In a significant development for healthcare in Buncombe County, over 200 community members gathered on Wednesday to participate in a public hearing regarding the expansion proposals from four major hospital systems. The competition, which includes Mission Hospital, AdventHealth, UNC Health West, and Novant Health, aims to secure state approval for the addition of up to 92 beds to their facilities, either new or existing.
These expansions are intended to serve residents across Buncombe, Clay, Graham, Madison, and Yancey counties, as per the requirements set by the state Department of Health and Human Services. The hearing, held at A-B Tech’s Ferguson Auditorium, saw representatives from each hospital system present their case for why they should be granted the opportunity to expand.
Novant Health seeks to enhance its South Asheville medical center with 20 additional beds, while UNC Health West has proposed a new 92-bed hospital at the current Westgate Shopping Center location. On the other hand, Mission Hospital aims to add up to 92 acute care beds to its existing facility, and AdventHealth is looking to increase capacity at its under-construction Weaverville hospital by the same number of beds.
Public opinion was a central part of the hearing. Concerns were notably raised about patient safety at Mission Hospital, which has encountered federal scrutiny and legal challenges following its $1.5 billion acquisition by HCA Healthcare in 2019. Denise Champagne from Asheville voiced a strong opinion, stating, “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.”
Despite these challenges, Mission Hospital remains the only Level One trauma center in western North Carolina and recently secured 95 beds in a previous competitive process governed by the state’s Certificate of Need law. Mission’s representatives expressed confidence in their ability to manage the additional patient load safely.
Support for the other hospital systems was also evident. Madison County Commissioner Alan Wyatt emphasized the importance of proximity, endorsing AdventHealth’s proposal due to its accessibility for rural communities north of Buncombe County. “It’s not just the patients making the trips,” Wyatt remarked. “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.”
Asheville Mayor Esther Manheimer also expressed her support for UNC Health West’s new hospital proposal. The decision on the allocation of the 92 beds is anticipated by late 2026, and each proposal comes with its own set of financial implications and strategic benefits for the region.
Detailed breakdowns of the proposals are as follows:
Mission Hospital: Plans to add up to 92 acute care beds, bringing the total to 869 acute care beds (excluding NICU beds), at a cost of $66.8 million.
Novant Health: Proposes adding 20 acute care beds to its upcoming Asheville Medical Center near Biltmore Park in South Asheville, at an estimated cost of $100 million, resulting in a total of 54 beds.
UNC Health West: Plans to construct a new 92-bed hospital at the current site of Westgate Shopping Center, with a projected cost of $747 million.
AdventHealth: Intends to add up to 92 beds to its new hospital under construction in Weaverville, costing approximately $273 million, which would increase the facility’s capacity to 185 acute care beds.
