SRHS Union Medical Center

SRHS UNION MEDICAL CENTER UNION, SC

ENTRANCE PHOTOGRAPHER Jim Roof @ Jim Roof Creative Inc.

SRHS UNION MEDICAL CENTER OWNER: Spartanburg Regional Healthcare System LOCATION: Union, SC DATE COMPLETE: February 2025

SIZE SQUARE FEET: 93,942 BEDS: 12

UMC: CUT FROM THE CLOTH OF GRIT & ADAPTABILITY

The Union Medical Center is a state-of-the art facility, continuing the legacy of providing excellence in care, fostering connection among the community, and redefining the future of rural health for generations to come.

Spartanburg Regional Healthcare System’s Union Campus comprises of a new acute care replacement community hospital and medical office pavilion. Tactfully mindful of the challenges when faced with maintaining access to healthcare in a rural setting, the campus was designed to efficiently share services across departments in efforts to provide a cost-effective solution, not only in construction but also operationally, while delicately balancing opportunities for growth and adaptability.

ARCHITECT Earl Architects LLC PROJECT TEAM

CONSULTANTS

PARTNER-IN-CHARGE Rick Earl, AIA, NCARB

INTERIOR DESIGNERS Earl Architects & BSA LifeStructures

DIRECTOR OF ARCHITECTURE Scott Meade, AIA, NCARB

STRUCTURAL ENGINEER Professional Engineering Associates

SR. HEALTHCARE ARCHITECT Hillary Earl Crosby, AIA, ACHA, NCARB

ELECTRICAL ENGINEER Smith Seckman Reid Inc. MECHANICAL ENGINEER Smith Seckman Reid Inc.

CONTRACTOR Spartanburg Regional Healthcare System

CIVIL ENGINEER Professional Engineering Associates FOOD SERVICE DRS Design Solutions

THE FABRIC OF THE COMMUNITY & THE FUTURE OF RURAL HEALTH

INTRODUCTION

WHY THE EA TEAM

As a rural Community Hospital located in the Upstate of South

Discussion for the new Union Medical Center had been long

Carolina, Union Medical Center (UMC) is the sole provider

circulated among the community, with the system having

for maintaining much needed access to healthcare services

purchased the land almost a decade prior to Earl Architects’

throughout their area.

involvement. The promise of a new replacement hospital had been visited many times before, however, remained afflicted

UMC’s commitment to their community has been nothing short with costly over-designed options and significant up front site of a demonstration of perseverance and grit, during a time

constraints through federally protected wetlands; an expensive

when rural healthcare facilities throughout our country are

barrier to overcome for the building footprint and parking

closing. Having a presence in the community since 1921, UMC

required.

worked diligently with administration towards carving a path forward. Their strategic elimination of various inpatient services, It was apparent our role was to bring the best of our healthcare expansion of specialty outpatient care, and preservation of 24/7 design expertise and create a tangible and financially emergency care are just a few of the lean operational initiatives

sustainable solution, not just through its construction, but

taken to achieve continued success and longevity.

operationally as well. Placing our mind-set into that of Owner and working alongside administration and the entire medical

The replacement facility smartly intertwines these delicate

care team, it was critical to maintain this vision, while building

components of clinical program including emergency care,

momentum and consensus amongst all stakeholders.

diagnostic imaging, on-site lab & pharmacy, nursing unit and multi-specialty services of a rural health clinic, pediatric care,

Some of our tools for success included:

obstetrics and gynecology, hematology, and infusion.

•

Right-sizing the architecture and allowing for future

The New Union Medical Center reaches beyond the definition

adaptability for shifting CMS reimbursement models

of a healthcare facility and showcases itself as a true community •

Necessary department adjacencies for sharing of FTEs and

center, with amenities including a walking trail, healing garden,

services

chapel, dining, café, and history museum located in the tower.

•

disturbance

The final phase will include a new 113 resident senior living facility, ultimately becoming a centralized health and wellness campus for all stages of life and care for the citizens of Union county.

Building Orientation to significantly minimize wetland site

•

Careful and strategic use of architectural materiality and interior finishes, creating impact where it matters most.

