Leaders Gather to Film Groundbreaking at AdventHealth Palm Coast’s New Hospital, Now a Larger, $145 Million Project

Ottati was in town to champion the “largest single investment we’ve ever made in Flagler County at a single time,” what will now be a $145 million, 4-story, 100-bed hospital and a medical office building, going up simultaneously and due to be ready near the end of the first quarter of 2023. The combined size of the hospital and the medical office building will be 188,000 square feet. 

When the hospital first announced the plan in January, it was to be a $100 million project, with the medical office building phased in later. That’s no longer the case, as simultaneous construction was found to be more feasible. In January, the expectation was for some 400 jobs by the time the hospital alone would open. The projection now is for 700 jobs as both buildings open for business. “It speaks volumes to our commitment. We’re committed,” Ottati said in an interview. “I think it will be busy Day One.”

Ottati–who formerly was the CEO at AdventHealth Palm Coast and will soon transition to a new role as CEO of AdventHealth’s West Florida division–was at the construction site with AdventHealth Palm Coast CEO Ron Jimenez, Chief Operating Officer Wally de Aquino, Dr. Paul Mucciolo, the hospital’s chief of staff, Palm Coast Mayor David Alfin and County Administrator Heidi Petito, among others. 

They’d gathered for the ceremonial ground-breaking. It was all there: the shovels, the golden sand in a neatly carpentered box, the hard hats, the tractors positioned behind the set. The only thing missing was an audience. 

That was intentional. Because as dump trucks drove by at a steady pace to dump what will amount to 4 feet of fill beneath the hospital, Kyle Massey of Orlando’s Massey Tone Productions–director, videographer–was directing the whole gathering and filming the carefully choreographed scenes into what will become the virtual groundbreaking production airing on on Set. 14 at noon on Facebook and other platforms. 




So the officials went through their paces like actors, standing where Massey told them to stand, singly reading the teleprompter when he signaled them, and doing it again, take after take, just to get the right tone and all stumbles out before everyone lined up with a shovel to throw a little sand up. The first take fell flat, the second was better, and Massey took a third just for safety: even the professionals do it. The sun was punishing, the sweat rolling and the noise at times loud enough to drown out human voices, but there was also that sense, in the vastness of the cleared acreage–which made the parcel look much bigger than it had when wooded–of the magnitude of the project under way: in current dollars, it’s the largest single investment in the city’s or the county’s history. 

“This is a monumental development for the city of Palm Coast,” Alfin said, outlining the history of the hospital’s impacts on the city going back years. “I almost always get negative comments from local residents, especially in close proximity and neighborhoods who drive by development sites. I have not had a one. I have had positive comments about how well you’ve taken care of the land, how well you’ve groomed it, getting it ready. That’s very unusual for me to have positive comments. So the word is already getting out there that you’ve got a lot of support.” 

Asked about the timing of the hospital’s construction–both with the pandemic and with Alfin’s recent election as mayor–Alfin spoke of a law enforcement officer’s funeral he had just attended in Volusia County, and of another he was to attend on Friday, as officers have been lowing their loves, like many others, to Covid. “So for those of us, all of us that either are prayerful or optimistic, it seems to me that the sun is shining today, and that we are talking about a new hospital facility, which in these dark times–and everybody is suffering a lot of wear and tear–it seems to me the concept of a new hospital could relieve the tear, once it’s finished down the road.” 

Jimenez, a physician who’s been CEO of the local hospital since 2016, spoke of the resilience of hospital staff–they’re tired but they’re still optimistic,” he said. Jimenez a year ago was named CEO of the Flagler-St. Johns market, so all the Advent facilities in the two counties are under his supervision, though there will be a chief executive at the new hospital. 

Jimenez expects the new facility to relieve the sort of pressures the original hospital has been experiencing: it’s a facility licensed for 99 beds, including ICU beds (past reporting and elected officials have incorrectly referred to AdventHealth Palm Coast as licensed for 132 beds), though “we have about 150 or so private rooms that can be used for patients,” Jimenez said. The pandemic has somewhat affected the design of the new hospital: “We have more flexibility with the rooms in this facility, to be able to go from a general medical bed into an intensive care type of bed. So that flexibility is really going to come in very, very handy when it relates to these types of incidences.” 




