State approves three Chesterfield hospital projects, totaling $672M

Two new hospitals and an expansion of another hospital totaling $672 million have been approved in fast-growing Chesterfield County, setting the stage for a major expansion of care by multiple health systems in the region.

Virginia State Health Commissioner Dr. Cameron Webb signed off on the projects last week, allowing VCU Health, HCA Healthcare and Bon Secours to move forward with plans that would collectively add more than 160 hospital beds between 2029 and 2030 — even after state staff had recommended denying one of the proposals.

The county currently has two hospitals: Johnston-Willis Hospital, owned by HCA, and St. Francis Medical Center, a Bon Secours facility. However, the Virginia Department of Health estimated Chesterfield’s population would swiftly grow by 42,000 people between 2020 and 2030. The state’s Certificate of Public Need (COPN) policy requires health systems to obtain state approval before building or expanding hospitals.

The approved projects include VCU Health’s plan to build a new 66-bed hospital, HCA’s proposed 60-bed Magnolia Hospital and Bon Secours’ expansion of St. Francis.

In fall 2025, a panel of Virginia Department of Health staffers recommended approval of the projects proposed by Bon Secours and VCU Health but recommended denial of the HCA proposal.

All three approvals include charity care requirements, mandating that hospitals provide free or discounted care to low-income patients. The value of that care must equal a set percentage of each hospital’s patient revenue — 0.9% for VCU Health and HCA, compared with 3% for Bon Secours.

Bon Secours

Bon Secours’s 58,400-square-foot expansion would add 36 medical and surgical beds and four ICU beds to St. Francis Medical Center at 13170 St. Francis Blvd. The $106 million project involves adding two floors and renovating existing space.

“This approval represents an important step as we continue planning to support access to care, advance health equity and responsibly respond to the growing health care needs of Chesterfield County — one of the fastest‑growing regions in Virginia — and the surrounding communities that St. Francis Medical Center has served for more than two decades,” a Bon Secours spokesperson said in a statement. “We will continue to move thoughtfully through the next phases of the process and look forward to sharing additional information as plans are finalized.”

The Bon Secours project is expected to be completed by Sept. 13, 2029, according to the COPN.

VCU Health

VCU Health’s proposal calls for a 66-bed hospital at 7220 Beach Road, including 42 medical-surgical beds, six pediatric beds, six obstetric beds and 12 intensive care unit beds. The 202,889-square-foot facility would also include six operating rooms, a cardiac catheterization lab, CT and MRI units and intermediate-level nursery services.

The project is expected to cost about $306 million, funded through a mix of bond financing and reserves. The hospital is projected to be completed by May 30, 2030, according to state documents.

Both Bon Secours and HCA previously opposed the project, with Bon Secours raising concerns about the potential impact on St. Francis Medical Center. At the same time, HCA, which operates Johnston-Willis Hospital, noted the proposed site is less than a mile from a freestanding emergency room it is developing nearby. Bon Secours did not comment on the project’s approval.

A VCU Health spokesperson said the health system was “thrilled” to receive the COPN approval.

“The approval recognizes the merits of our application and the positive impact that VCU Health System provides throughout the commonwealth,” she said. “We are taking steps to begin the design and planning process and are excited about expanding access to our unwavering care in Chesterfield County. We look forward to sharing more information as plans are finalized.”

HCA

HCA’s proposal for a $260 million, 60-bed acute care hospital in Chesterfield was initially recommended for denial by state staff but ultimately won approval from Webb.

In his decision, Webb wrote that the project would improve the distribution of hospital beds in Planning District 15, citing the county’s rapid growth. “The applicant has demonstrated that the status quo is not a reasonable alternative,” Webb wrote. He also cited the lack of more efficient alternatives and “considerable” community support.

The proposed facility, Magnolia Hospital, would be located in Moseley on Hull Street Road and include 54 medical-surgical beds, six intensive care unit beds, four operating rooms and an MRI scanner. HCA has said it plans to relocate beds from Retreat Doctors’ Hospital and operating rooms from Retreat Doctors’ Hospital and Johnston-Willis Hospital. It also plans to close its Swift Creek freestanding emergency room.

The project is expected to be completed by Oct. 13, 2029.

Both Bon Secours and VCU Health previously opposed the HCA project. Bon Secours raised concerns about its potential impact on St. Francis Medical Center, while VCU Health argued its own proposal would create more access and reduce barriers to care. Neither system commented on the project’s approval, and HCA did not respond to a request for comment.