The announcement on the long-awaited decision in the competitive race between four hospital companies, first reported on heraldonline.com, came Wednesday from the state Department of Health and Environmental Control.

"This is the day that we at Piedmont have been anticipating and working toward for a number of years," PMC President and Chief Executive Officer Charlie Miller told employees and members of the media. "And I'm excited to tell you that the news is good, very good indeed."

Tenet Healthcare, PMC's parent company, proposed a $125 million, 100-bed hospital on 40 acres at the corner of S.C. 160 and U.S. 21. Beds will be transferred between the proposed Fort Mill Medical Center and PMC, a 288-bed hospital in Rock Hill.

"We strongly believe that our proposal for Fort Mill is the best one for that rapidly growing area of York County," said Miller, who declined to answer questions from the media, citing anticipated appeals by the losing hospitals.

Others vying for the right to build were Carolinas HealthCare System and Presbyterian Healthcare, both non-profit; and Hospital Partners of America of Charlotte.

DHEC released in a statement that Tenet's application "best fits the projected growth and needs of York County while being consistent with the State Health Plan."

More beds a factor

The agency cited PMC's contract with the York County Council and the company's ability to build a 100-bed hospital from the start as reasons for approval. PMC's proposal had 36 more beds than the others because it can transfer beds from its existing facility already in the county.

The other hospital companies, all based in North Carolina, had to stick with 64-bed plans because of the State Health Plan and beds could not be transferred across state lines.

DHEC wrote that the 100-bed plan by PMC is "a more efficient use of funds and time."

Some of Tenet's selling points had been its commitment to the community for more than two decades and its $2.6 million in property taxes, which the nonprofits Presbyterian and CHS would not have paid.

However, some residents dislike the hospital company's historically high rates and questionable corporate practices. DHEC received many negative letters from the community about PMC.

The four companies have been battling for more than a year for the state's approval to build York County's second hospital.

The decision comes after more aggressive campaigning that included letter writing and newspaper ads. PMC first expressed interest in building a Fort Mill hospital more than 18 months ago. Residents voiced their opinions through letters, petitions and forums.

The losing hospitals, upset and unsure of whether they will appeal, expect to receive the written decision in the mail this week.

Opponents puzzled

Officials at Presbyterian and CHS were puzzled why the state would allow PMC to build after their hospitals received the most support from York County residents, many of which cross the state line for care.

CHS Senior Vice President Dennis Phillips said the hospital company will keep increasing its presence in York County.

"The people have voted with their feet in the past," he said. "We look forward to keep caring for those patients."

Presbyterian, considered the front-runner by many, even got the backing of the York County Medical Society.

"We're incredibly disappointed by the decision," Presbyterian spokeswoman Kati Everett said. "The state didn't listen to the people, who sent in more than 4,000 letters for us, and they didn't listen to the physician community when they overwhelmingly voted to support Presbyterian."

Terry Linn of Hospital Partners said the problem of York County residents going to Charlotte for health care has not been solved.

"They made the worst decision for the community that they could have," he said. "The community spoke very clearly that they wanted a choice and wanted someone else. They'll continue to leave for health care because of that."

In March, the companies presented their final cases at a project review meeting to DHEC officials, who have visited the hospitals since then.

But a decision doesn't mean it's the end for the losing companies.

DHEC officials and healthcare experts expect at least one of the three failed applicants to appeal. With court dates and more appeals, it could be years before ground is broken on a new hospital and a decade before doors open to the public.

"We fully expect appeals," DHEC spokesman Thom Berry said. "And we anticipated that, but we thought it was important to go ahead and announce the decision."

Why did Tenet win?

Rock Hill's Piedmont Medical Center is owned by Tenet Healthcare. • 100-BED PLAN: The plan, submitted in October, moves 36 beds from PMC to the proposed Fort Mill Medical Center, what DHEC officials say is, "in the long run, a more efficient use of funds and time." The other hospitals can't move beds across state lines. • GROWTH: DHEC officials say the 100-bed plan best copes with the expected growth and needs of York County. "Projected needs can be included in the initial construction rather than building a 64-bed facility, as proposed by the other three applicants, which might have to be expanded only a few years after opening," DHEC officials say. • REGULATION: The new hospital would have to answer to the York County Council when it comes to pricing and other issues. The county requires PMC to submit quarterly reports and will fine them $100,000 a month when the hospital's prices are the highest in the region. The county, which sold the hospital in 1979, has had a contract with PMC on certain issues such as pricing since then. • COMMITMENT: PMC has been open in Rock Hill since 1983. Since 1995, the company has spent $138 million on enhancing health care in York County. Source: Department of Health and Environmental Control