A proposed nursing home and workforce housing development in Edgartown is nearing the final phase of its review before the Martha’s Vineyard Commission, after the commission closed its public hearing Thursday night.

Located on about 28 acres of land at 490 Edgartown-Vineyard Haven Road, the Martha’s Vineyard Hospital-Navigator Homes project would replace the hospital’s Windemere facility with a 66-bed skilled nursing home composed of five separate residences, along with 76 bedrooms for hospital and Navigator employees in 48 units of townhouse and duplex housing.

“We’re chomping at the bit to get this built,” said hospital trustee Ed Olivier during Thursday’s hearing, which was continued from a series of public sessions earlier this fall.

Hospital hiring is nearly at a standstill due to the Island housing crisis, Mr. Olivier said.

“Recruiting is just getting tougher and tougher,” he said.

Some neighbors of the undeveloped property have decried the project, saying it will bring traffic and unsightly views to their semi-rural area, while proponents maintain it’s urgently needed to help meet the Island’s chronic shortages of both nursing home beds and workforce housing.

“There is not another location for this,” said project attorney Geoghan Coogan, who noted that the hospital and Navigator Homes have agreed to plant additional trees and shrubs to help soften the visual impact of the main entrance, among other landscaping.

“We think with the surrounding buffers that we have and we’ve created, we can really minimize the neighborhood impact,” Mr. Coogan told the commission.

To offset nitrogen build-up from the development’s wastewater, project applicants are proposing to use an advanced denitrifying system and build 14 more at homes elsewhere in the watershed.

Commissioner Ben Robinson asked project engineer Ed Pesce whether an additional level of treatment could be added to account for the number of medications Mr. Robinson said it was likely that an elderly population of nursing home residents would be passing on to the wastewater stream.

The advanced septic system will be sufficient, Mr. Pesce said, adding that pharmaceutical use is going on in the neighborhood already.

“People on Teaberry [Lane] are taking drugs,” he said.

Other concessions made during the public hearing process have included a change from vinyl siding to cedar shingles for duplexes visible from the road and cementitious siding for townhomes on the far end of the property.

The Navigator buildings, also known as Green House Residences after the nonprofit Green House Project for alternative nursing home living, can’t be shingled because of strict federal safety rules, company president David McDonough told the commission in September.

“They are hypersensitive to anything that has any fire-causing capabilities,” he said.

Staying at Navigator Homes will cost $600 a day for privately-insured patients, Mr. McDonough told the commission last Thursday.

Long-term stays insured by Medicaid will cost $328 a day and short-term Medicare stays $689, both rates set by the state of Massachusetts, he said.

While high at $219,000 a year for private payers, the rate is not out of line in the current market, Mr. McDonough said, echoed by Mr. Coogan.

“The cost of care in a nursing home is pretty much the same anywhere,” Mr. Coogan said.

“It’s a very expensive place to live no matter what [insurance] track you’re on.”

Navigator Homes is committed to having no more than 50 per cent private-pay patients, Mr. McDonough told the commission.

“That’s how you make the project economics work,” he said.

Mr. McDonough also said that the average remaining lifespan of a patient in the Green House-style facility planned for Edgartown — with a limited number of residents in each of multiple buildings, and staff living nearby — is 5.5 years, compared to 1.5 years for someone in a traditional nursing home.

Vineyard residents can’t legally be given preference in admissions to the facility, Mr. Coogan said.

If approved, Mr. McDonough said, the project is expected to take 18 months to two years to complete.

Navigator Homes recently announced $44.5 million in loans for the project from the U.S. Department of Agriculture.

While the MVC’s public hearing is closed, the written record remains open until 5 p.m. Nov. 3, to be followed by commission deliberations at a later date.