Free-standing emergency departments sprouting up in growth pockets

Castle Rock Adventist Health Campus was a free-standing emergency department in Colorado designed by Orlando's HuntonBrady Architects in 2011. Positive response by the Denver suburb prompted development of an Acute Care Hospital not long after.

A growing number of free-standing emergency departments are in development in the Greater Orlando region as the area's top hospital systems respond to new pockets of population growth and land prices make urban infill development with small facilities more attractive.

Unlike in some states, free-standing emergency departments in Florida must be an off-site department of an existing hospital in the vicinity and operate under the hospital's license.


All three of Metro Orlando's major hospital players are engaged in free-standing emergency department plans. The concept may be a way to establish their brand in growing communities, with a larger hospital possibly to follow.

Florida Hospital has plans for a free-standing ED in Lake Mary pending approval by local government, with a hearing set for late July with the city commission. It also has Florida Hospital Winter Garden, a 97,000 square-foot free-standing ED expected to open in January.


Orlando Health has more than 70 acres of undeveloped land in Horizon West on Porter Road. The company has yet to announce a master plan for the site, but could develop a free-standing ED tied to Health Central Hospital in Ocoee. Orlando Health declined to comment on plans for that land for GrowthSpotter.

Hunter's Creek ER, a department of Osceola Regional Medical Center at 12100 John Young Parkway, opened in June 2014. That followed Central Florida Regional Hospital's Oviedo ER, located at 8300 Red Bug Lake Rd., which opened in November 2013. Both are owned by Hospital Corporation of America (HCA).

Orlando-based HuntonBrady Architects cut its teeth on the free-standing ED concept in 2011 by designing an emergency department in Castle Rock, Colo., for Adventist Hospital. The facility let that health-care provider plant its flag in the growing Denver suburb, and its rapid success with the community led Adventist to build a full-scale hospital there quicker than intended,  said Chuck Cole, president of HuntonBrady.

"The free-standing emergency department movement really started to gain traction three to four years ago, in response to long waiting times at existing hospitals," he said. "Operators were looking for a way to offload demand and shift to a more retail approach to health care that emphasizes customer service, and puts it closer to home for people."

Key factors sought by HuntonBrady's local clients that are pursuing free-standing EDs are cost-effective construction, design with a retail approach in mind, and speed to market, Cole said.

"They want high visibility, a readily accessible site and a strong placement in the retail setting to stand out," he continued. "Some (free-standing EDs) we're doing now in Central Florida won't grow into a hospital. They're being placed on prime commercial strips in high-traffic areas, all of which have outdated or underutilized commercial buildings being torn down to put an emergency department in."

Demand is building for free-standing EDs so quickly that HuntonBrady began studying in January how to define prototype formats for the concept so they could help clients quickly shop for property sites that fit the model.

"We used to do site test-fits for our commercial office building developer clients, and we're now doing this for hospital clients for free-standing EDs," Cole said.


"They used to go shop for a 25-acre site for a big hospital, fairly often in a suburban area for that size. Now they're looking more urban where the populations are moving, so site studies are more challenging. The format of these emergency departments is usually the same ... you're looking for at least three acres," he said. or (407) 420-5685