Clayton — Johnston Memorial Hospital plans to turn its future outpatient center here into a full-service hospital.

JMH is seeking the state's permission to move 27 inpatient beds from the hospital in Smithfield to the future Clayton medical center, which will be built on N.C. 42 West near Amelia Church Road. The expansion would double the size of the main building to 110,423 square feet.

In addition to the inpatient beds, the Clayton hospital would offer cardiopulmonary, echocardiography and respiratory services, physical therapy, nuclear medicine, a pharmacy and an extended lab. Also, endoscopy and C-section rooms are included in the plans. Four of the inpatient beds would be designated for labor, delivery and postpartum care.

Kevin Rogols, chief executive and president of JMH, said expanding in Clayton would eliminate the need to remodel the second floor of the main building in Smithfield. The hospital had planned to renovate that floor after building a $61 million, five-story inpatient tower with 110 beds, he said. But the hospital decided it would be wiser to invest the money in brand-new beds in Clayton, Rogols said.

"The second floor of this 56-year-old building was to receive a significant remodeling where we would go in and gut it," Rogols said. "For every three patient rooms, we would build two new rooms. We thought that maybe we should take that money to Clayton and build brand new beds that have a 40-year useful life."

According to the hospital's census, patients from Clayton use 27 acute-care beds daily at JMH, Rogols said. "It is a better investment to make it in Clayton, and that is where people live, so it gives them a better service," he said.

Original plans in Clayton called for a freestanding emergency department, outpatient diagnostic imaging services, a lab and two operating rooms for $31 million. With the expansion, the bill now comes to almost $60 million. Construction on the outpatient facility is expected to wrap up next July, Rogols said. The inpatient facility and the Smithfield tower would open one year later, he said.

Rogols said construction in Clayton would begin in two weeks. "The heavy construction will begin in June, but what we have got to do in May is get the site ready," he said.

Clayton Town Manager Steve Biggs said a full-fledged hospital would be a big boost for residents. It would provide high-income jobs for medical professionals, add vital medical services and anchor retail development along N.C. 42, he said.

"We see JMH as being a very good business and service partner to the Town of Clayton," Biggs said. "They have been great to work with, and we see our relationship continuing indefinitely into the future. They have outstanding leadership, and they work hard to promote the quality of life that Clayton is becoming well known for."

In the meantime, the U.S. Department of Housing and Urban Development has agreed to underwrite a $137 million loan from the Bank of America to finance the two projects. The hospital will issue mortgage bonds insured by HUD's Federal Housing Commission. To pay for the proposed Clayton hospital expansion, JMH will seek an additional $28 million in financing through the same HUD program.

As for moving inpatient beds to Clayton, the state will hear that request in June and likely make its decision in September, said April Culver, vice president of government affairs for JMH.