ASHEVILLE, N.C. (828newsNOW) — Four health systems are competing for 92 acute-care hospital beds that state planners have determined are needed in the Buncombe County service area, setting up another major decision over the future of hospital care in Western North Carolina.

The North Carolina Department of Health and Human Services will hold a public hearing at 10 a.m. Wednesday, Aug. 19, at Ferguson Auditorium at Asheville-Buncombe Technical Community College.

AdventHealth, Novant Health, UNC Health and HCA Healthcare’s Mission Hospital have submitted competing Certificate of Need applications for the beds.

The 92-bed need determination covers Buncombe, Clay, Graham, Madison and Yancey counties. All four applicants propose placing the beds in Buncombe County.

Four proposals

The proposals differ significantly in size, location, cost and timing.

Novant Health is seeking 20 additional beds for a new hospital in Arden. Novant was previously awarded 34 beds for the project and is seeking to add the 20 beds through the latest application.

The project is estimated to cost $100.6 million and is expected to be completed in January 2031.

UNC Health is seeking all 92 beds for a proposed hospital in Asheville. The project is estimated to cost $747.3 million and is expected to be completed in July 2032.

UNC Health recently purchased Westgate Shopping Center in Asheville, a move that has drawn attention to the health system’s plans for a potential hospital in the area.

The purchase of the property, however, does not mean UNC Health has received state approval to build a hospital.

UNC Health still must receive approval for its Certificate of Need application before moving forward with the proposed hospital.

AdventHealth is seeking all 92 beds for its hospital under construction in Weaverville. The project is estimated to cost $272.7 million and is expected to be completed in January 2030.

HCA Healthcare, which owns Mission Hospital, is seeking all 92 beds to expand the existing hospital in Asheville. The project is estimated to cost $66.8 million and is expected to be completed in January 2032.

The state Certificate of Need process requires health care providers to receive state approval before undertaking certain major capital projects, adding beds or developing certain health care services.

Public hearing Wednesday

Wednesday’s hearing will allow residents to comment on the competing applications.

The hearing is scheduled for 10 a.m. at Ferguson Auditorium at A-B Tech.

Reclaim raises concerns about Mission

Reclaim Healthcare WNC, a local health care advocacy group, said it has received questions from community members about UNC Health’s purchase of Westgate and the competing hospital proposals.

The group said it is not taking a position on which health system should receive the 92 beds but said it believes Western North Carolina needs alternatives to Mission Hospital under HCA’s ownership.

“Reclaim continues to take no position on which hospital system should be awarded the beds, other than to say that we need alternatives to Mission Hospital under HCA’s ownership,” Campaign Director Aaron Sarver said.

The state will evaluate the competing applications under North Carolina’s Certificate of Need law and applicable regulations before deciding which proposal, if any, will receive approval.

The decision could have a major impact on the region’s hospital landscape, with proposals ranging from an expansion of Mission Hospital to new hospital development by UNC Health, AdventHealth and Novant.