Plans for a surgical hospital in western Delray Beach to treat patients with orthopedic issues moved forward last week after the Palm Beach County Zoning Commission unanimously endorsed the project.  

Following an hourlong presentation, the commissioners agreed there is a strong need for such a facility that, according to sponsors, will provide Palm Beach County with “world-class care, the likes of which the state has never seen before.”

The proposed South Florida Spine and Orthopedic Institute, to be built and operated by 29 area orthopedic surgeons, would be located on an 11.3-acre parcel off West Atlantic Avenue near Delray Marketplace in an unincorporated area of the county. The site is 1.2 miles west of Florida's Turnpike at the northeast corner of West Atlantic Avenue and Smith Sundy Road, between Lyons Road and State Road 7.

The institute will treat ailments ranging from minor aches to debilitating conditions caused by sports, work-related injuries and everyday wear and tear. The institute expects to perform as many as 3,000 surgeries a year.  

The Palm Beach County Commission will have the final say July 22 when the issue will be considered.  

The project, though, has its detractors, and the war of words between the institute and the Alliance of Delray Residential Associations is expected to play out once again during the County Commission meeting.  

During the Zoning Commission hearing, the alliance questioned the need for such a facility, said it is concerned with the impact it will have on area hospitals and argued it is not permitted under Agricultural Reserve rules meant to bar projects that attract people from outside the region.

The institute will have its own emergency room, which Lori Vinikoor, executive vice president of the alliance, called “frightening.” She questioned whether first responders will transport patients with heart-related issues to the Institute’s ER instead of to an ER at hospitals designed to handle such emergencies.  

But Dr. Robert Norton, a participating institute surgeon, accused Vinikoor of engaging in “fear-mongering” and spreading false and misleading information.  

“The first responders know where to take patients based on the situation,” Norton said. “Our ER is solely there to treat our patients in the case of an emergency. We have asked a number of times to meet with alliance members to explain the project. They refused.”  

Norton said most of the procedures will be outpatient but about a third will involve overnight stays, a factor that resulted in it having to have an emergency room. Norton also noted that the Zoning Division staff supported the project, citing a provision in the zoning code that encourages zoning districts to approve health-related projects.  

Norton questioned Vinikoor’s motivation, pointing out she serves on the board of Delray Medical Center, a sponsor of the alliance. “We believe she has a conflict of interest,” said Norton.  

Vinikoor told The Post that alliance members are against the project and the alliance is reflecting their views. “I cannot help that I serve on the board at Delray Medical Center,” she said.

In a follow-up letter sent Monday to County Commissioner Maria Sachs, Alliance President Bob Schulbaum reiterated Vinikoor’s concerns. He called on the commissioners to address treatment for those unable to pay. And he emphasized, as Vinikoor did at the zoning hearing, that the ER at the institute could cause problems for patients.

“If I were to arrive at the emergency room requiring critical orthopedic medical treatment, would I be treated or transferred to another hospital?” Schulbaum asked.

The facility would consist of two, two-story buildings, each consisting of 60,000 square feet. One of them will house a 24-bed surgical center; the other will include medical offices. Construction could begin later this year. The hospital is expected to open in early 2023.

The institute is one of the first medical facilities in Florida to seek approval since the state Legislature repealed the “certificate of need” law in 2019. The law had required a builder of a medical facility to convince the state Health Department of the need for such a facility.  

Robert Hill, the retired CEO of Bethesda Hospital, called the Legislature’s decision to dismantle the law "potentially dangerous,” arguing county planners are not in a position to fill the void and are not in a position to conduct the exhaustive review that the state had been doing.

And Schulbaum, in his letter to Sachs, questioned the quality of care that patients will receive at the institute versus the care at hospitals that had to undergo the certificate-of-need process.  

However, Norton and another institute surgeon, Dr. Elvis Grandic, wrote in a recent op-ed in the Sun Sentinel that repealing the law was a good thing as the old law kept specialty surgical centers from opening near existing hospitals and allowed “large hospital systems to form monopolies, stifle innovation and, in the process, keep health care costs high.”

Norton said the certificate-of-need process has nothing to do with the quality of care a facility offers. The state Health Department will fulfill that function, he explained.  

Norton noted that the 65-and-older population in Palm Beach County is expected to increase by 40% by 2030, ensuring a demand for spine and orthopedic care.  

He said patients treated at specialty surgical centers receive much better care than they receive at hospitals. Complications are significantly reduced, Norton said.  

Zoning Commissioner Sheri Scarborough said she had an excellent experience at a surgical center and a not-so-good one at a hospital. She called the project an asset to the community.  

Efforts to obtain comment from Delray Medical Center and Bethesda Hospital were unsuccessful. Neither hospital has publicly taken a position on whether the county should approve the institute’s plans.  

The facility is being built as part of a partnership with Legent Health of Irving, Texas, a company that is involved in the operation of a number of physician-owned surgical centers in Texas.  

Legent is currently involved with Delray Beach Surgical Suites, which opened in 2017. At 6,500 square feet and two operating rooms, it is much smaller than the proposed facility west of the turnpike. Some of the orthopedic surgeons at the Delray facility are also involved with proposed institute as well.