PROCESS IDENTIFYING THE NEEDS During the initial stages of design, stakeholders were

between the Emergency Department, Observation Unit, and

challenged with deciding the final model of care that would

opportunity to connect a Skilled Nursing Facility.

be provided on the designated site. Initially, a hospital, medical office building, and skilled nursing facility were the components Pivotal stakeholder decisions reflecting in the design of the being considered, whether all built simultaneously, strategically

replacement facility and its operational efficiency include

grouped, or individually phased. In addition, the promise

having transfer agreements in place for higher acuity patients,

of building a replacement hospital for their currently aging

immediate elimination of various inpatient services like surgery,

facility had been made to the community years before, further

future conversion of the nursing unit to an observation unit

compounding the decision at hand.

and initial adjacency to emergency care, and a consolidation of specialty outpatient services on site, including a rural health

The design team led the stakeholders through a series of

clinic.

discovery workshops, identifying a vision for the campus, while also prioritizing goals for maintaining access to care in a rural setting. While much of the components of the final project were still evolving, the designers created a programmatic solution integral to the success of the project, allowing for a multitude of “plug and play” opportunities.

Through creating separate programs for the MOB, hospital, and nursing facility, they derived a separate “commons” program at the core of the facility. Considering the final build out, shared spaces like the central energy plant, facilities, kitchen / dining, etc. were pulled into the “commons,” allowing shared infrastructure to be right-sized from the beginning and grow in place as needed.

OPERATIONAL FLEXIBILITY & FINANCIAL SUSTAINABILITY Plagued with an oversized and aging healthcare facility with unsustainable infrastructure, created tremendous operational inefficiencies and high energy costs. Compounding the issue further, the system had multiple off-site lease agreements housing their various outpatient services sprinkled in outdated facilities throughout the community, causing duplication of services and inconvenient access to care.

Ultimately, the consolidation of outpatient and inpatient services to a singular location alleviated many of the perpetually crippling day-to-day challenges, creating a financially sustainable model, improving the patient’s experience, ease of healthcare access, and overall facility image.

APPLYING A FUTURE-PROOF APPROACH In August 2020 and in the early stages of design, the timeline

The clinical design establishes pod modules, while introducing

aligned itself with the impending release of CMS’s new

a connected corridor along the rear of the suite, allowing for

provider type designation, the Rural Emergency Hospital.

each clinic to easily ebb and flow, when experiencing high

Working diligently alongside leadership to translate this new

patient volumes.

care model to an architectural response, the design reflects the consideration of this future conversion by creating a more compact, efficient footprint, with the direct adjacencies needed

PROCESS & PRELIMINARY DESIGN PROCESS & PRELIMINARY DESIGN

ESNC MAIN ENTRANCE

NO

1

2

YES

ESNC MAIN ENTRANCE

3

YES ESNC MAIN ENTRANCE

UMC AMBULANCE MOBILE TECH UMC AMBULANCE MOBILE TECH

ED PUBLIC ENTRANCE

SERVICE ACCESS

UMC AMBULANCE MOBILE TECH SERVICE ACCESS

SERVICE ACCESS ED PUBLIC ENTRANCE

UMC MAIN ENTRANCE

UMC / MOB MAIN ENTRANCE

MOB MAIN ENTRANCE

ONE LEVEL

MULTI-LEVEL

SITE

UMC / MOB MAIN ENTRANCE

COMBO

ED PUBLIC ENTRANCE

Local LocalVernacular Vernacular

Exterior ExteriorRenderings Renderings

DESIGN INTENT INDUSTRIAL HERITAGE & THE LANGUAGE OF PATTERN

ENHANCING THE HUMAN EXPERIENCE

The rural South Carolina county of Union has a deeply rooted

Located in Southeast, where climate allows for outdoor rooms,

history dating back to the Revolutionary War, the Industrial

patios, and porches to serve as the backdrop for social settings

Revolution, and both World Wars. Throughout history, Union

yearlong, this placemaking culture was pivotal to all things

has played a pivotal role in the very fiber of what makes our

familiar to a southern rural community like Union.

nation.

In the design of the facility, it was important for us to embrace In the 1890s, Union transitioned from a quaint farming

the creation of outdoor spaces and the social significance they

community to a bustling textile mill industry. Historical and

hold, while also highlighting these views to nature throughout

generational ties to mill life inspired the industrial aesthetic,

the facility. Today, the campus hosts a series of outdoor spaces

with the architecture celebrating the connection through the

open to the community, including a walking trail with integral

exaggerated scale of glazing, stone, exposed steel members,

exercise equipment and community garden space, a trellis-

and a monumental tower symbolic of the Buffalo Mills, a once

covered outdoor dining area, and a large healing garden

prominent textile mill in the area.

featuring a fountain, butterfly motifs, and an inspirational sculpture, generously donated by renown country music

Exterior and interior architecture plays with intersecting planes and lines, much like the process of weaving fabric through a loom. Interior textures and materials juxtaposition themselves for a feeling of familiarity and comfort.

legend, Dolly Parton and family.

