From modern new hospitals and freestanding ERs to massive medical office buildings and major renovations, health systems throughout South Carolina are embarking on expansion projects that will change the health care landscape for years to come.
These projects, totaling billions of dollars in investment, are driven by substantial growth from the Upstate to the Lowcountry, experts say.
“It’s all about population growth,” said Thornton Kirby, CEO of the South Carolina Hospital Association.
“The state is growing so fast – there’s supposed to be another 1 million (people) in 10 years and there are 5 million now,” he added. “There is a growing need in the community.”
This population growth is mainly occurring in large urban areas along the interstates, he said, and hospitals are trying to keep up with it and to build enough capacity for the future.
In the Upstate, Prisma Health has begun a $350 million expansion of Greer Memorial Hospital at its 48-acre campus on Highway 14.
“There has been dramatic growth in the population and occupancy over the last five to six years and the community shows no sign of slowing down,” Greer Memorial CEO Todd Walker said.
“And information from our community partners points to an ever-increasing need for health care.”
The project includes about 100,000 square feet of medical offices in a three-story building that will expand current physician practices and add new, such as ENT and pediatric subspecialties, he said.
The first floor will feature a four-room outpatient center, an outpatient lab, drive-through pharmacy, and an outpatient imaging center, he said.
On the other side of the highway, a “pretty significant expansion” to the existing hospital will be built, Walker said. It will span about 200,000 square feet and increase the hospital from 82 to 175 licensed beds, the ER from 25 to 50 rooms, and from four to eight ORs, he said.
The medical office building is scheduled to open in the second quarter of 2027 while the three-story patient tower should be operational in the first quarter of 2028, he said.
The project is anticipated to create hundreds of jobs, he said, and officials have already implemented a recruitment strategy.
Most of the investment is coming from capital funds, he said, noting that the hospital has gotten close to reaching capacity and has plans in case that happens to use alternate space.
“We are more than doubling our current space,” Walker said. “We’re trying to make this a good 20- to 25-year solution for the community.”
Bon Secours St. Francis Health System recently completed a $27 million expansion at its downtown hospital in Greenville that added 34 medical-surgical beds and 18 ICU beds, said David Walsh, vice president of support services.
Other projects include a $25 million freestanding ER in Five Forks scheduled to open in March that will span 13,000 square feet over nine exam rooms, trauma care rooms, and imaging and lab services, he said.
And in Powdersville, Bon Secours recently broke ground on a 40,000 square foot medical office building that will feature primary care as well as specialists and another freestanding ER like the one in Five Forks. Scheduled for completion in the first quarter 2027, that project totals more than $50 million, he said.
“That area is experiencing tremendous growth,” Walsh said, “and we are aligning our projects with population trends.”
All the projects are funded through a combination of routine capital, long-term planning, and strategic investment, he said.
“We are always evaluating across the market and Greenville is growing at one of the fastest rates in the Southeast,” he said. “(This is) about anticipating the needs of our community and ensuring care remains accessible and high quality and rooted in our mission.”
The hospital also launched a graduate medical education program to train residents in family medicine, officials said.
AnMed Health has embarked on a $105 million campus in Central/Clemson that includes an ER, primary and specialty care, and physical therapy as well as lab and imaging services.
“The growth of Central, Clemson, Clemson University and the surrounding area brings a need for more access to exceptional medical care and services,” AnMed CEO William Kenley said in a release. “It’s an investment in the health and well-being of every person we serve.”
Scheduled to open early in 2027, the AnMed Central/Clemson campus spans about 150,000 square feet of space and includes room for future expansion, officials said. It also will create at least 50 new jobs.
Located near the intersection of U.S. Highway 123 and 18 Mile Road, the project comes after the 2025 opening of AnMed Piedmont, a health care campus and freestanding ER off Interstate 85 Exit 35.
And AnMed Urgent Care, a joint venture of AnMed and Urgent Care Group, in January opened a new urgent care center on Laurens Road in Greenville that will include X-ray and labs. The cost for the project was not available.
“By expanding our urgent care network, we’re providing convenient, cost-effective options for patients who need timely care without the wait of an emergency department,” Kenley said.
Meanwhile, Novant Health is building a new medical campus in Greenville that will include medical offices, an ambulatory surgery center, and a 20-bed hospital scheduled to open in 2027, officials said.
The $132 million hospital will feature specialty services, operating rooms, and diagnostic imaging, and have the capacity to expand based on future demand.
Ryan Lee, president of the Novant Health Greenville area, said Greenville is a thriving community with tremendous growth.
“By investing in an innovative medical campus on Patewood Drive, complemented by our new orthopedics clinic, and Novant Health Urgent Care locations throughout the Upstate, we’re creating additional access points that make care more convenient,” he said in a statement. “Our goal is to ensure patients have the options they deserve for seamless, coordinated care close to home.”
