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I think that Two Point Hospital has no multi floors because it has been designed that way. Making use of the floor space to design your Hospital and get all the departments working to complete the level is part of the challenge. If you could just keep adding floors it would reduce the challenge maybe?
Adding multiple floors to the hospital would make navigating the game more complex and would make it impossible to have a complete overview of the entire hospital in one screen.
Maybe it could be done and still be just as fun and easy, but it would definitely be a major redesign of the game levels, etc... which means doing so now would anger a lot of current players which like/are used to the current game. Best leave that to 3Doint Hospital or to some other Two Point X game.
Disclaimer: I would be furious! I love how it is now, save for some minor quirks! Maybe I'm biased... ;)