TOPPING OUT CEREMONY On February 29, 2024, the final beam of the new Union Medical Center made its journey to the top of the tower for final placement, an important milestone throughout the construction process. Weeks prior, the beam had been placed in the lobby of the existing Wallace Thomson hospital, and signed by various Union Medical Care team staff and fellow community members.

Paul Newhouse, President of Union Medical Center stated, “As the beam is lifted into place, you can see the new Union Medical Center take shape and imagine generations of families being cared for here. As a healthcare system, we are honored to be a part of this community, and we are proud of the progress we are making here together.”

PHOTOGRAPHER ABOVE : SRHS UMC Social Media / RIGHT: Paul Newhouse, President of UMC

SYMBOLISM OF STRENGTH: THE MILL TOWER A MENDING OF HISTORY, TRADITION, & RESILIENCY THROUGH ARCHITECTURE The architectural design language explores “woven intersections” of lines, planes, and volumes, much like creating patterns in a loom. Here we see that concept take form through the intersecting canopy, lobby, and tower forming the main entrance of Union Medical Center. Materiality of glazing, stone, exposed steel, and a bright copper soffit borrow from the local vernacular and industrial feel but are expressed in a clean modern display promoting comfort and familiarity.

The incorporation of the tower into the design not only reinforces the spatial hierarchy but serves as an architectural nod to Union’s textile history. The once lead manufacturing mill in town, Buffalo Mills, had two distinct towers as a part of their factory design, serving as a prominent community landmark and source of pride well after the mill had closed. Today, although the original towers of Buffalo Mill no longer stand, the Tower at Union rises to carry the historical legacy, featuring a chapel for community reflection on the first floor and a history museum on the second. Enveloping the tower is corner curtain-wall glazing and a clerestory highlighting its expansive height and generous views to nature and access to daylight. The steel members were intentionally left exposed, reinforcing its metaphor as symbol of community strength.

PHOTOGRAPHER LEFT/ABOVE: Jim Roof @ Jim Roof Creative Inc.

LEVEL 1 THE LOOM: WEAVING TOGETHER LOCAL CULTURE & A STRONG SENSE OF COMMUNITY The use of natural materials, such as wood and stone from the exterior materiality transcends into the interior for a warm welcome, while the expansive glazing allows for visual connection to Dolly Parton’s butterfly healing garden and provides access to natural daylight. The wood-look baffle ceiling creates a “loom” like pattern, reinforcing the celebration of pattern and texture.

The reception is well placed to provide guidance to the adjacent registration, while maintaining visibility of the entrance and vertical circulation components.

Also seen within the Lobby is the intersecting Tower. The three linear windows are inspired by architectural elements of the original Buffalo Mills Tower. The wood doors and stained-glass sidelights were brought from the original hospital and adorn the entrance of the chapel on the lower level.

The two-story lobby space provides a visual connection and wayfinding element to the second story mezzanine, adjacent wait space and history museum.

PHOTOGRAPHER RIGHT/ABOVE: Jim Roof @ Jim Roof Creative Inc.

A PLACE TO GATHER, A PLACE FOR MAKING The café and gift shop have been strategically placed at an exterior corner, nestled along the public corridor of the medical office pavilion for convenience and ease of wayfinding. Creating a variety of touch down areas for patients, visitors, and staff encourage pleasant user experience through opportunities for personal choice, positive distractions, and respite.

The dining area and servery were designed with the future phase of Ellen Sagar Nursing in mind. Creating a shared space at the heart of dining encourages social connection, supporting the strong sense of community bond users expressed throughout our user meetings. A trellis-covered outdoor seating area can be seen through the glazing, further highlighting direct access and views to the wooded natural surroundings.

PHOTOGRAPHER Jim Roof @ Jim Roof Creative Inc.

ADAPTABILITY IN MODEL OF CARE In conjunction with the design process and learning of the emerging CMS provider type, the Rural Emergency Hospital (REH) designation, the design team made a critical design “pivot” during design development to move patient beds from the second floor and strategically co-locate the Inpatient Bed Unit adjacent the Emergency Department on the first floor.

This decision anticipated the essential need for providing flexibility among limited FTEs between the two departments but also noted how its direct connection strongly supports its adaptability for conversion from an inpatient to observation unit, further supporting a smoother operational transition to the Rural Emergency Hospital care model in the future.

PHOTOGRAPHER LEFT/ABOVE: Jim Roof @ Jim Roof Creative Inc.

SUPPORTING THE PATIENT & ENTIRE CARE TEAM The facility has 12 all-private patient rooms, with an ability to easily expand to include an additional six observation rooms through provided shell space, adjacent the ED. Two ADA-compliant airborne infection isolation rooms complete with ante rooms and patient lifts are provided to adapt to higher acuity level patients as needed, while supporting best practices for infection control management.

