COLUMBIA, SC — The state health department is giving Kershaw County hospital officials one more chance to go forward with their long-stalled, $11.5 million expansion of the community’s medical center in Camden.

But if the medical center doesn’t make progress on the project within the next nine months, the hospital will have to restart the expensive and possibly lengthy process of gaining state approval for the work.

The SC Department of Health and Environmental Control board late last week granted Kershaw Health an unprecedented fifth extension on a certificate of need it must have to expand. The medical center gained the certificate about three years ago but has not had the money to go through with the expansion. Since getting the certificate, DHEC has granted four extensions each time the license was nearing expiration.

DHEC board members said they won’t do that again if Camden can’t jump-start the project.

“I understand the circumstance here, but I think it’s a bit of a precedent-setting thing,’’ board member Ann Kirol said. “Continuing to renew these (expansion approvals), there’s a certain level of discomfort I have with it.’’

Kershaw Health wants to renovate an old shopping center for an outpatient medical diagnostic services center on U.S. 1 in Camden. The center would provide services such as CT scans and ultrasounds that now are done at the main hospital.

Kershaw Health already has acquired the property for the center, but has had trouble coming up with the money for the rest of the project because of the nation’s tough financial times, officials told the DHEC board.

Donnie Weeks, chief executive with Kershaw Health,, said the board’s concerns were fair. Weeks said he hopes his organization makes headway on the project in the next nine months, but that depends on the economy and whether his hospital can find a way to finance the project.

“I can’t stand here and tell you I think we can come back in nine months and ... all of a sudden things have turned to the point that we can do the project,’’ Weeks told the board. “But I can earnestly tell you the need for the project has not gone away.’’

Having to restart the process of gaining a certificate-of-need could easily cost Kershaw Health thousands of dollars, Weeks said.