Middletown Regional Hospital's possible move to Warren County could be hampered by Monroe's reluctance to rezone land for a companion development.

        Middletown Regional has not yet said whether it will move to Greentree Road in Warren County or rebuild at its present site in Middletown. However, it has talked with city and county officials in Butler and Warren counties about the possible move.

        Plans include not only a 100-acre-plus hospital campus just east of Interstate 75, but also doctors' offices, research and development facilities, and supply companies just west of I-75, the hospital says.

        Much of that west-side development would be on several hundred acres of Monroe land — also in Warren County — that's zoned industrial, city Development Director Jay Stewart said.

        “Hypothetically, (rezoning) is a large concern,” Mr. Stewart said. “We just want to make sure there's not a net tax base loss. They are going to ask for some mixed-use (zoning); what we don't know is how much of what.”

        Cities typically get more income from industrial development than from retail or commercial.

        The hospital is expected to decide by month's end where it will build, but getting zoning for the related development is not a make-or-break factor, hospital Vice President Larry James said.

        Other issues remain:

        • Who would supply sewer service? The contenders are Butler County and Middletown, and both say they expect the question to be resolved without controversy. Butler's lines are closer — a mile versus about four miles for Middletown — but City Engineer Andy Braun said the hospital wants city utilities.

        • Annexation of the new hospital site from Turtlecreek Township into Middletown. Middletown Regional says it's a condition of moving to Warren County.

        Under Ohio law, however, only land that's contiguous to city boundaries may be annexed, and the Greentree and Union road area is not. The city, therefore, would have to persuade property owners in between to allow their land to be annexed.

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