In the end, five council members voted early Thursday morning against Tiwari's plan to create a for-profit inpatient facility on the city's southwest side. The other four passed on the preliminary vote taken at 1:30 a.m.
Tiwari operates the Bloomington-based Pain Management Center of Southern Indiana, which has five locations.
Council members voting against Tiwari's rezoning request said it offered no compelling reason for Bloomington to support a second inpatient facility in the city.
Bloomington Hospital, which opposes another inpatient facility, is the only entity that allows overnight medical stays.
At the meeting Wednesday, hospital supporters stressed that their only opposition to the project was the inpatient beds.
If Tiwari scratched the overnight beds from the project, there would be no resistance to the outpatient care.
But Tiwari is not interested in eliminating the inpatient use, he said, calling it an integral part to the project.
"The hospital will do OK. The question is what will happen to the community if this ( a specialty hospital) goes on?" Slaughter said, who is medical director of the emergency department.
The guiding principle for councilman Sabbagh to vote against the project was an e-mail, one of many correspondences from the public he had received: "Above All Else, Do No Harm."
Sabbagh said he was concerned what sort of impact a competing facility would have on the Bloomington Hospital and its ability to provide a number of services, including the ambulance and CHAPS Clinic for low-income county residents.
He said he didn't want to see Bloomington become home to two weak hospitals instead of one strong one.
While council members called the land-use portion of the project a "home run," they said the driver behind the debate was public policy.
With councilman Dave Rollo, who serves on the plan commission, raising awareness of the environmentally sensitive nature of the land, any future proposal to rezone it will need to include green space, said councilman Gaal. The 101-acre site is zoned quarry.
Slaughter admitted on Thursday that Bloomington Hospital and opponents to the project did a disservice to Rollo by presenting another "piece of the puzzle" at the last minute.
He credited Rollo for working toward the green space.
An issue for some on the council that came out of Tiwari's preservation plan was shifting the cost of a future road to connect Tapp Road with Fullerton Pike to the public.
Hospital staff and administrators agreed.
"We're all very supportive of Dr. Tiwari doing whatever he wants to do and wherever he wants to do it. What we don't want, what is bad for the community, is for Tiwari to open a for-profit specialty hospital," Slaughter said.
Whether his project is passed or not, Tiwari predicts at some point the Bloomington Hospital will have in-patient competition.
"I guarantee you it will happen sooner or later," he said.