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A rezoning would help clear the way for Conway Medical Center to build a hospital in Carolina Forest. The site is located off International Drive across from the Lewis Ocean Bay Heritage Preserve and beside a county-owned preserve. Photo by Janet Morgan/janet.morgan@myhorrynews.com

State health officials support Conway Medical Center’s proposal to build a 50-bed hospital in Carolina Forest.

The S.C. Department of Health and Environmental Control (DHEC) on Monday approved a certificate of need for the planned $160.8 million facility on International Drive, according to DHEC records.

"This is a major win for the Carolina Forest community," said Bret Barr, president of CMC, in a news release. "We are thrilled DHEC recognizes the importance of what Conway Medical Center will bring to this area in a facility that will be unlike any other in the state. As the first hospital in Horry County, there is no better healthcare system to provide the services so desperately needed in this growing area. This decision allows CMC to provide a total healthcare solution that will create happier healthier lives for the people of Carolina Forest and beyond."

A certificate of need (CON) indicates a provider has proven to DHEC that a project is needed in a community. In South Carolina, this designation is required by the state to build new medical facilities. The intent of the CON program is to help control healthcare costs and prevent the duplication of services, but the process does allow providers to file appeals and even challenge other organizations’ applications. This can delay the construction of facilities for months and sometimes years. 

DHEC initially planned to issue a decision about CMC’s hospital plans in December. But after McLeod Health applied to build a Carolina Forest hospital in August and Tidelands Health submitted its proposal for a Socastee hospital in September, DHEC said those two projects would likely be competing with CMC’s hospital.

However, in a letter to Barr approving the certificate of need, DHEC noted the Tidelands and McLeod projects are not considered competing with CMC under state law. If they had been deemed competing, state officials could have approved one or more applications and rejected others. DHEC has not announced a decision about certificates of need for the McLeod and Tidelands projects, and representatives for those organizations also confirmed that they had not received any word about their applications.

Monday’s decision marked a key victory for CMC, which applied for the hospital certificate nearly a year ago and has faced opposition from McLeod, Tidelands and Grand Strand Medical Center. Neighbors, state wildlife officials and environmental advocates have also raised concerns about the project’s impact on the wetlands-laden tract, which sits close to thousands of acres of conservation land. The state Department of Natural Resources periodically conducts controlled burns in that area as a way to minimize the wildfire hazard.

“The grounds for opposition include claims that the Project does not comply with applicable South Carolina law and the South Carolina Health Plan,” wrote Maggie Parham Murdock, director of DHEC’s certificate of need program, in a letter to Barr. “In addition, and of particular concern to the Department, are issues raised in opposition to the proposed location of the Project, including the potential negative effects of the Project on plant and wildlife species in nearby areas like the Lewis Ocean Bay Heritage Preserve and Horry County wetland mitigation bank, as well as proximity of the proposed location to certain prescribed fire management activities vital to the continued health and preservation of these areas. Nevertheless, the Department finds that the opposing parties have not presented sufficient evidence to justify outright denial of the application at this time.”

One major difference between the CMC project and the hospitals proposed by other providers is that CMC is not seeking to add hospital beds in the county. The organization is asking DHEC to shift 50 underutilized beds from CMC’s main 210-bed Conway campus to the proposed hospital in the growing Carolina Forest area.

"CMC adequately justified, through patient origin and other data, the need for the new additional hospital," Murdock wrote. "CMC further addressed the impact the Project could have on existing hospitals in the service area."

CMC officials have said the Carolina Forest hospital would offer orthopedics, women’s health programs and cancer care, among other services. This includes eight labor and delivery rooms, two C-section rooms, six ICU beds and three operating rooms.

Constructing the hospital would take about three years. CMC currently employs about 1,500 people, and hospital officials said the Carolina Forest project should create more than 250 jobs.

"What this hospital is that all the other applications weren't is it's full service," said Brian Argo, CMC's chief financial officer. "It's complete. It offers ICU beds. After this pandemic [began], we saw ICU beds in very, very short supply across the country and locally. … It has labor and delivery beds, which, again, that's a growing, younger community. We think that will really, really benefit the folks that live there in Carolina Forest. So it is really a full-service option."

CMC officials also stressed that the facility will be designed in a "pandemic mode" that allows all patient rooms to function as infectious patient isolation rooms. This would include anti-microbial touch surfaces and special air distribution systems.

"Every room will be designed with the pandemic in mind," Barr said. "So let's say you had a [labor and delivery] room that needed to be converted to a room that would house an infectious person. You could do that."

Murdock noted in her letter that CMC presented "substantial evidence" showing the project complies with South Carolina Health Plan. 

“CMC demonstrated that staffing for the Project will not unnecessarily deplete staff of existing hospitals, and the record does not indicate that an excessive rise in staffing costs would occur as a result of the Project,” the letter stated.

Locally, the biggest challenge for the project is that the nearly 360-acre site being eyed for the hospital needs to be rezoned. Neighbors have objected to the facility — they say it would hurt their quality of life — and the state Department of Natural Resources (DNR) has also asked the county not to rezone the land.

DNR maintains the controlled burning that is done on nearby public land is incompatible with a hospital. Horry County officials are worried about DNR’s concerns because they are trying to establish a wetlands mitigation bank on an adjacent property and DNR plays a role in that process. 

The bank would allow the county to earn credits from restoring wetlands, and they would use those credits when building infrastructure projects. If the county can’t get the bank approved because of DNR’s objections to the hospital, county officials said their nearly $600 million road-building program would be delayed and cost tens of millions more.

But CMC officials have been working with county leaders to address those concerns. They have been preparing a development agreement that would help the hospital get the zoning change while providing buffers and other concessions to neighbors and the county. Under the proposed deal, the hospital would be built near the center of the tract between the border with the county preserve and the border with The Farm subdivision.

If the development agreement is ready as scheduled, it could go before the Horry County Planning Commission at a workshop in late April.

"We are continuing to work out the details on that agreement," Barr said. "We feel we've made very good progress and I think that we're very near a final agreement."

McLeod would not need a rezoning for its $56 million, 48-bed project — that provider wants to add a hospital to its existing Carolina Forest campus — but Tidelands would need a zoning change to build a 36-bed, $80 million hospital at the intersection of S.C. 31 and S.C. 707. 

Tidelands has submitted a rezoning request, but that matter won’t be heard by the county’s planning commission until May, said David Schwerd, the county’s director of planning and zoning. Once the commission makes a recommendation, it would go to Horry County Council for final approval.

DHEC has also not decided what to do with Grand Strand Medical Center’s application to upgrade its South Strand facility to a hospital. The provider’s plans call for expanding the emergency room, constructing four operating rooms and adding acute care beds.

Grand Strand was the last provider to submit an application for a hospital (they filed it in November). Grand Strand is also seeking approval to add a three-story inpatient tower at its main Myrtle Beach hospital. Combined, the two projects would cost $215 million and add 111 hospital beds.

Local healthcare providers are trying to keep up with the county’s surging growth. Last year, a DHEC analysis showed the county will need an additional 155 hospital beds by 2024.

Contact Charles D. Perry at 843-488-7236


I'm the editor of myhorrynews.com and the Carolina Forest Chronicle, a weekly newspaper in Horry County, South Carolina. I cover county government, the justice system and agriculture. Know of a story that needs to be covered? Call me at 843-488-7236.

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