South Carolina Will Let This Hospital Bypass Its Certificate of Need Laws, but That’s It

In the same state where health care regulators once held up construction of a new hospital for more than a decade, state lawmakers are on the brink of exempting one proposed new hospital from those same onerous, anticompetitive requirements.

One hospital, that is. Just one. The regulations themselves will remain on the books and will apply to everyone else.

The exemption is buried deep within an appropriations bill that could get a final vote as early as Wednesday, when state lawmakers will convene to pass the annual budget. “For the current fiscal year, the relocation of a licensed hospital in the same county in which the hospital is currently located shall be permitted,” the bill reads, in part.

Normally, such permission is granted via the state’s Certificate of Need (CON) process, overseen by the Department of Health and Environmental Control. It was that same permitting process that held up the construction of a new hospital in Fort Mill, South Carolina, for well over a decade, as Reason has previously reported. By inserting these few lines into the appropriations bill, lawmakers are creating a special loophole in those rules.

Though it isn’t immediately obvious from the text of the bill, the hospital that seems likely to benefit from the exemption is Roper St. Francis Healthcare, which announced plans last year to spend $500 million relocating from downtown Charleston to another part of the city. To say that Roper is a Charleston institution is probably an understatement: the hospital has been around for so long that wounded Civil War soldiers were treated there.

The relocation makes sense. Hospital executives told The Post and Courier newspaper last year that the growing city requires a more modern hospital that’s more centrally located (downtown Charleston is on a small peninsula, but much of the city’s more recent growth has been outside of that area).

But the project ran the risk of being tangled in CON-related red tape, the paper noted back in November: “Many of the key components of the 2030 initiative will require approval through the S.C. Department of Health and Environmental Control’s Certificate of Need program, whic