The land being scraped clean on S.C. 90 at the S.C. 22 interchange is the site of Conway Medical Center’s new freestanding Highway 90 Emergency Department. It is a 44.45-acre parcel, and the emergency room is phase one of what the hospital system has described as a multi-stage medical campus [Conway Medical Center, 2024; WBTW, 2024].

That is the short answer to the question drivers have been asking each other on that stretch of road. The longer answer is more interesting, and it is the part the announcement-day coverage did not carry: this site was not Conway Medical Center’s first choice, the opening date has already moved about a year, and the campus is landing on a corridor whose residents have spent years telling the county it cannot handle the traffic and water it already has.

None of that makes the project a bad one. For the people it is designed to serve, it is straightforwardly good news, and the strongest number in the entire story is the one that explains why.

This new facility will significantly improve access to emergency care for local residents and is expected to alleviate some of the pressure on other nearby emergency departments.

Introducing the Highway 90 Emergency Department: Meeting Community Needs

A 12-bed emergency room built for people who live too far from one

Conway Medical Center announced the CMC Highway 90 Emergency Department in August 2024 as a 24/7 freestanding emergency department at the intersection of S.C. 90 and S.C. 22, at an announced cost of approximately $18 million [Conway Medical Center, 2024; WBTW, 2024]. The plan calls for 12 emergency treatment beds, with what the health system describes as state-of-the-art diagnostic and treatment technology [Conway Medical Center, 2024].

Conway Medical Center projects roughly 17,000 patients in the facility’s first year [Conway Medical Center, 2024]. That is a substantial volume for a 12-bed operation, and it tells you the health system is not building on speculation.

The justification came from Paul Richardson, the hospital’s chief medical officer, at the time of the announcement. **”About 45,000 people within the emergency department’s service area are more than 10 minutes away from access to emergency care,”** Richardson told WBTW [WBTW, 2024]. That is Conway Medical Center’s own figure rather than an independent finding, but it is the clearest statement of the problem anyone has put on the record. In a cardiac event or a stroke, 10 minutes is not a rounding error. Along the Highway 90 corridor between Conway and North Myrtle Beach, where subdivisions have gone up faster than anything else has, that gap has been widening for a decade.

Richardson called it “probably one of the most important projects we’ve done in quite some time” [WBTW, 2024]. Brian Argo, the health system’s president and CEO, framed it against county growth: “As Horry County continues to experience rapid growth, we’re committed to ensuring all residents have access to high-quality emergency care” [Conway Medical Center, 2024].

The growth premise underneath that statement is not in dispute. Horry County remains one of the fastest-growing counties in the nation, and the corridor in question has taken a large share of it. Richardson also noted that Conway Medical Center has been operating in the county for 96 years [WBTW, 2024] — a longer track record than most of the subdivisions its new emergency room is meant to serve.

The part the announcement did not lead with: this was plan B

Before Conway Medical Center was building on S.C. 90, it was planning something considerably larger somewhere else.

The health system had proposed a $161 million hospital along International Drive in Carolina Forest. It abandoned that project, and the S.C. 90 plan followed, according to reporting by The Post and Courier and WBTW [Post and Courier, 2024; WBTW, 2024]. The International Drive proposal had drawn organized opposition from residents and environmental groups over noise, controlled burns and flooding, concerns tied to the site’s proximity to a nature preserve [Post and Courier, 2024]. Local outlet myhorrynews described what came next in plain terms — Conway Medical Center shifting plans to build off Highway 90 [myhorrynews, 2024].

Set the two side by side and the arithmetic is hard to miss. A $161 million hospital in Carolina Forest became an $18 million emergency department on S.C. 90. Residents are entitled to see that sequence laid out rather than discovering it later.

What that sequence does not establish is that the region’s care got downgraded. A freestanding emergency department and a full hospital do different jobs — one stabilizes and transfers, the other admits — and Conway Medical Center has not said the S.C. 90 campus stops with the emergency room. The health system has called this phase one and said future phases “may include additional services,” without specifying what those services are [Conway Medical Center, 2024]. That is a real, open question, not a settled loss. The honest position is that we do not yet know what the rest of the campus becomes, and neither, on the public record, does anyone outside the health system.

A year has already come off the front end

The August 2024 announcement anticipated the emergency department opening in 2026 [Conway Medical Center, 2024].

By October 2025, WMBF News reported the S.C. 90 location as expected to break ground in 2026, with completion in 2027 [WMBF News, 2025]. That is roughly a year of drift between the opening date first put in front of the public and the completion date currently expected.

This is worth reporting and not worth inflating. Permitting, site work and county approvals routinely move dates on projects this size, and nothing in the record suggests anything unusual has gone wrong here. Conway Medical Center said in 2024 that construction would begin once all county approvals were received [Conway Medical Center, 2024].