The patient room design took into consideration of the entire care team of the patient, including dedicated zones for medical staff, patient, and family to support a continuum of care and ease of use and comfort for all. Medical devices are integrated within the headwall design for a clean appearance, while organized to support a multitude of moveable equipment as needed.

Epic mounts are integrated into every patient head wall, providing bedside access to telemedicine resources and the vast multi-disciplinary specialty services Spartanburg Regional has to offer.

PHOTOGRAPHER LEFT/ABOVE: Jim Roof @ Jim Roof Creative Inc.

A SEAMLESS INTEGRATION OF COMMUNITY OUTREACH & OUTPATIENT SPECIALTY SERVICES

Located along the exterior public corridor, the classroom provides ample space for hosting internal meetings among medical care teams, continuing education sessions for staff, and lends itself as a convenient assembly place for community outreach programs.

The ribbon of clerestory glazing allows for borrowed natural light to enter the space, while still providing needed privacy.

Continuing along the exterior public corridor of the medical office pavilion and leading from the corner café, a monumental stair made of steel, glass railings, and floating porcelain tile treads leads to specialty outpatient care services and rural health clinic on the floor above. Serving as visual and physical connection between the two floors and adjacent a future outpatient rehab therapy suite, its presence encourages healthy lifestyle choices amongst its users, one step at a time. Beyond the stair, we can see the corridor lead away towards the classroom and dining. Following the push and pull pattern of the exterior wall, the space graciously opens providing break out areas for “technology touchpoints” in the form of parsons tables. Integrating technology through furniture encourages ease of use and comfortability for all users.

PHOTOGRAPHER LEFT/ABOVE: Jim Roof @ Jim Roof Creative Inc.

CONTINUITY OF CARE Arriving onto the second floor, waiting areas are situated along the public corridor, introducing views to nature, natural daylight, and continuously orienting our users along their experience. Easily identifiable reception areas located along the corridor for each clinic assist with intuitive patient journeys, while exam pod modules have been designed to optimize throughput and implement lean concepts for a more efficient delivery of care, ultimately resulting in less wait time and more face time with providers. In addition, the individual exam room module was carefully and uniformly designed to respect patient privacy, support the entire care team, and integrates telemedicine technology into each space for multi-disciplinary specialty access and flexibility in delivery of care.

PHOTOGRAPHER ABOVE / RIGHT: Jim Roof @ Jim Roof Creative Inc.

LEVEL 2 WARMTH AND CONNECTIVITY Looking out over the second-floor balcony and mezzanine, we capture panoramic views of the lobby, reception, and Dolly Parton’s Butterfly Healing Garden situated just beyond the glazing.

Fundamental to the design was creating an entrance that embodied a welcomed sense of warmth, connection, nature, and healing. The large volumed space embodies itself as a physical representation meant to uplift and inspire all those along their journey through the facility.

Visual connection and direct access to the healing garden filled with sculptures & butterfly motifs, plantings, bench seating, and reflective pool and water fountain promotes a sense of wellbeing and therapeutic respite.

“To the wonderful people of Union, just know how much love I have for you and how proud I am to share this connection to you and this place… I wish you nothing but success for this hospital and all the lives I know it’s going to touch.”

PHOTOGRAPHER LEFT: Jim Roof @ Jim Roof Creative Inc.

– Dolly Parton

BUTTERFLY HEALING GARDEN “Butterflies have always been one of my favorite symbols. To me, they represent love, hope, and transformation, qualities that go perfectly with this new hospital… This garden is my way of showing love, like a butterfly, for this community and for everyone who will get care here in Union Medical Center.”

– Dolly Parton

PHOTOGRAPHER LEFT: Hillary Earl Crosby/ ABOVE: Jim Roof @ Jim Roof Creative Inc.

RIBBON CUTTING CEREMONY FEBRUARY 3, 2025 Warm welcomes were exchanged from the local community and healthcare leadership as they toured through the new facility, a much anticipated and well-deserved moment for all. During the ceremony, a personalized message was shared from country music star Dolly Parton, a generous donor to the project, offering words of encouragement and congratulations.

“When I was asked to contribute to this beautiful project, I wanted to help create a space that would bring peace, hope, love, and comfort to patients and their families, and everyone who visits the hospital.” – Dolly Parton

PHOTOGRAPHER LEFT PAGE: Spartanburg Regional Healthcare System / RIGHT PAGE: Hillary Earl Crosby

ENTRANCE PHOTOGRAPHER Jim Roof @ Jim Roof Creative Inc.

Earl Architects 301 N Main St. 17th Floor Greenville, SC 29601 www.earlarchitects.com