Representatives from four hospital systems that want to expand in Buncombe County made their case to residents Tuesday in a public hearing at A-B Tech’s Ferguson Auditorium.
Mission Hospital, AdventHealth, Novant Health and UNC Health West Medical Center are all competing to add as many as 129 beds to their new or existing facilities in the county.
The state-led session was the latest step in the Certificate of Need process, which is mandated by state law for health care providers that want to build new facilities or provide certain services.
About 200 people attended the meeting, where members of the public and elected officials also shared their thoughts on the region’s health care landscape. Two central themes of the morning session were competition and access to care.
Asheville City Council member Bo Hess, who is also a licensed clinical social worker, summed up the situation facing Western North Carolina, which he noted is growing, aging and facing increased health care demand.
“From my perspective as a clinician, competition matters,” Hess said during the public comment session. “Thoughtful competition improves patient choice, encourages innovation and helps health care systems attract and retain skilled professionals.”
Asheville’s Mission Hospital is the largest hospital in Western North Carolina and was recently named the region’s only Level One Trauma Center. But it has faced repeated federal sanctions over patient safety issues and alleged understaffing by its parent company, HCA Healthcare.
Melina Arrowood, chief operating officer at Mission Hospital, said the beds should go to Mission because of its size and ability to provide complex care. Mission regularly operates at 90% capacity or above, Arrowood said, compared with about 30% for other hospitals in the region.
“Beds alone do not care for patients,” Arrowood told the crowd. “It’s the caregivers at the bedside and the environment and systems in which those beds exist that save lives.”
Representatives from UNC Health and UNC Health Pardee — which are jointly applying as UNC Health West Medical Center — emphasized the hospital system’s record on patient safety. If approved, the new medical center would have 129 acute care beds and be located in Asheville.
“Our record of achievement, our proven ability to respond to community needs and our deep understanding of this region make us an exceptional partner in this endeavor,” Jay Kirby, president and CEO of UNC Health Pardee, said during the hearing.
Novant Health, which currently has urgent and specialty care clinics in the region and hopes to build a 34-bed hospital in Arden, said it’s intentionally focused on smaller-scale community care. A representative noted that state officials are not required to award all 129 beds to a single facility and that dividing the beds among applicants would provide residents with greater options.
“The additional applicants can absolutely meet the needs they’ve identified with fewer than 129 beds,” Andrea Flynn, vice president of Novant Health’s Cancer Institute, said. “In other words, Western North Carolina can gain additional health care options without exhausting the full bed need on any single proposal, and that gives this region the flexibility and diversity of care it deserves.”
Mission’s biggest competitor is AdventHealth, which is moving ahead with building a new hospital in Weaverville after the state Supreme Court last week declined to hear a legal challenge by Mission’s owner, HCA Healthcare.
The AdventHealth hospital could have anywhere from 93 to 222 beds, depending on how the Certificate of Need process plays out. The hospital was a key issue in Weaverville’s municipal elections last month, as the town prepares for its population to double in the coming years with the arrival of the new facility.
DeLaina Lewkowicz of AdventHealth said Mission staff acted heroically during Hurricane Helene, when they continued to care for patients even as the hospital lost access to its water supply for 9 weeks.
But she argued that being forced to rely on a single health care facility makes the region more vulnerable when natural disasters strike.
“‘Only’ can be bad when it means only one hospital system with a single water system to serve a county of almost 300,000 people,” Lewkowicz said. “‘Only’ can be problematic when it means only one tertiary hospital in the region. ‘Only’ can be dangerous when it means only one trauma center in Western North Carolina.”
A decision from the North Carolina Department of Health and Human Services is expected in the coming months
Details on the four proposals as provided by NCDHHS are below:
- UNC Health West Medical Center Inc proposes to develop a new hospital in Asheville — UNC Health West Medical Center — with 129 acute care beds. The project is expected to cost $711.1 million and would be completed in July 2031.
- Novant Health Asheville Medical Center LLC and Novant Health Inc propose to develop a new hospital in Arden — Novant Health Asheville Medical Center — with 34 acute care beds. The project is expected to cost $322.2 million and would be completed in January 2030.
- AdventHealth Asheville Inc and Adventist Health System Sunbelt Healthcare Corporation propose a change of scope to develop 129 additional acute care beds at AventHealth Asheville in Weaverville for a total of 222 acute care beds. The project is expected to cost $253.7 million and would be completed in January 2030.
- MH Mission Hospital LLLP proposes to develop 129 additional acute care beds at Mission Hospital in Asheville for a total of 862 acute care beds. The project is expected to cost $198.5 million and would be completed in January 2031.
