More than 200 people turned out Wednesday for a public hearing on proposals from four hospital systems to expand in Buncombe County.
Mission Hospital, AdventHealth, UNC Health West and Novant Health are all competing for state approval to add up to 92 beds to their new or existing facilities. According to state Department of Health and Human Services requirements, the beds must serve residents of Buncombe, Clay, Graham, Madison and Yancey counties.
Representatives from each of the four hospital systems made their case for expansion during the hearing at A-B Tech’s Ferguson Auditorium. The proposals range from Novant Health’s bid to add 20 beds to its new South Asheville medical center, to UNC Health West’s proposal for a new 92-bed hospital at the site of the current Westgate Shopping Center.
Then members of the public weighed in.
One of the biggest concerns cited by audience members was patient safety at Mission, which has faced lawsuits and federal scrutiny in the years since HCA Healthcare purchased the previously-nonprofit Mission Health System for $1.5 billion in 2019.
Denise Champagne of Asheville said Mission should not be “rewarded” with more beds.
“In the last few years since HCA has acquired Mission, there have been four immediate jeopardy violations – or citations, I should say – and at least two EMTALA violations that we know of. That is why the people in this area are concerned,” she said.
“Immediate jeopardy” is the most serious sanction a hospital can face from the federal Centers for Medicare and Medicaid Services (CMS). EMTALA, or the Emergency Medical Treatment and Labor Act, ensures patients can receive emergency care regardless of their ability to pay.
Despite those sanctions, Mission won 95 beds in the state’s last competitive process in March. The process is dictated by North Carolina’s Certificate of Need law.
Mission representatives said they’re confident they can safely care for additional patients. It’s currently the only Level One trauma center in western North Carolina.
Many participants on Wednesday spoke in favor of the other applicants. Madison County Commissioner Alan Wyatt said AdventHealth’s Weaverville hospital, which is currently under construction, represents the best choice because it’s closest for the rural communities north of Buncombe.
“It’s not just the patients making the trips,” Wyatt said. “It’s their spouses, their children, their grandchildren. It’s the family members who take time away from work and drive back and forth to Asheville. Distance matters when you’re sick. And in the mountains, distance matters even more.”
Other speakers included Asheville Mayor Esther Manheimer, who said she supports UNC Health West’s proposed hospital.
A decision on the 92 beds is expected in late 2026.
More details on the proposals by the four hospital systems are below, as provided by NCDHHS:
Mission Hospital: Add no more than 92 acute care beds to the hospital, for a total of 869 acute care beds (excluding NICU beds), at a cost of $66.8 million.
Novant Health: Add 20 acute care beds to the Novant Health Asheville Medical Center that is under construction near Biltmore Park in South Asheville. The addition of the new beds would cost about $100 million. If approved, the facility would have a total of 54 beds.
UNC Health West: Build a new 92-bed hospital on the site of the current Westgate Shopping Center in Asheville. The total cost is about $747 million.
AdventHealth: Add no more than 92 beds to the new hospital currently under construction in Weaverville. The addition of the new beds would cost about $273 million. If approved, the facility would have a total of 185 acute care beds.