The two hospitals will not have a trauma center or a maternity ward between them: that responsibility will still fall on Halifax hospital, because of demographics. (For a detailed explanation about the maternity ward, which repeatedly elicits questions of hospital executives, go here and here.) Those developments will be dependent on future growth. The new facility, de Aquino said, is intended to stay “ahead of the curve” of local health care needs. “When we look at an investment like this, we’re not looking to say, okay this is what we need right now right, we’ve got to look at 10, 15 years,” de Aquino said. “It would be imprudent for us just to look at the next five years.” The blueprint–and footprint–of the complex is serving as a model for AdventHealth in other locations that need medium-size hospitals. 

Overall, de Aquino said, the project now under construction is 21 percent larger than it was when first conceptualized. He spoke of the medical office building that will house specialists and result in a combined workforce of 700 in the workforce. That’s a lot of people who will need housing in a trite housing market. “We are creating jobs. We would love to have them stay in Flagler County,” de Aquino said. “So, it will take a village, leadership from Flagler County to work together for us to come up with a solution.”

Petito, the county administrator, said the county recently approved an ordinance intended to spur affordable housing, but “it’s a bigger issue than just a county issue,” she said. “It’s really something that the community as a whole needs to come together. When you look at the density and the available infill lots in the City of Palm Coast or the city of Bunnell, or Flagler Beach, I think that’s where you’re going to see the largest growth for our community, just because of services that are available–water, sewer and things like that that make it a viable option for housing.” Petito said the county’s lead on an affordable housing ordinance could encourage the cities to follow suit. 

A small tent served as a green room, where the hospital’s John Subers oriented new arrivals and dispensed cool water to alleviate the heat (or showed off the Observer’s story on Carla Cline delivering 450 $20 gift cards to hospital staff last Monday). The stars of the show meanwhile waited their turn as Massey took them singly before the camera to read their script. Mucciolo, his part done (until the shoveling of dirt), imagined the new hospital’s role in the context of Covid when it opens: “We’re going to go from a pandemic to an endemic,” he said. “Covid is going to be with us for years to come. It’ll just be a matter of how we manage it,”  especially with the variants. 

The timing of the new hospital will help–and will lower travel times for residents in the Hammock and at the north and west ends of the city, which are expected to grow fastest. “When people say every minute counts, it really does,” Mucciolo said, especially with strokes and heart disease. “And now with sepsis management. That’s the same thing because that’s the number one cause of mortality. So we’ll be able to provide better services here, just because of proximity.” 




The morning had started at 8:30 with a prayer by Chaplain Eddie, then with the Jimenez, Mucciolo and Alfin film clips, before the group gathered for the shoveling. Council member Nick Klufas wasn’t part of the script, but he’d turned up, having shepherded the project along from the city’s end. “This expansion is a game changer,” he said. AdventHealth is truly building a state-of-the-art facility to provide a myriad of surgical services not only for Palm Coast citizens but also neighboring counties.” The hospital’s growing imprint, he said, “is a huge step towards Palm Coast continuing to establish itself as a medical hub in Northeast Florida.”

By 11, the set was breaking down, the quadrant returning to the sole domain of Superintendent Casey Mabe, the project superintendent for Robins & Morton, the Maitland-based construction company. Ottati, ever the unassuming executive, was helping pack up some of the crew’s wares. He was last up in front of Massey’s camera, stumbling a couple of times over a particular line but finally getting it down as he wanted. 

So when viewers will see the edited, finished product on Sept. 14, they’ll hear the usual enthusiasm from Ottati, who with his wife raised four children when they lived in the county for many years (“I’m absolutely excited to bring healthcare right here and to Palm Coast,…”) He’d been to a few groundbreakings in his years here and since, though none so virtual, and he expects to be back for the hospital’s grand opening in 2023. 

It won’t be the last. Ottati said there are still 83 empty acres around the hospital on State Road 100. “There may be an additional expansion we’re looking at on services that are not acute,” he said.