Atrium’s $450M SC expansion plan ignites competition in booming Charlotte suburb
Atrium Health plans to build a hospital in Fort Mill, creating competition for a part of York County that’s long been coveted by healthcare providers.
Atrium outlined plans for a $450 million hospital project Tuesday at the Charlotte-Mecklenburg Hospital Authority board meeting. That group makes businesses decisions for Atrium, a nonprofit healthcare group based in Charlotte.
The Atrium facility will add to a growing list of healthcare sites in Fort Mill, which has been one of the fastest-growing communities in the Charlotte region for several years.
The four-story hospital will be 200,000 square feet and have 60 beds, according to Atrium. There’s also a 73,000-square-foot medical office building planned. Work would begin next year, ahead of a 2029 hospital opening.
Three years ago, after more than a decade of legal wrangling between hospital systems wanting to build in Fort Mill, Tenet Healthcare opened Piedmont Medical Center—Fort Mill. The 100-bed facility near The Peach Stand on S.C. 160 became York County’s second hospital, joining Piedmont Medical Center in Rock Hill.
The Tenet hospital took years to gain state approvals and withstand legal challenges, including one from the hospital system that became Atrium, due to South Carolina law requiring a certificate of need. Healthcare companies had to apply for and prove the need for new health facilities.
That law has since changed, allowing healthcare groups access to build much quicker.
Encompass Health opened a 39-bed rehabilitation hospital last year on Vista Road. A 54-bed hospital from Medical University of South Carolina and a Piedmont Medical Center freestanding emergency room are under construction in Indian Land. The five-story, 150,000-square-foot MUSC hospital will come with a three-story, 62,000-square-foot medical office building beside it. Atrium cited a 1.6% growth rate in the past year for Fort Mill and an expected 18% York County population increase in the next five years as reasons for building a hospital. A high percentage of patients at Atrium’s hospital in Pineville, North Carolina, are South Carolina residents too, according to the hospital system.
“To continue meeting the evolving and growing needs of our communities, we must grow alongside them,” reads a statement Atrium provided to The Herald Tuesday night.
Atrium Health in York County
This spring, Atrium bought Fort Mill EMS and took over its ambulance service in York County.
That sale came despite protest from Piedmont Medical Center, with that companying asking York County Council to let it take over the service area of the former rescue squad.
Atrium owns two properties in downtown Fort Mill after purchasing the Fort Mill EMS site on White Street in April for $730,000.
Charlotte-Mecklenburg Hospital Authority owns 11 Fort Mill properties, according to York County land records. Four of them combine for about 83 acres at the Sutton Road interchange off Interstate 77, near the Masons Bend subdivision. Six other parcels are together, combining for 34 acres southwest of the Walgreens at Tom Hall Street and Fort Mill Parkway.
There were plans for medical facilities at those undeveloped properties prior to the Piedmont hospital being built, when multiple providers were still vying to build the town’s first hospital.
A return to ‘hospital wars’?
Atrium Health hasn’t discussed or submitted new hospital plans to the town, Mayor Guynn Savage told The Herald on Tuesday
But town officials have known about hospital groups looking to build in the area for two decades, she said. Several of them owned property during what became known as the “hospital wars” in town, or the drawn-out legal fight over the certificate of need.
“With the growth that Fort Mill has experienced over several years and now the regional growth, certainly our population has reached a point where multiple medical facilities make sense,” Savage said.
Fort Mill has more than 36,000 residents. That number doesn’t include unincorporated areas like the busy Baxter neighborhood or the Carowinds corridor. Those places have Fort Mill addresses but aren’t in the town limits.
The 36,000 population figure also doesn’t include high-growth neighboring areas like Tega Cay or Indian Land.
Piedmont has a strong record since entering the market, Savage said. But Fort Mill doubled its population during the long delay between initial hospital proposals and final state approval for Piedmont Medical Center.
So even when it opened, there was a need.
“We’re an aging population,” Savage said. “We’re a growing population. I don’t think having an additional hospital or so is a bad thing.”
This story was originally published December 3, 2025 at 5:00 AM.
