A project that has spent months focused largely below ground is now becoming visible across the North Charleston skyline.
Construction crews have started installing structural steel at the future Roper St. Francis Healthcare hospital campus, advancing the $1.2 billion development into a new phase as work intensifies on what is expected to become one of the region’s largest medical facilities.
The hospital development comes as healthcare providers across rapidly growing Southeastern metros continue expanding inpatient capacity, emergency services, and specialized treatment infrastructure to meet long-term demand. In the Charleston area, population growth and suburban expansion have increased pressure for newer and larger healthcare campuses outside the historic urban core.
Located on a 27-acre site in North Charleston, the future campus is planned as an 805,000-square-foot complex with 328 inpatient beds and extensive acute-care capabilities. Current plans also include 18 operating rooms, critical care units, a large emergency department, diagnostic imaging services, and dialysis treatment space.
The development represents another major transition in the long history of Roper Hospital, whose origins in Charleston date back to the mid-19th century. When the North Charleston campus opens, it will become the institution’s fourth primary location since its founding in 1856.
Construction team
The project’s construction team — a partnership between Barton Malow and Edifice — is using a collaborative target-value delivery system rather than a more rigid traditional build model. The strategy allows teams to continuously refine portions of the design and construction process. While maintaining broader financial and scheduling targets.
That approach has been particularly useful given the technical conditions surrounding the site. Engineers and builders have had to work through groundwater-related complications, seismic requirements, and airspace limitations tied to federal aviation rules during the project’s early phases.
While hospital construction is often dominated by technical infrastructure hidden behind walls and beneath foundations, the steel phase marks the point where the scale and form of the facility begin to emerge publicly. For nearby residents and commuters, the development will now transition from an active construction zone into a recognizable hospital structure over the coming months.
Architects E4H Environments for Health Architecture and Skidmore, Owings & Merrill designed the campus with a strong emphasis on outdoor connectivity and patient-centered planning. Instead of separating buildings through isolated medical blocks, the masterplan integrates pedestrian corridors, landscaped open space, and shaded public areas intended to create a more navigable and calming healthcare environment.
The start of structural steel work at the North Charleston campus mirrors similar progress seen in other major U.S. healthcare builds, including the ongoing expansion of Smilow Cancer Hospital in Connecticut, where construction is also advancing.
Future Roper Hospital Campus – Project Factsheet
Project Overview
- Location: North Charleston
- Owner: Roper St. Francis Healthcare
- Project Type: Healthcare / Hospital Campus
- Estimated Cost: $1.2 billion
- Site Size: 27 acres
- Projected Completion: 2029
Current Construction Status
- Structural steel installation has officially begun
- Project has transitioned from below-grade work into vertical construction
Development Team
- Construction JV: Barton Malow | Edifice
- Architects:
- E4H Environments for Health Architecture
- Skidmore, Owings & Merrill
Facility Specifications
- Total Building Area: 805,000 square feet
- Inpatient Beds: 328
- Emergency Department: 47 bays
- Critical Care Beds: 44
- Operating Rooms: 18
- Hemodialysis Unit: 12 bays
- Comprehensive Imaging Department: Included
Design & Planning Features
- Central pedestrian green belt connecting three site parcels
- Landscaped walkways, plazas, and gardens
- Lowcountry-inspired architecture and interiors
- Patient-centered healing environment focus
Delivery Method
- Target-value delivery approach used to maintain cost and schedule flexibility
Key Site Challenges
- Seismic design requirements
- FAA-related height restrictions
- High-water table conditions