The project is part of a broader effort by Novant Health to increase its presence in South Carolina, officials said.
The nonprofit system already owns more than 50 urgent care centers across the state as well as three hospitals and 27 physician practices in Charleston County, Hilton Head Island, and Beaufort County. It also plans to build a new hospital in Bluffton that will open by 2028.
Grand Strand Health is investing $350 million in new projects throughout the coastal region, said Nicole Runyon, vice president of operations.
“The reason is our community is growing rapidly and we want to ensure our patients have quality care that is close to home,” she said. “We strategically looked at where we needed to expand and we very much listened to our community.”
The main project is South Strand Hospital, a new 59-bed hospital off the Highway 17 Bypass and Sheffield Parkway. At a cost of $226 million, it will feature four ORs as well as imaging capabilities, she said.
“We will be starting to do the land clearing in the first quarter of ‘26 and anticipate 18 months construction time,” Runyon said.
Also in the works are freestanding ERs in Conway, Murrells Inlet, and Little River at a cost of $15 million each. They will span more than 10,000 square feet each and feature at least 10 exam rooms, a triage room, advanced imaging, and laboratory services.
The ERs are in areas where Grand Strand has no other facilities, she said.
The system also will spend $55.2 million to enhance the ER, ORs and laboratory at Grand Strand Medical Center’s main campus in Myrtle Beach. It will include three new ORs, updates to the ER entrance, upgrades to the lab and enhanced storage.
Lastly, Runyon said, Grand Strand is building a much-needed new $30 million 742-space parking garage on the main campus.
The projects will be funded by HCA Healthcare, Grand Strand’s parent company, she said, and will also mean more jobs. The system plans to hire from its residency programs and area nursing schools, she said.
McLeod Health also has several expansion projects in its service area, said Lesli B. McGee, senior vice president and chief strategy officer.
Among them is a renovation and replacement of a bed tower at McLeod’s Cheraw campus, she said. Estimated to cost $50 million, it’s expected to open in a year and a half, she said.
Another big project is construction of a new approximately $90 million 48-bed hospital in Carolina Forest, she said.
“We are nearing the finish line of our new hospital in Horry County,” she said. “We expect to complete it by the end of summer 2026.”
Once finished, McLeod will have a total of seven hospitals in the region – three in Horry, one in Dillon, one in Florence, one in Cheraw, and one in Manning, she said.
McGee said McLeod also has three ambulatory medical parks underway that will house medical offices, pharmacy, imaging, and other services in Sumter, Conway, and Socastee.
While there is no cost estimate for those projects yet, they typically take about a year to build, she said, and all are expected to be open by 2027.
In addition, she said, doctors’ offices are planned throughout the Pee Dee and at the coast, along with a variety of renovation projects throughout McLeod’s footprint.
The work is part of a strategy that is constantly assessing the status of building and the need, she said, noting that many people retire to the area and that age group uses more health services. They are also tourism communities, she said.
“The coast is one of the fastest growing areas … in the nation,” McGee said. “We are expanding to make sure we have appropriate facilities in that region.”
Funding largely comes from McLeod’s capital budget but also includes some bonding, she said.
“Our not-for-profit status lets us reinvest any of our profits back into services for direct patient care,” she said.
In November, Prisma Health opened its new $115 million Northeast Columbia Medical Park, said Clarence Sevillian, executive vice president and chief operating officer.
The 135,000-square-foot campus includes specialty and primary care, ambulatory surgery, GI endoscopy, medical oncology, a pharmacy, and lab, he said.
“Our primary goal is to make sure patients don’t have to leave our area,” he said, “and are able to have access to care and providers … they trust.”
Also under construction is Prisma’s 112-bed behavioral health hospital in Easley, he said. At a cost of nearly $140 million, including a $100 million grant from the state, the 133,000 square foot facility is slated to open in the spring of 2027, he said, and serve children as well as adults.
The system is also building the Fountain Inn Medical Park, which includes two buildings over 160,000 square feet, Sevillian said. It features an ambulatory surgery center with four ORs and two GI rooms and a medical office building. Also at that location is a 100,000 square foot cancer institute with radiation and infusion center, imaging, pharmacy and lab, he said.
Expected to cost about $180 million, it should be open in the summer of 2027, he said.
And this summer, Prisma plans to open two more free-standing imaging sites – it currently has five – in Anderson and Seneca, he said. And it’s also developing more urgent care centers in partnership with Georgia-based WellStreet, he said.
“Back in 2023, we had 10 urgent care centers,” Sevillian said, “and by the end of (2025), we should have 27 throughout the state. And our goal is to have 10 more over the next year.”
Funding is from a combination of operating capital, bonding, and some philanthropic support, he said.
As with other health systems, Prisma’s projects are a response to growth.
