It Took More Than 15 Years for a South Carolina Hospital To Get Permission To Be Built
Construction finally began in May on a new hospital in Fort Mill, South Carolina, more than a decade and a half after state regulators determined that the area was in need of more medical services.
Without that long delay, residents of the fast-growing Charlotte suburb would have one less thing to worry about during the COVID-19 pandemic. The coronavirus has strained the capacity of hospitals across the country, but especially in Southern states—at one point during the recent “delta wave,” more than 85 percent of hospital beds in South Carolina were filled—and put a spotlight on the availability of medical care in America, which has fewer hospital beds per capita than most other developed nations.
What happened in Fort Mill offers an explanation for why that’s the case.
Before being able to break ground on a new hospital there, Piedmont Medical Center had to navigate the state’s Certificate-of-Need (CON) process, which in this case required going all the way to the state Supreme Court to fend off a legal challenge from a competitor. All that to build a 100-bed facility that the South Carolina Department of Health and Environmental Control had determined, all the way back in 2004, was indeed needed in the region.
Unfortunately, “need” is not enough in many cases. Like how zoning laws and mandatory environmental reviews might be well-intentioned policies but are frequently wielded by “not in my backyard” (NIMBY) activists as a way to tangle new development in costly piles of red tape, the CON laws on the books in many states can be used by existing hospitals to delay or prevent new facilities from opening.
That’s exactly what happened in Fort Mill. A hospital chain based in Charlotte challenged Piedmont Medical Center’s plans for a new facility, then sued to block the state’s decision to give Piedmont permission to build the hospital. The litigation cost thousands of dollars and delayed construction by several years. Researchers at Americans for Prospe
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