A new era of healthcare for the Lowcountry

Rising in the heart of North Charleston, the Roper Hospital campus marks a bold step into the future of healthcare—one that fuses innovation, resilience, and regional identity. Working in partnership with the architecture firm E4H, SOM designed a facility that seamlessly integrates operational efficiency within a supportive, patient-centered environment. More than a hospital, the new campus is envisioned as a model of 21st-century healthcare—built to persevere through environmental challenges while improving access and enhancing the experience for patients and visitors alike.

A legacy reimagined

For over 160 years, Roper Hospital has been a cornerstone of healthcare in Charleston, continually evolving to meet changing community needs. As climate change and extreme weather events have made coastal flooding more severe, Roper St. Francis Healthcare sought an inland location that would ensure its resilience for decades to come.  

Sited north of the Charleston peninsula, the new campus and 320-bed hospital improves access to high-quality care for the area’s growing population. Planned on a 27-acre site with room for expansion, the campus continues Roper St. Francis Healthcare’s tradition of excellence while preparing for the needs of future generations. 

A connected, intuitive campus

Connectivity is the guiding principle in the design. SOM’s campus masterplan organizes the hospital around a central pedestrian Green Belt that links the site’s three separate parcels with shaded walkways, gardens, and plazas. Inspired by Charleston’s historic streetscapes and the native flora of the Lowcountry, the Green Belt offers a recognizable, serene experience for visitors while laying the groundwork for future campus expansion.

From tidelands to marshes

The architecture and interiors draw deeply from the surrounding Lowcountry, using natural forms, materials, and palettes as both design inspiration and placemaking strategy. This connection to nature begins at the campus entry, where regionally specific plantings and a broad, shaded porte cochere create a sense of welcome. Inside, the hospital unfolds as a sequence of immersive environments inspired by the region’s unique ecosystems—from tidelands, to dunes, to marshes.

The main lobby acts as a central compass, orienting visitors between the entrance, parking, and hospital tower. Here, blue and green tones reference shifting tidelands, while terrazzo flooring and curved seating offer comfort and calm. Just beyond, a double-height promenade connects the waiting area to the café. Earth tones, recessed alcoves, and a commissioned mural from a local artist enrich the space with warmth and texture, recalling the palette and topography of coastal dunes. 

At the rear of the building, Roper Hospital’s café evokes the local salt marshes and their signature grasses—with green ceramic tile, wood accents, and rattan lighting creating a laid-back but refined atmosphere. A patio extends this theme outdoors to a lush garden, where trellises offer shade and help reduce overall energy demand.

Resilient Design

The location posed a unique set of challenges, with extensive restrictions emerging from flight and radar paths from the nearby airport, vehicular accessibility, climate resiliency, and clinical efficiency requirements. Innovative solutions—like the use of a performance-based seismic design approach—were critical to realizing the vision of the masterplan. As key elements of the structural system, the hospital’s buckling restrained braces also became distinct expressive elements of the building’s exterior, demonstrating how structural necessity can shape architectural form.

Built to last, designed to inspire

The new Roper Hospital campus stands as a model for how healthcare environments can be reimagined—not only as places of treatment, but as resilient, restorative, and deeply connected community facilities. By blending technical ingenuity with regional character, the design pays homage to Roper St. Francis Healthcare’s legacy while ensuring its enduring relevance.