“In some of our markets, we are seeing double-digit growth,” he said. “Greer itself, over past year (2025), had 15 percent growth and is projected for 10 percent in the coming year.”
The Medical University of South Carolina, meanwhile, has multiple projects in the works around the state, including a new cancer hospital in Charleston.
“Three things are driving it,” said Dr. Patrick J. Cawley, CEO of MUSC Health and executive vice president for health affairs at MUSC.
“No. 1 is that South Carolina is growing a lot and any time you have a lot more people, you’re going to need a lot more health care. Everybody’s trying to respond to this,” he said.
“The second is that baby boomers are getting into an age group when there’s a lot of health care needs,” he added. “And the third is that MUSC is growing and trying to make sure we’re everywhere people want to see us.”
Top among the projects is a new state-of-the-art 100-bed cancer hospital, he said. It will provide both inpatient and outpatient services, including chemotherapy and radiation, immunotherapy, stem cell transplants, and cancer imaging and urgent care.
“Every single community we go into that wants help, cancer is No. 1,” he said. “And to deliver cutting-edge cancer care, you need the full spectrum of services.”
Expected to open in 2030, he said, its cost was not available.
Also being built is a $300 million 50-bed hospital outside Charlotte, Cawley said, and a $383 million 70-bed hospital in Nexton.
On 84 acres in Indian Land, the MUSC Health Indian Land Medical Center is slated to open in 2027, officials said. Before that, the MUSC Health Indian Land Medical Pavilion, a three-story, 62,000-square-foot medical office building, will open in 2026.
Together, they will provide services across nearly a dozen specialties.
Cawley said that late last year, MUSC also purchased some 53 acres of the Citadel Mall in West Ashley for $83.5 million.
“It’s an aging shopping mall, and like a lot of them across the states, they are … being repurposed,” he said. “We decided to expand out there.”
The 556,000-square-foot property includes the MUSC Health West Ashley Pavilion, which was previously leased, the vacant Sears building, the inline mall space, and more than 2,000 parking spaces.
Easy to access, the project will include medical offices, an ambulatory surgery center, imaging, and lab, he said.
Part of the mall will continue to house retail space, he said, such as Belk, Dillard’s, and Target.
Cawley said the project is cost-effective because land in Charleston is at a premium.
Kirby said there are other projects around the state as well.
For instance, he said, Atrium Health is building a hospital in Fort Mill and Roper St. Francis Healthcare is replacing its aging hospital in Charleston.
Meanwhile, HCA Healthcare Trident Hospital opened Live Oak Mental Health and Wellness in 2023, officials said. The $48 million hospital in Ladson has 60 beds and offers inpatient and outpatient care to adolescents and adults.
MUSC and McLeod also just opened a new $100 million behavioral hospital in Florence, Kirby said.
In December 2025, Lexington Health announced the opening of Blythewood Medical Park in Blythewood, which includes Blythewood Family Medicine.
And later this year, the medical park will add Lexington Women’s Care Blythewood and Lexington Health Physical Therapy.
“We’re very excited to become part of the Blythewood community,” Tod Augsburger, president and CEO of Lexington Health, said in announcing the expansion. “This area continues to experience tremendous growth, which significantly increases the need for primary care. By bringing these services closer to where people live and work, we can improve access, reduce wait times, strengthen continuity of care and help residents and employers manage health care costs. We look forward to caring for our friends, families and neighbors in Blythewood.”
And Spartanburg Regional Healthcare System also opened its new Union Medical Center at 1201 Furman L. Fendley Highway last year, replacing the old facility.
The $55 million, 99,600-square-foot inpatient hospital centralizes services, officials said, and includes the Bearden-Josey Center for Breast Health, emergency care, and Gibbs Cancer Center infusion services as well as imaging, lab, and primary and pediatric care. It also boasts a healing garden, a quarter-mile outdoor walking trail with exercise equipment and more, officials said.
ERs are seeing increased volume as well, he said, which accounts for the proliferation of free-standing units in strategic locations.
For instance, HCA Healthcare Trident broke ground on a $15 million freestanding ER on Johns Island set to open this fall, officials said.
It also recently broke ground on a new freestanding ER off I-526 in Mt. Pleasant that will open this year, and another on James Island recently celebrated its first anniversary, officials said.
Each of the ERs span nearly 13,000 square feet, include 11 private rooms and cost about $15 million each, officials said.
To staff all these new facilities, hospitals are developing workforce pipelines, working with the state legislature on programs to increase the number of medical professionals, and offering enhanced working conditions, Kirby said.
“It’s fine to build a building,” he said, “but you’ve got to find staff to take care of the patients.”
South Carolina is a destination not only for retirees, but others who enjoy its great weather and amenities, Kirby said. And they all need health care.
“Hospitals are seeing the growth,” he said, “and they’re saying, we better start building now for the next 15 years.”
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