Fort Mill just landed another hospital. How much competition can the region handle?

Two decades ago, several healthcare companies jockeyed to see which one could build a hospital to serve the fast-growing Fort Mill area. Today, there’s one hospital open and another planned. There’s even a separate hospital under construction in nearby Indian Land.

“Nothing has changed over the last 20 years, except a lot of growth,” said Scott Broome, Catawba Division CEO with the Medical University of South Carolina.

So, can Fort Mill support an influx of hospitals? Is it big enough to warrant new players in the healthcare market?

Atrium’s governing board approved $450 million this month for a hospital and medical office building in Fort Mill. Broome, whose group is behind the $300 million hospital and medical office building set to open in Indian Land by early 2028, sees Atrium Health as a quality and formidable entry into the area.

Even with Piedmont Medical Center—Fort Mill opening three years ago, Broome sees opportunity for each provider — and maybe more — in the area.

“They’re going to have plenty to do there in Fort Mill, I suspect,” Broome said. “And we’re going to have plenty to do in Indian Land.”

Atrium Health declined to give details about its plans or outlook for the area competition beyond confirming the hospital funding on Dec. 2.

Population and hospital coverage

The 50-bed MUSC hospital in Indian Land is designed for a population of about 40,000 people. Fort Mill and Tega Cay have more than 48,000 people combined, which doesn’t count areas like Baxter that would easily push the township total past 50,000.

Broome’s group uses a model of 100 admissions and 500 emergency department visits per 1,000 people in an area, per year. When facilities reach 65% to 80% occupancy, he said, it’s time to look for more capacity.

“Our hospital is already pretty close to full from just Indian Land utilization,” Broome said. “Now you never get 100% market share, but you also don’t want to plan to 100% occupancy.”

Piedmont’s hospital in Fort Mill has 100 beds. The Atrium plan would add 60 beds. Several new hospitals joining a community reminds Broome of the Mooresville and Lake Norman areas in North Carolina, in another booming part of the Charlotte region.

“It seems like a lot of hospitals, and it is, but it’s a lot of population,” Broome said. “And it’s a high growth rate.”

The Indian Land project has competition from multiple directions after Novant Health opened a 36-bed Ballantyne Medical Center two years ago, just a mile outside Indian Land. Piedmont opened a freestanding emergency room on Gold Hill Road five years ago, and has another one under construction in Indian Land.

Numerous smaller medical facilities have joined the area in recent years, too, including a women’s health services clinic in Baxter that Novant announced is open just this month.

“As our communities grow, it’s essential that access to high-quality care grows with them,” Novant’s Charlotte region President Sid Fletcher said in a release.

New opportunity for hospital providers

One reason why so many healthcare sites are targeting Fort Mill is the same reason it took so long to get the town’s first hospital.

South Carolina had a longstanding rule requiring a Certificate of Need for projects from hospitals to large surgical devices, clinics and even hospice facilities. The state approval process not only required providers to prove the need for new services, but gave competitors an opportunity to challenge them.

In 2003, multiple surgical centers planned for the S.C. 160 and U.S. 521 in Indian Land fell through amid pushback during the Certificate of Need process.

Piedmont Medical Center parent company Tenet Health applied in late 2004 to build a $107 million, 64-bed hospital in Fort Mill. By the following spring, four providers had applied to build in or just outside of Fort Mill.

Legal challenges through the Certificate of Need program cost Piedmont nearly two decades before its hospital opened. Changes to state law in recent years have relaxed the rules for healthcare companies looking to expand.

But will Fort Mill see more hospital providers?

“Is it possible? Yes,” Broome said. “You never know what other players might do. Particularly in South Carolina, that barrier to entry is gone.”

The task would be to find land, he said, which has become more expensive and parceled into smaller pieces over the past two decades.

Atrium declined to give a location for its new hospital. The nonprofit hospital group owns 83 acres at Interstate 77 and Sutton Road near Masons Bend, along with 34 acres at Tom Hall Street and Fort Mill Parkway. Other properties already have medical facilities on them.

Hospital construction should begin next year and finish in 2029, according to Atrium.

Atrium’s initial hospital proposal in 2005, when it was called Carolinas HealthCare System, involved 15 acres just across the Catawba River in Rock Hill. It later changed locations to the property at Sutton Road and the interstate.

Presbyterian Healthcare, part of Novant Health, submitted plans two decades ago for a hospital on Sutton Road in Fort Mill. York County land records show Novant still owns the 50-acre site at the northeast corner of I-77 and Sutton. Novant did not respond to The Herald for comment on the future of that property.

Foundations are being poured and the steel is going up on the Indian Land hospital by MUSC. The area population is going up, too.

Fort Mill is the fastest-growing municipality in the Charlotte region, and unincorporated Indian Land is growing even faster, according to U.S. Census Bureau estimates.

By the time Atrium opens its new facility, having two hospitals in town won’t be an issue of having to fight for customers, Broome said.

“That is enough to keep both of those hospitals busy,” he said.

Reality Check reflects the Rock Hill Herald’s commitment to holding those in power to account, shining a light on public issues that affect our local readers and illuminating the stories that sets the Rock Hill region apart. Email realitycheck@heraldonline.com