St. Augustine’s Flagler Hospital Planning Medical Inroad in AdventHealth’s Palm Coast Backyard, on Matanzas Woods Parkway

On July 25, the Palm Coast Realtor Margaret Sheehan-Jones, Larry Torino of Palm Coast’s United Methodist Church and officials from St. Augustine’s Flagler Hospital–now Flagler Health Plus–met with Palm Coast building and development officials to talk about a 4-acre parcel at Matanzas Woods Parkway and Belle Terre Parkway: what it’s zoned for, what can be built there, what cannot. 

There were no solid concepts. But Flagler Hospital is buying the parcel and plans on building medical offices, according to half a dozen people familiar with some aspect of the plans, with closing on the property now set for Oct. 7. 

The St. Augustine hospital is planning possibly a “medical village” with amenities, a concept other health care providers, including AdventHealth, are developing in various places. It would be the first competitive foray by an out of county health care provider in what has overwhelmingly been AdventHealth territory until now. And it would be built at 1000 Matanzas Woods Parkway, just down the road from 2355 Matanzas Woods Parkway, where AdventHealth is planning a stand-alone emergency room.  

“It’s a health village concept that they’ve done,” County Administrator Jerry Cameron said of Flagler Hospital’s plan. “The one I went to and looked at in St. Johns County had a pediatrics office, an orthopedics office, a primary care office and a couple of other offices, and they had a YMCA built in there that was open to the general community but it was used for rehabilitation too.” 

Flagler County’s economic development office had some conversations with Fagler Hospital–Sheehan-Jones works closely with Helga van Eckert, the department’s director–but isn’t more directly involved in the plans, other than in some ways to ride the coattails of a public announcement. The hospital hasn’t asked for economic development incentives. But it did explore what broader possibilities it could offer from that land. 

The meeting with Palm Coast officials was “informal,” City Manager Matt Morton said, without so much as site plans or anything to that effect. Those have yet to be submitted. “They didn’t leave us with anything,” Jason DeLorenzo, the city’s development director, said, though it appears the plans call for a two-level building or set of buildings. The parcel is zoned neighborhood commercial, limiting its uses to medical offices as opposed to anything more elaborate such as an actual hospital or a laboratory. The designation precludes any variances, or exceptions, to zoning rules.

The closing was initially set for late September but was extended to the October date, Larry Torino, an official with First United Methodist Church of Palm Coast, said today. The church is selling the land to the hospital. “We’re under contract with them,” Torino confirmed today. “We gave them one thirty-day extension.” (Torino is a building official with Flagler Beach government, but that association has nothing to do with the hospital deal.) The church previously sold two acres off the same parcel to Dollar General, which is under construction there.

In concept, Torino said, the Flagler Health Plus plan is similar to AdventHealth’s satellite operation on Cypress Edge Parkway in Palm Coast. County Commission Chairman Donald O’Brien compared it to “World Golf Village and a couple of other places in the region,” but he said he has not been briefed on the plans. 

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Flagler County officials have been clamoring for more mental health services in the county, and some, among them Cameron and Joe Mullins, the county commissioner, have been speaking of a maternity ward despite demographics that argue against one: the county has around 800 births a year. But Flagler Health Plus’s plans for Palm Coast entail neither. “I don’t think there is mental health that I’ve heard about,” Cameron said. “I do know that Flagler has a telemedicine program that will be available there, and they do provide mental health services in that way. But that’s generally med-prescribing and things of that nature.” 

AdventHealth officials have been in conversation with local county and city leaders to assure them that mental health services are on their horizon.

Flagler Health Plus’s advance into Flagler is an early example of the Legislature’s erosion earlier this year of the Certificate of Need process, which since 1973 has regulated health care facilities’ expansions based on need. The process is still in place for such services as nursing homes, cancer-treatment facilities and the like, but many other services are no longer similarly regulated. That’s unleashing what officials privately speak of as hospital wars. 

AdventHealth officials are concerned–but shouldn’t be, say Cameron and O’Brien, who chairs the county’s economic development board and is a member of the AdventHealth Foundation board. “I have it through third parties that they’re saying that Flagler is just going to come down here and use this outpost to get patients and take them to St. Johns County,” Cameron said. “That’s a little preposterous.” 

“It’s competition,” O’Brien said. “What I’ve heard from Dr. Jimenez and from some of their leadership is,” he said, referring to Ron Jimenez, AdventHealth Palm Coast’s CEO, “they have a concern about wanting to deploy a lot more capital in Flagler County until maybe they can get a better understanding of the lay of the land, because we’re in a brave new world now with the changes in the certificate of need program. Less requirements now. And they’re a huge player, they’re a multi-state operation, a multi-billion dollar corporation, so I think at their highest level they’re trying to understand how they reallocate capital around their whole system, and it’s not just Flagler. I think they’re going to go slow for a while until they figure things out. So do they have a concern? Absolutely. Why wouldn’t they. It’s competition. They haven’t had that before, and the world is changing. But it’s kind of early.” 

That hesitancy about deploying more capital in certain areas may be having a direct effect on plans in Palm Coast where, for example, certain planned expansions could be paused so more attention may be given to marketing what’s already in place, as a counterforce to competition. But that’s not expected to impact other investments, such as AdventHealth’s partnership with the school district in a new health flagship program at Flagler Palm Coast High School, or Palm Coast’s efforts to land a university presence in town that would be heavily tied to medical fields.

“For us and Advent, it’s kind of new,” O’Brien said. “Look everywhere you go in other larger areas, multiple facilities right next to each other,” as in Jacksonville, where the Baptist Medical center, Mayo Clinic, Satin Vincent’s Hospital and UF Shands, among others, all operate within relatively short distances of each other (though not quite down the block, as on Matanzas Woods Parkway). “That’s just new for us because we’ve been a smaller community, but we’re now in a transition from I think rural to mid-size county.” 

Will it be to the good? “Competition to me is always good,” O’Brien said. 

It’s also the sort of development local government leaders were hoping for, if not that specifically, when they inaugurated the opening of the Matanzas Woods interchange with I-95 three years ago.

“What I hope comes out from the competition pressure is that we will have women services and mental health services in Flagler County,” Cameron said, even though neither is in the works at the moment. Of Flagler Hospital, he said: “They are a credit to the community. I accomplished a lot of things with them when I was the assistant administrator in St. Johns and then when I left that position, I did some work for Flagler to continue what we had started at the county. It is all about outreach to health care partners and trying to have a network of providers that are sharing information and supporting each other.”