Conway Medical Center’s plans for a Carolina Forest hospital got a favorable recommendation from the Horry County Planning Commission Thursday night, but the project still faces a major hurdle.
Opposition from the state Department of Natural Resources (DNR) has led some Horry County Council members to withhold support for the $161 million project.
“I can’t jeopardize the mitigation bank,” said Horry County Councilman Johnny Vaught, referring to the wetlands restoration project that county leaders are depending on to support their road-building program.
Council members’ concerns stem from the 3,707-acre property that the county purchased in 2018 for $11 million. Located on International Drive, the tract sits beside the site CMC is eyeing for a new 50-bed hospital. The county’s goal for its land is to restore wetlands there through controlled burns. That restoration would allow county leaders to earn mitigation credits, which they would need when they fill in wetlands while completing infrastructure projects.
RIDE III, the nearly $600 million roads package county voters approved in 2016, is expected to use those mitigation credits. In fact, if the county can’t secure the credits for the infrastructure projects from this land, the roads program could be delayed and the cost of buying outside credits could add tens of millions of dollars to the RIDE III price tag, according to county officials.
“All those are ifs,” said David Schwerd, the county’s director of planning and zoning. “We don’t have any direction from DNR that they wouldn’t do it. They have answered that they have concerns about [the hospital], and that is where we stand. … That would hurt all of Horry County if we were not able to get that wetlands mitigation bank.”
Despite the planning commission’s thumbs up, county staff said they can’t support a rezoning for the project until they have a formal agreement from DNR saying that the hospital won’t impact the mitigation bank’s approval.
“Not only are we talking about saving birds and wetlands, we’re talking about the fact that if we can’t have that wetlands mitigation bank you won’t be able to drive down [U.S.] 501 because we won’t be able to widen it,” Schwerd said. “We won’t be able to build the Conway Perimeter Bypass and we won’t be able to build the [S.C.] 31 extension. So it’s not just about saving those [wetlands], it’s about saving the ability to do the infrastructure projects.”
DNR has not said if the hospital would impact the mitigation bank, but the agency has repeatedly expressed concerns about building a medical facility across from the 10,427-acre Lewis Ocean Bay Heritage Preserve and beside the property that Horry County owns. DNR already conducts controlled burns on the Lewis Ocean Bay site and the same thing is expected to happen at the county preserve.
DNR is one of the agencies involved in the mitigation bank approval process and county officials don’t want to support anything in that area that the state agency opposes.
CMC and DNR officials discussed the plans for the hospital just before Christmas. CMC leaders had hoped to persuade DNR to change its stance, but DNR’s position remains the same: the state agency is asking county officials not to rezone property for a hospital that would be built near public land that is occasionally burned for wildlife control.
“SCDNR’s position regarding the use of prescribed fire management on the Lewis Ocean Bay property has not changed,” DNR spokesman David Lucas said via email. “It is a requirement to maintain the sensitive habitats on the Lewis Ocean Bay Heritage Preserve and it is an obligation SCDNR has to the citizens of SC to maintain, as we have done for the past 31 years. Ultimately, Horry County will be responsible for decisions regarding compatibility for the rezoning request. The SCDNR wants anyone who may be our neighbor to understand that smoke and fire will be a part of this landscape, and SCDNR’s use of prescribed fire cannot be limited.”
The nearly 360-acre property being considered for the hospital sits along International Drive just past The Farm subdivision. The site is zoned residential, but the county’s future land use plan states that the acreage should be designated as scenic and conservation land. CMC is seeking a rezoning and a change in the land use plan.
In response to DNR’s concerns, last fall CMC redesigned the proposed facility and moved it away from the preserve land. The healthcare provider also researched other facilities in fire-prone areas and offered to incorporate a more elaborate ventilation system into its design.
“We have been trying to work with DNR,” said Rob Wilfong of Castles Engineering, the firm representing CMC. “The different parties have been trying to reach an agreement. … We’re trying to get to a place where we can get on the same page and make everybody happy.”
At the planning commission meeting, Wilfong stressed that CMC’s 50-bed facility would help address the growth needs in Carolina Forest. He also noted that he was speaking to the commission because his colleague John Poston (who is also the District 8 school board member) couldn't be there because he is hospitalized with COVID-19.
“If you look through all of this, it is very simple,” he said. “We’re talking about a hospital. We’re talking about helping people. We’re talking about Horry County.”
During Thursday night’s meeting, the commission heard from neighbors who said the arrival of a hospital near their homes would disrupt their way of life with bright lights, loud noises and additional traffic. They spoke about how they researched the adjacent property before they bought their houses and knew that, at worst, there would be another subdivision nearby. Nearly 150 people signed a petition opposing the project.
“We really would like to see those folks look elsewhere,” said Rich McAndrew, who lives on Picket Fence Lane.
McAndrew acknowledged that a growing county like Horry will need more medical facilities, but he pointed out that CMC’s plan would not add hospital beds; it would shift underutilized beds from the organization’s main hospital in Conway to a Carolina Forest facility. He also noted that McLeod Health has proposed building a 48-bed hospital less than two miles away and there are other areas of the county to construct such a facility.
“That piece of land is not all of Horry County,” he said. “Horry County is Loris, Longs. There’s plenty of other areas to build a hospital.”
Daniel Flaherty, another resident of Picket Fence Lane, also spoke about the potential impact on The Farm.
“For 14 years, it’s been a blissful place to live,” he said. “It’s been a great quality of life. And I just want to convey to you that [building] a hospital right behind my home will irrevocably have a negative impact on my quality of life.”
CMC representatives said they understood the neighbors’ concerns. They added that their original plan for the hospital placed the campus on the other end of their tract, but they moved it closer to The Farm in an effort to appease DNR. They also discussed the possibility of a third option — shifting the facility to toward the center of the property to create buffers between both the subdivision and the proposed mitigation bank. However, they said everything depends on DNR’s feedback.
“We’re willing to be as flexible as possible to accommodate everyone’s interests,” said Bret Barr, Conway Medical Center’s CEO. “We want to be not only a good neighbor, but we want to be a great neighbor to everyone.”
Planning commissioners voted 7-2 to recommend the rezoning. Some commissioners said the area needs more medical facilities.
“I wouldn’t mind if it was in my backyard,” commissioner Charles Brown said. “We can work out all this. We can work out these mitigation credits. We’ve got good negotiators here in Horry County and at the state level. … I can assure you, at the state level, there’s nobody up there that’s going to kill a mitigation credit or an opportunity to get these credits over a hospital.”
Steven Neeves, the commission’s chairman, said he voted for the proposal because he sees the situation as one that needs to be resolved by county council, not the planning commission.
“When it comes to the politics … and everything else, that’s for the elected officials,” he said. "It gets it up to county council level so that they can work those things out with the applicant and the public."
So far, multiple council members who represent Carolina Forest have said DNR’s objections are their overriding concern.
Councilman Dennis DiSabato said he can’t support the new hospital at this point. Apart from DNR’s issues, he’s heard from people who live in The Farm.
“There are issues that need to be worked through concerning that proposed new hospital,” DiSabato said. “If I were voting for it right now, I would probably lean [toward] … not voting for it just based on the community feedback.”
County leaders could delay a vote on the rezoning while discussions with DNR continue. Right now, county officials said the mitigation bank must take priority.
“Not saying that there’s not a solution or a possible path forward,” Schwerd said. “All I can say is right now there is a lot of unknowns.”