South Nassau Communities Hospital officials have submitted their latest plans for a $279 million project to establish a permanent emergency room in Long Beach and expand the main hospital in Oceanside.

Building applications and documents needed to begin the state environmental quality review process were submitted Friday to the City of Long Beach and the Town of Hempstead’s Board of Appeals, marking the beginning of a potential 18- to 24-month process before South Nassau can begin construction on either site.

Hempstead Town officials said the board does not comment on pending zoning matters, but the town has contracted an engineering firm to conduct an environmental report on the project.

In a statement, Long Beach City Manager Jack Schnirman said the city had received the environmental documents, and “will be starting our due diligence and review.”

“These projects represent a once-in-a-generation opportunity to improve health care for the South Shore of Nassau County for decades to come,” South Nassau’s president and chief executive Richard J. Murphy said in a statement.

Hospital officials will hold a series of community meetings in Oceanside and Long Beach starting this week to hear resident input on the project, with a look at what specific services will be provided. The sessions will be held Tuesday and Thursday afternoon at the hospital’s conference center in Oceanside, and at the Long Beach Public Library July 19 and 25.

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The project is split into four parts: creating a Long Beach Medical Arts Pavilion at the site of the former Long Beach Medical Center; building a four-story addition to the Oceanside hospital; raising and upgrading that hospital’s electrical grid and infrastructure; and building a three-story parking garage in Oceanside.

The project uses $154 million in Federal Emergency Management Agency money, which Congress granted to South Nassau after the Long Beach Medical Center was flooded during superstorm Sandy in 2012. South Nassau purchased the hospital, which had declared bankruptcy, two years after the storm.

South Nassau plans to invest $108 million of its own money for hospital improvements, in addition to FEMA reimbursements.

FEMA approved an alternative use plan last year for South Nassau to use $45 million of the FEMA dollars to build a permanent 25,000-square-foot emergency room and medical arts pavilion 23 feet off the ground at the site of the former Long Beach hospital on East Bay Drive. The remaining FEMA funds would go to Oceanside.

A Long Beach group, the Beach to Bay Civic Association, has a federal lawsuit pending against FEMA, disputing how the money was allocated, and demanding funding instead be used to return a full-service hospital to the barrier island.

A study last year showed a rebuilt hospital in Long Beach would lose $11 million per year and was not likely to draw enough patients to attract top-level medical staff, said Joe Calderone, South Nassau’s vice president for communications.

The Medical Arts Pavilion plans include radiology and rotating specialists for cardiology and urology. Officials are seeking regulatory permission to add on-site dialysis. The pavilion would be equipped with a space for a medevac helicopter and would add to an existing floating dock, added last year by the Town of Hempstead, for marine access to the bay.

South Nassau upgraded the city’s urgent-care center in 2015 to accept 911 calls and ambulances at the site of the former hospital. The current stand-alone emergency room since has treated 18,000 patients, 87 percent of whom did not need to be transferred to a hospital, Calderone said.

Hospital officials are planning to use $113 million, including the majority of FEMA funding, to make a four-story addition to the southwest part of the Oceanside hospital, Calderone said. Hospital officials said the addition will best serve residents on Nassau’s South Shore and residents in Long Beach.

An emergency room expansion for South Nassau will be about the length of a football field, but keeps the hospital capacity at 450 beds. The resulting larger ER could treat 30,000 more patients a year and increase the ICU capacity to 40 beds.

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South Nassau officials said the renovations will add two floors of critical care and create nine new 600-square-foot operating suites with robotics and diagnostic equipment.

The hospital will use part of the FEMA funding toward infrastructure improvements costing $93 million, including raising the electrical grid above the ground floor and hardening it for storm protection of generators, heating, ventilation and chilled water.

Additionally, the hospital plans to float bonds to cover a $28 million three-story parking garage to create 400 new spaces and alleviate parking on neighboring streets, Calderone said.

There is no estimate when the projects would be completed, as it could take up to three years for permits and construction plans to be finalized, hospital officials said.