Interpreting and Revising Zoning to Accommodate New Trends in Healthcare

Emerging Trends in Healthcare and Zoning

There are a number of emerging trends in healthcare which do not fall neatly into existing zoning regulations. As land use attorneys, it is our role to establish how these services are permitted under existing zoning regulations, or to work with municipal officials to revise zoning laws to accommodate these uses. Cuddy & Feder’s team is fully prepared to guide its healthcare clients through these efforts so that they can provide their patients with the care they need.

Examples of Zoning Challenges in Healthcare

To better understand this issue, here are examples of issues faced by healthcare providers, and the unique zoning-related work being undertaken to permit these operations:

• Hospital Expansions. Hospital expansions are becoming more common. However, many of these hospitals were established before zoning laws came into effect, or otherwise face restrictive zoning laws. As such, when hospitals seek to expand, they can face notable constraints that may mandate acquiring area variances, or even the more elusive use variance. Examples of such zoning constraints include restricting the footprints of hospitals; and burdensome regulations regarding the design of on-site parking and the placement of off-site parking, as well as the placement of necessary HVAC and other mechanical equipment. In response, some municipalities are embracing zoning amendments which allow for hospital growth expansion. This includes, for example, the City of Poughkeepsie, New York, which adopted the Campus Development District, enabling the growth of Vassar Hospital. ¹

• Medical providers are continuously seeking space. Simultaneously, there is a growing abundance of vacant commercial spaces. Zoning attorneys are key to framing how medical uses should be permitted under existing commercial zoning schemes, and can also assist in modifying said regulations to secure approval of these unique adaptive re-use projects. This approach has been achieved in the Town of Poughkeepsie, enabling a former Circuit City to be used as office and patient space by orthopedic providers.²
• Online distributors such as Amazon. Online distributors such as Amazon are getting into the business of providing prescriptions. This entails ensuring that zoning accommodates for a hybrid use of traditional product and medication storage and distribution. The regulation of such uses can become particularly nuanced, as a result of regulations from the local, state, and federal governments, including regulations related to the segregation of products, installing security features, maintaining certain temperatures, etc.³ Again, zoning attorneys can establish that said uses are permitted under current zoning regulations, or work to revise zoning regulations as needed to accommodate these uses.
• Senior living facilities. Senior living facilities can require extensive zoning changes. This is because such uses typically present a combination of uses, including independent living, assisted living, memory care, entertainment, shared dining, and more. Moreover, traditional planning and zoning concerns need to be approached differently, in light of the fact that said uses typically have lesser parking demand; the need to combine different uses inside of single, large buildings; and the fact that the application of affordable housing requirements make such uses uneconomic. As such, many municipalities have begun adopting zoning regulations or creating new zoning districts specific to senior living facilities.⁴
• Wellness uses. Wellness uses are becoming more common. These uses are unique from traditional personal services, but less intensive than hospitals. These uses include wellness spas, anti-ageing centers, skincare/hair regeneration centers, physical therapists, walk-in clinics with or without pharmacies, urgent care centers, etc.⁵ Zoning regulations need to be modified to accommodate such uses, particularly as they have users that stay on-site longer than traditional personal service establishments and, as such, require less parking.
• Specialized healthcare facilities for pets. There is also a growing trend of specialized healthcare facilities being provided for pets. This includes, for example, animal dermatologist clinics.⁶ Depending on a municipality’s zoning regulations, the establishment of such uses requires land use attorneys to argue that they fall within veterinarian-related uses, or to have zoning regulations crafted to specifically accommodate such uses – including the need to accommodate for their specialized facilities.

Cuddy & Feder’s Role in Advancing Healthcare Projects

Cuddy & Feder’s team of land use attorneys is fully prepared to argue that emerging health care uses are permissible under existing zoning regulations; and when such designations are not available, to work with municipal officials and elected leaders to amend zoning laws to ensure these uses are permitted.

Our Successes Include:

• Expansion of White Plains Hospital⁷
• Land use entitlements for Westmed Medical Group⁸
• Establishing an animal dermatology clinic in the Town of Greenburgh, NY⁹
• Ensuring wellness-related health care uses are specifically permitted in the Village of Pelham Manor, NY¹⁰
• Securing land use entitlements for senior living at the Wartburg in Mount Vernon, NY,¹¹ and securing approvals for Minute Clinics and urgent care centers.¹²

It is such success that led Cuddy & Feder to be honored by Burke Rehabilitation Hospital as a Committed Partner.¹³ We stand ready to ensure that healthcare providers of all types and scales can provide services to their patients.

1. See City of Poughkeepsie, NY Local Law Number 12-2024 at https://ecode360.com/PO1408/laws/LF2274760.pdf.
2. See POUGHKEEPSIE JOURNAL at A3 (January 6, 2013) at https://www.newspapers.com/newspage/115361563/?locale=en-US.
3. See Amazon.com, “Amazon Pharmacy now offers Same-Day Delivery in New York City and the L.A. area. Here’s how AI is helping us deliver medication faster.,” available at https://www.aboutamazon.com/news/retail/amazon-pharmacy-same-day-delivery-new-york-nyc-los-angeles-la.
4. See Town of Mount Pleasant, NY Local Law Number 3 of 2018, available at https://ecode360.com/9608116#33505850
5. See Village of Pelham Manor, NY Local Law 1 of 2025, available at https://www.pelhammanor.gov/DocumentCenter/View/848/Proposed-Local-Law-1-of-2025-PDF.
6. See Town of Greenburgh, NY Planning Board Case No. 23-08, available at https://agendaquick.greenburghny.com/agenda_publish.cfm?id=&mt=ALL&get_month=7&get_year=2023&dsp=ag&seq=2092
7. See CUDDY & FEDER, “Cuddy & Feder Secures Final Approval for White Plains Hospital Extension” (August 6, 2024), available at https://www.cuddyfeder.com/news-event/cuddy-feder-secures-final-approval-for-white-plains-hospital-expansion/
8. See Town/Village of Harrison Special Exception Use Permit 2011—206—a; 2011 –207—b.
9. See Town of Greenburgh, NY Planning Board Case No. 23-08, available at https://agendaquick.greenburghny.com/agenda_publish.cfm?id=0&mt=ALL&get_month=6&get_year=2023&dsp=agm&seq=8650&rev=0&ag=2090&ln=40610&nseq=8651&nrev=0&pseq=&prev=#ReturnTo40610.
10. See id. at 6.
11. See CUDDY & FEDER, “Helping Renowned Senior Care Facility Achieve its Vision,” available at https://cuddyfeder.com/case-study/helping-renowned-senior-care-facility-achieve-its-vision/.
12. See One Medical, Vernon Hills Shopping Center, Town of Eastchester, NY; City of Mount Vernon, NY Site Plan Resolution Number S-03-2009.
13. See CUDDY & FEDER, “Cuddy & Feder to be Honored by Burke Rehabilitation Hospital,” available at https://www.cuddyfeder.com/news-event/cuddy-feder-to-be-honored-by-burke-rehabilitation-hospital/.