Beaufort County is beautiful – it’s the home of picturesque palmettos, idyllic beaches, and miles of marsh glittering in the warm sun. Who wouldn’t want to live and work here?
As the Lowcountry region continues to grow, so does the need for healthcare services. With more people moving into the community, the healthcare workforce needs to grow as well to keep up with that demand.
There’s one problem: Many healthcare workers, such as nurses, technicians, clerical specialists, and medical assistants, can’t afford to live here. For an area growing (and aging) as rapidly as this one, that is a large, looming issue.
Beaufort Memorial, the largest private employer in the county with more than 1,800 employees, is developing a playbook for workforce housing in the Lowcountry. With one workforce housing project currently underway in Bluffton, the organization is investing in its employees, understanding that a strong and sustainable workforce can directly impact the long-term health of the community.
Cost of Living: The Beaufort County Dilemma
The cost of living in Beaufort County poses one of the biggest challenges – if not the biggest – to the recruitment of nurses and medical professionals.
“The lack of affordable housing here directly affects our ability to recruit and retain the staff that provide this community with critical healthcare services,” said Beaufort Memorial President and CEO Russell Baxley. “At this point, the issue has reached a crisis level for the Lowcountry’s healthcare workforce.”
The median home price in Bluffton grew almost 2.5% from 2023 to 2024 and grew more than 5% in Beaufort during the same period.
Nurses are among the professionals that make up the Lowcountry’s “missing middle” – the population of cost-burdened professionals who often pay more than 30% (and sometimes 50% to 60%) of their income on their rent alone.
“This affordable housing crisis is a huge issue,” Baxley said. “How can this growing and aging community’s critical and evolving healthcare needs be met when, with the combination of increased rent and high childcare costs, the majority of healthcare workers can’t afford to live here?”
The issue goes beyond healthcare worker wages; the solution is not so simple.
“Most people don’t realize that nurses in communities like ours are making more than double the area median income (AMI) and are still unable to afford the cost of living,” said Tina Jackson, Beaufort Memorial Chief People Officer.
Consistent annual cuts to Medicare and Medicaid, paired with 20% healthcare supply cost increases since the COVID-19 pandemic, have resulted in a complicated and strained landscape for employers and employees alike.
Medicare cuts have resulted in payments to hospitals and healthcare systems dropping almost 10% since 2020 – adjusting for inflation, that’s between a 20% to 25% decrease in 2026.
“Even with reimbursement decreases, Beaufort Memorial has still increased salaries for its workforce by almost 10% in the past three years,” Baxley said.
The 14% to 15% increase in home prices during the same period, however, has had a significant impact, as have rising childcare costs, limited childcare availability, and an 11% increase in the cost of groceries.
“As these housing market challenges started to ramp up several years ago, we knew that we needed to do something to support our staff,” Baxley said.
Representatives of Beaufort Memorial, Woda Cooper Companies, Beaufort County and the Town of Bluffton gathered for the ceremonial groundbreaking last month. (Photo: Kate Morrison)
Pioneering Workforce Housing in Bluffton
On June 11, Beaufort Memorial broke ground on a housing project driven by cross-sector collaboration between the community health system and workforce housing developer Woda Cooper Companies.
This milestone marks a huge step forward in expanding housing opportunities for Beaufort Memorial staff and other professionals in the “missing middle.”
“Cost of living isn’t just a housing issue, but a workforce issue, an economic issue, and a quality-of-life issue,” said Victoria Smalls, affordable housing director for the Town of Bluffton. “When teachers, nurses, first responders, hospitality workers, and young professionals cannot afford to live near where they work, the entire region feels that impact.”
The project, LiveWell Terrace, is a partnership not only between Beaufort Memorial and Woda Cooper, but the Town of Bluffton and Beaufort County as well.
LiveWell Terrace is a 120-unit rental apartment development, featuring 30 one-bedroom units, 60 two-bedroom units and 30 three-bedroom units, as well as medical office space dedicated to further expanding primary care access in the southern end of the county.
The development is located along Buckwalter Parkway, less than a mile from where the new Beaufort Memorial Bluffton Community Hospital is being built. The new hospital will see its first patients in early 2027.
Once completed, units will be open for anyone to rent, based on income qualifications.
Bluffton town council member and Mayor Pro-Tempore Fred Hamilton highlighted that Bluffton has long championed the idea of “smart growth” – a priority they share with the community health system.
“We can’t have smart growth without the ability for our professionals to live, work and play here,” Hamilton said, echoing the Town of Bluffton’s motto. “For many years, housing has become a challenge throughout our region. But today, affordable and attainable housing is becoming a reality.”
Despite broad, community-wide recognition that the cost of living and lack of affordable housing affect the economy and labor landscape of the entire Lowcountry region, workforce housing projects like LiveWell Terrace commonly face resistance within the community.
“It’s important to challenge this resistance by supporting this community’s professionals and continuing to move toward sustainable solutions,” Baxley said. “We need to back policies that expand opportunities for workforce housing in our communities. When the ‘not in my neighborhood’ crowd stands up, help us advocate for these solutions. We need community support for the policies and leaders working to strengthen this much-needed infrastructure.”
Rendering of LiveWell Terrace, Beaufort County’s first healthcare workforce housing project, scheduled for completion in early 2027.
A Strong Workforce Supports a Healthy Community
The healthcare footprint of Beaufort Memorial continues to expand. Along with the new Bluffton hospital, the organization is opening a combination emergency room and urgent care facility on Hilton Head Island in early 2027.
As this footprint expands, so does the organization’s investment in its team members as Beaufort Memorial works to break down barriers to recruiting and keeping skilled healthcare professionals.
While the cost of living and the lack of workforce housing options are major obstacles for “missing middle” professionals such as healthcare workers, affordable and accessible childcare is another hurdle.
In late 2024, Beaufort Memorial cut the ribbon on the on-campus location of the Beaufort Memorial Learning Center, an employer-subsidized childcare center that developed during the COVID-19 pandemic to support working parents at the hospital. With the new hospital opening in six months, this model for on-campus childcare services will expand to Bluffton, allowing parents who work at the southern Beaufort County facility to have an option for childcare, too.
“The high cost of living and childcare availability and affordability are a challenge here, but Beaufort Memorial is working to bridge these gaps for its employees,” Baxley said. “A strong, sustainable healthcare workforce is critical to building a healthy community.”
Building a ‘Playbook’ Through Partnerships
As with many challenges faced by the healthcare industry, the COVID-19 pandemic was the catalyst for the merging of the housing and healthcare sectors for Beaufort Memorial.
“No one who worked in health care at that point, except possibly large healthcare centers in major metropolitan areas, would have told you that they were considering stepping into the housing sphere,” Baxley said. “And especially not community hospitals and health systems like Beaufort Memorial.”
Since then, Beaufort Memorial has deepened its commitment to workforce housing. Along with the development of LiveWell Terrace in Bluffton, these efforts include the purchase of Canal Apartments in Beaufort. Together, these initiatives demonstrate innovative approaches to addressing workforce housing challenges and, according to Baxley, could serve as a “playbook” for other organizations looking to support and retain their employees. “It’s the right thing to do,” he said. “And as these projects move forward, we hope to build a model for affordable workforce housing in the Lowcountry that others can follow.”
Critical to tackling the overarching challenge of Beaufort County’s cost of living are the partnerships that make possible these projects, as well as others that can help employees overcome community barriers.
“It’s crucial to have solid, forward-looking partnerships as we look for answers to these community-wide issues,” Baxley said. “These partnerships, such as our collaboration with Woda Cooper Companies, have provided unique opportunities to help us navigate these challenges for our current and future employees.”