WEAVERVILLE, N.C. (828newsNOW) — A years-long battle over a certificate of need for more hospital beds in the Asheville area has come to an end after the North Carolina Supreme Court declined to hear an appeal from HCA Healthcare, clearing the way for AdventHealth to move forward with plans for a hospital in northern Buncombe County.

The court’s decision, confirmed Friday afternoon by an AdventHealth spokesperson, leaves in place lower court rulings that upheld the state’s approval of the beds for AdventHealth. The ruling was celebrated by local officials and community members, including newly elected Weaverville Town Council member Jennifer Young, who posted the news on her “Young for Weaverville” Facebook page: “GREAT NEWS!!! Advent has secured the CON for 93 beds! NC Supreme Court declined to hear HCA’s appeal. Let’s start building our hospital!!!!”

The state awarded AdventHealth a certificate of need for 67 beds in 2022. Mission Health, owned by HCA Healthcare, challenged the decision, arguing regulators erred in granting the beds to a competitor. The case wound through multiple appeals before reaching the state Supreme Court, which opted not to review it.

The ruling marks a major step for AdventHealth’s proposal to build a $300 million hospital on a 30-acre site in Weaverville. The planned facility includes 222 beds, an emergency department, an intensive care unit, women’s services and specialty clinics. Health system leaders say the project could create more than 1,000 jobs and expand care for residents in Buncombe, Madison, Yancey and Graham counties.

“For a county of 275,000 people to have just one hospital, people feel like they don’t have enough options,” Graham Fields, an AdventHealth administrator, told residents during an August community meeting.

Although the 93 beds are now approved, AdventHealth is seeking an additional 129 beds to reach its planned capacity of 222. Young said a public hearing on that request is scheduled for 10 a.m. Tuesday at Asheville–Buncombe Technical Community College. If approved, AdventHealth officials say the facility could meet trauma center criteria.

Health system leaders have said that if the Supreme Court declined HCA’s appeal by the end of 2025, construction could begin soon afterward, with the hospital potentially opening as early as late 2027.

Throughout the legal challenge, Mission Health argued the state needs clearer standards for determining “substantial prejudice” in certificate-of-need disputes, saying ambiguities hinder meaningful review of agency decisions. AdventHealth has countered that Mission is attempting to block competition in a rapidly growing region.

In a statement Friday, AdventHealth spokesperson Victoria Dunkle said the organization received official notice of the Supreme Court’s decision and is reviewing what the ruling means for the project’s next steps.

“Yes, we got good news,” Dunkle said. “Our teams are now doing their due diligence to understand all the details of the decision, and we look forward to sharing more on Monday.”

With the court’s action, AdventHealth can advance the long-delayed project while continuing to seek approval for the remaining beds.

Efforts to reach Mission Health for comment were unsuccessful.