Those approvals are the loose thread. Horry County Council gave first-reading approval on Aug. 13, 2024, to rezone the 44.45 acres for medical use, and two additional readings were required at that point before the rezoning was final [WBTW, 2024]. We have not confirmed a final third reading or its date.

Two other numbers deserve a caution label. The $18 million figure is the announced cost, and it has not been confirmed as still current two years on. Nor has a groundbreaking date been confirmed — 2026 is an expectation, not an event. Conway Medical Center is separately building a different, unrelated emergency department on Highway 707 in the Socastee area, which broke ground in October 2025 [WMBF News, 2025]. That project’s cost, bed count and square footage are not this project’s numbers, and the two are easy to mix up.

Landing on a corridor that already has complaints

S.C. 90 is one of Horry County’s most contested growth corridors. Residents along it have raised flooding and drainage concerns for years, and the road has been repeatedly examined for widening, including a closer look from the RIDE road-program process [myhorrynews, 2024].

Nothing in the public record indicates a drainage problem at this particular 44.45-acre parcel. No stormwater finding, permit condition or site-specific study has been reported, and it would be unfair to the project to imply one exists. The corridor-level concerns are documented; this site’s are not.

But the corridor context still matters, because an emergency department is only as useful as the road that reaches it. A facility built to serve 45,000 people who are more than 10 minutes from care depends entirely on those minutes staying at 10. If S.C. 90 backs up the way residents say it does at peak hours, the drive time the project exists to close starts opening back up. That is a road question, not a hospital question, and it belongs to Horry County Council and the RIDE process rather than to Conway Medical Center.

It also cuts the other way. A 24/7 emergency room at S.C. 90 and S.C. 22 is a genuine asset for a corridor that has absorbed heavy subdivision growth with very little in the way of public infrastructure to match. Taxpayers are not funding this one — it is a health system building on land it rezoned through a public process, which is a better arrangement for residents than most growth arriving on that road.

What to watch next

The cleared ground on S.C. 90 is the visible end of a two-year sequence that started somewhere else entirely. What is coming is a 12-bed emergency department that Conway Medical Center says will see 17,000 patients a year in a place where thousands of people currently drive too far for emergency care. That is worth having.

The questions that stay open are narrow and answerable. Whether the rezoning cleared its remaining readings and when. Whether $18 million is still the number. Whether 2026 groundbreaking and 2027 completion hold, or slip again. And most consequentially for anyone living between Conway and North Myrtle Beach, what the later phases of this campus actually contain — because the difference between an emergency department and a campus with admitting capability is the difference between a stabilizing stop and a hospital, and that answer is still Conway Medical Center’s to give.

Horry County residents will know the first of those answers the moment equipment starts pouring footings. The rest will take asking.

Further Reading

Highway 90 Emergency Department – Conway Medical Center — “CMC Announces Plans for New Emergency Department Location” (Aug. 13, 2024): https://www.conwaymedicalcenter.com/news/topic/cmc-announces-plans-for-new-ed-90-22/

Highway 90 Emergency Department – WBTW — “Conway Medical Center ready to build $18M emergency department as part of multi-year expansion plan” (Aug. 14, 2024): https://www.wbtw.com/news/grand-strand/horry-county/conway-medical-center-ready-to-build-18m-emergency-department-as-part-of-multi-year-expansion-plan/

Highway 90 Emergency Department – The Post and Courier — “Conway Medical Center plans to build a new campus on S.C. 90”: https://www.postandcourier.com/myrtle-beach/health/conway-medical-center-highway-90-campus-sc/article_17ccdfac-5918-11ef-b68b-1b0c6d16792e.html

Highway 90 Emergency Department – myhorrynews — “Conway Medical Center hoping to bring ER to Hwy 90”: https://www.myhorrynews.com/news/cmc-shifting-plans-to-build-new-multimillion-dollar-facility-off-highway-90/article_b652e0fa-59e4-11ef-9d68-4f5839338c1a.html

Highway 90 Emergency Department – WMBF News — “Conway Medical Center breaks ground on new $20.5M emergency department” (Oct. 30, 2025) — the separate Highway 707 project: https://www.wmbfnews.com/2025/10/30/conway-medical-center-breaks-ground-new-205m-emergency-department/

Highway 90 Emergency Department – myhorrynews — “Hwy 90 gets closer look from RIDE IV commission“: https://www.myhorrynews.com/news/highway-90-gets-closer-look-from-ride-iv-commission/article_99b103f6-a40d-11ee-b874-135ca3ac6804.html

Highway 90 Emergency Department – Horry County Planning and Zoning: https://www.horrycountysc.gov/departments/planning-and-zoning/