs Assessment, Chair of the Emergency Food and Shelter Program for many years, and he was a founding member of the Mental Health Collaborative, the Senior Collaborative of IRC and the IRC Executive Roundtable. As a Hospital District Trustee he is committed to serving all the citizens of our county. In particular, he hopes to see enhanced availability and affordability for behavioral/mental health for all in need.


Term: 1/23- 12/26

Origination: Elected 1 OC

Occupation: Retired CEO United Way



Marybeth’s professional career encompasses 34 years of working for GM/Delphi in a variety of positions. Starting out as a traffic claims clerk, she worked her way through the organization, with roles in Purchasing, Engineering, and Quality and Reliability. She retired in 2009 as the executive director of Global Operations for the Packard Electric Division of Delphi. In this position, she was responsible for 94 plants in 33 countries. Marybeth has served on the board of directors for numerous non-profits, including Northeast Ohio Adoption Agency; United Way of Warren Ohio, where she served as chairman of the annual campaign for two years; Up with People; Head, Heart and Hands of Indian River Club; Indian River Community Foundation, and the Indian River Mental Health Collaborative. She earned her B.A. in Political Science from Albion College. Marybeth was elected to the Indian River County Hospital District Board of Trustees in 2014, and joined the Board in January 2015. She currently serves as Chair.


Term:  1/15-12/18   |   1/19-12/22   |   1/23- 12/24

Origination: Elected 1 OC | Elected  NOC | Elected NOC

Occupation: Retired Executive GM