Proposed Riverhead mobile stroke unit rejected after hospital clash

The Riverhead Zoning Board of Appeals rejected Stony Brook University Hospital’s proposal to house a mobile stroke unit at a Riverhead shopping strip Thursday night after heated debate over emergency access, public safety and the future of stroke care on the East End.

In the 23-page decision, the board voted to deny the application for a 14,236-square-foot ambulance storage bay behind the former Big Lots space — where Stony Brook had sought to station its $1.5 million Mobile Stroke Unit along with up to eight ambulances.

The decision followed weeks of public disagreement between Stony Brook officials, who argued the unit could speed stroke diagnosis and treatment in the field, and Peconic Bay Medical Center leaders, who said the plan duplicated expanding stroke services at the Riverhead hospital and posed safety concerns in the busy Staples Plaza.

“This is one of the longest cases we’ve ever had as far as time, meeting with the participants, and listening to all the people with comments to make from the town itself,” ZBA Chairman Otto Wittmeier said before voting to deny the application. “We did listen, we read everything, we got pounds of paper, which was appreciated, we learned a lot of things — my hat’s off to all those doctors, on both sides, that are involved with stroke medication.”

The Mobile Stroke Unit, operated by Stony Brook University Hospital, is an ambulance equipped with a CAT scan that allows doctors to diagnose strokes in the field and route patients to the most appropriate hospital.

Supporters said the approach could speed care for the most severe strokes by identifying large vessel occlusions before patients reach the emergency room and directing them immediately to thrombectomy-capable hospitals.

Critics, however, argued patients are better off being taken directly to nearby hospitals — especially as facilities like Peconic Bay Medical Center rapidly expand advanced stroke treatment.

Last month, PBMC, part of the Northwell Health system, unveiled a new $7.3 million neuroscience center that will make it the only facility on eastern Long Island capable of performing cerebral mechanical thrombectomies once fully staffed later this year.

“The issue before the zoning board is to determine if the proposed use, to wit, storage/warehousing of ambulances, office, teaching center for ambulance personnel and location for dispatch of a mobile stroke unit for emergency response will alter the character of the neighborhood, and not if the use will benefit the community,” ZBA member John Porchia said. 

Citing the 2003 and 2024 town comprehensive plans, the shopping center district’s purpose is mainly for retail use, such as grocery stores, restaurants, banks and personal services. 

While traffic is not seen as an issue, the ZBA determined the dispatch of an emergency vehicle in an area designed for customer access “is contrary to the purpose and design” of the shopping zoning district. 

The property manager argued at prior ZBA hearings the rear of the former Big Lots space was difficult to market to potential buyers due to lack of loading docks and little visibility from Old Country Road, near Roanoke Avenue. 

However, the zoning board said there was no “dollars and cents proof of an inability to realize a reasonable return” under existing permitted uses. Additionally, the ZBA did not find evidence any reconfiguration of the space would hurt the market for available tenants. They pointed to similar storefronts within the complex with little visibility that maintain successful leases. 

The Riverhead ZBA determined the hardship was “self-created” because the property owner sought approval for a use not allowed under the town’s zoning code. 

“While the present owner may not have designed the shopping center, the owner did have knowledge of the L-shaped configuration and potential for marketing the space, with some of the space having frontage on the shopping center,” the ZBA determined. “The property owner knowingly submitted an application for use that is not permitted within the shopping center zoning use district, nor is it akin to any of the permitted uses within the district.” 

Mr. Wittmeier said he and his fellow board members learned a lot during this application process about enhancements being made to stroke care on the East End and expressed excitement for the expanded advanced stroke treatment at Peconic Bay Medical Center. 

“I believe we did the right thing tonight,” the chairman said.