Editor's note: This story has been updated to include CMC's response to a letter from the state Department of Natural Resources.
Conway Medical Center’s plan to build a hospital in a wetlands-laden section of Carolina Forest conflicts with the county's future land use guide and is opposed by the state Department of Natural Resources, according to public records.
CMC is requesting both a zoning change and an amendment to the county’s future land use plan to accommodate the $161 million project. The Horry County Planning Commission will discuss the hospital proposal at a workshop Thursday and could make a recommendation about the zoning change a week later.
“We continue to actively work with our engineers and site planners to maintain the integrity of the property while maintaining its natural habitat and beauty and will move forward with the permitting process, including zoning requests, as appropriate,” said Brian Argo, CMC’s chief financial officer, in a prepared statement. “While the site we plan to purchase is more than 350 acres, we have designed a facility that would be primarily located on 35 to 40 acres of that property. We are still completing our due diligence on purchasing the property.”
The property sits on International Drive just beyond the The Farm neighborhood. Most of the tract — 223 acres — is wetlands and is unavailable for development, according to county records. But even the upland areas are narrow, meaning a hospital project would have a “significant” impact on wetlands, said David Schwerd, the county’s director of planning and zoning.
“It’s a lot of frontage and a lot of wetlands,” Schwerd said. “In order to construct a hospital, you would have to impact wetlands. You could build something like an office building [there], but a hospital’s a much larger facility.”
CMC hopes to build a 50-bed hospital that offers a wide range of services, including emergency care, labor and delivery rooms, orthopedics, cancer care, surgery and imaging.
Owned by a limited liability company, the property's current zoning allows some residential development, including single family homes or even apartments. But the future land use plan, which outlines the county’s intended use for the site, is different. It calls for the nearly 360-acre tract to be scenic and conservation land.
Although the county’s planning department considers the project to be in conflict with the future land use plan, that doesn’t mean county council members will agree with that assessment. Planning commissioners provide recommendations on rezonings and council members make the final decision on zoning changes. County policy also allows developers to show that land planned to remain scenic could be suitable for development, particularly if a project blends with what's next door. In this case, The Farm subdivision provides a suburban land use beside the proposed hospital location.
But the site CMC is eyeing is also adjacent a Wildlife Action animal corridor, utilities and the county’s 3,707-acre Independent Republic Heritage Preserve. It’s also across from the 10,427-acre Lewis Ocean Bay Heritage Preserve.
The property's proximity to the preserve land is a concern to the state Department of Natural Resources (DNR), which sent a letter to the county this week asking county officials to deny the rezoning request.
DNR's objections stem from the agency's management of the thousands of acres of conservation land in that area. When International Drive was extended from Carolina Forest to S.C. 90, adjustable barriers were installed on the road so traffic could be closed during controlled burns on the preserve property. Those controlled burns eliminate the shrubs and overgrowth to help prevent uncontrollable wildfires.
The site being considered for the hospital sits near the gate on the Carolina Forest end of International. That means a controlled burn would close the road and limit access to the hospital. DNR officials also worry about smoke from the burning causing problems for the medical facility.
"It's not a good idea to have a facility there when the management of that property requires periodic burns and the closing of those gates," DNR spokesman David Lucas said..
He noted that the county's preserve sits beside the proposed hospital site and DNR will eventually be burning there, too. Like the county's planning department, DNR worries about the wetlands on the site as well.
"If you put in infrastructure, parking lots, roads and other things that you would need for a medical campus, it's going to have a big impact on that wetlands … which is also not a great thing," Lucas said.
The letter, which was written by DNR Director Robert Boyles Jr., describes the state's efforts to protect the Carolina bays in the area and the unique plants and wildlife there, including the Venus flytrap, the red-cockaded woodpecker, bald eagle and black bear.
"While I understand and appreciate the need for medical facilities to meet the needs of a community, such a facility has other options, but there is only one Lewis Ocean Bay Heritage Preserve," Boyles wrote.
On Wednesday afternoon, a CMC spokeswoman said in an email that a representative from CMC had been in touch with Boyles about his letter to the county.
"Mr. Boyles indicated he is happy and willing to work with the hospital towards a resolution over the environmental and other concerns," the statement read. "Additionally, CMC and its representatives have been and will continue to work with Horry County to alleviate any possible concerns. CMC will maintain a landscaping and architecture plan that will blend into the natural setting while creating a natural buffer to any neighboring property."
Rezoning the property is just one hurdle CMC faces in building the hospital. The healthcare provider must also receive approval from the state Department of Health and Environmental Control (DHEC) called a certificate of need.
That process requires providers to prove the community needs the proposed project. In some cases, DHEC doesn’t approve a project. Other providers can also challenge their competitors’ applications.
For example, McCleod Health has proposed building a $56 million, 48-bed hospital at its campus less than two miles away. McLeod is already opposing CMC’s Carolina Forest proposal, according to DHEC records.
In June, an attorney representing McLeod wrote DHEC asking to be notified of all meetings and hearings related to the CMC application.
“McLeod further reserves its rights as such to oppose the application under review and to assert that the proposed project does not comply with the South Carolina Health Plan, the applicable project review criteria set forth in the Plan, the CON Act or its regulations,” wrote Trudy H. Robertson with the firm Moore & Van Allen.
McLeod submitted its application for a certificate of need in August. The CMC proposal was filed in May.
DHEC spokeswoman Laura Renwick said in an email that the state has not determined if it will consider the two applications competing. If that happens, DHEC could decide to approve one project and not the other.
It’s obvious why healthcare providers are targeting Carolina Forest. Between 2000 and 2010, the community grew by more than 500%, swelling to over 21,000 residents, according to U.S. Census records. The community’s population has continued to skyrocket as more development has arrived, and the growth isn’t slowing down. Horry County records indicate that more than 10,400 additional residential units are planned for Carolina Forest, including nearly 7,500 single family homes.
"Healthcare is a necessary part of a community’s infrastructure," CMC said in a Wednesday news release. "As Horry County’s oldest healthcare provider and the only nonprofit hospital currently based in Horry County, CMC believes it is our responsibility to provide better access to care for this rapidly expanding area."