ASHEVILLE – AdventHealth plans to build a 93-bed hospital on 25 acres of land that the nonprofit health care conglomerate recently purchased in Weaverville. But whether AdventHealth will receive the certificate required to open the hospital is still in question.
AdventHealth must navigate North Carolina’s Certificate of Need process to open the hospital. Health care providers in the state must apply for CONs if they want to expand their facilities, equipment, or initiate medical services.
North Carolina’s certification process can take years. AdventHealth’s two pursuits to bring 67 and 26 beds to Buncombe County are respectively at the gestation and embryonic phases. Long court battles and potential competition from neighboring providers could delay and stymie the nonprofit’s effort.
AdventHealth submitted a CON application June 2022 to open a 67-bed hospital with one C-section operating room and five procedure rooms.
The nonprofit received competition from Mission Health and Novant Health, which also submitted applications for the certificate. AdventHealth eventually won the bid. The company gained support from Democratic nominee for governor and North Carolina Attorney General Josh Stein and the Buncombe County Board of Commissioners who submitted letters to the North Carolina Department of Health and Human Services summer 2022, asking the state to choose alternative providers to Mission.
As the state mulled the decision, people submitted around 4,000 letters, most showing support for AdventHealth to win the certificate.
AdventHealth in part argued that the facility would increase health care competition in Western North Carolina. Mission is facing two antitrust lawsuits in state and federal court brought respectively by a group of individual plaintiffs and local governments, including Asheville and Buncombe County.
NCDHHS awarded the bid to AdventHealth in November 2022 . In its application the company estimated it would spend $254.1 million on the facility.
Mission challenged the state’s decision. The case was heard in front of Administrative Law Judge Michael Byrne in Waynesville in fall of 2023. That decision is expected by May 10 at the latest. Either party can appeal the case to the N.C. Court of Appeals. The case can then be appealed to the N.C. Supreme Court.
AdventHealth bought the land for the hospital in Weaverville Feb. 21 for $7.5 million, according to the Buncombe County Register of Deeds and tax records. The nonprofit announced its intention to build the 67-bed hospital in that location in a March 19 news release. In a March 21 news release, AdventHealth said it would apply for 26 additional acute care beds in Buncombe County, identified in the 2024 state medical facilities plan. It plans to combine all 93 beds in one facility.
AdventHealth spokesperson Victoria Dunkle told the Citizen Times March 22 that the nonprofit will begin building when the state issues the CON and the company receives it. She did not answer a question about AdventHealth’s plans with the land if the company does not receive the CON.
A spokesperson for Mission did not answer a Citizen Times question about applying for the 26-bed certification. Novant is evaluating applying for the beds, a spokesperson told the Citizen Times in an email.
AdventHealth's announcement may have been part of an aggressive public relations effort to build community support for the CON, UNC Chapel Hill Professor Richard Saver speculated to the Citizen Times March 22. Saver teaches a course on health law, with a unit on certificates of need.
“While usually the agency decision is initially upheld through all the levels of review, there are cases where it gets reversed on appeal,” he said.
This announcement could galvanize NCDHHS to vociferously defend the certificate in higher courts, Saver said. Announcing the land use could also initiate local governments to begin the ancillary steps to prepare for the hospital to open, like workforce recruitment.
Prolonging a CON battle can also be good business for Mission, which will not compete with a new AdventHealth hospital while the court deliberates.
Mission and AdventHealth are familiar foes in CON battles. The two providers are ensnarled in battles over two Buncombe County freestanding emergency departments. NCDHHS initially awarded the certificates to Mission. AdventHealth appealed.
More: Document shows why Mission, Novant hospital CON bids were denied, AdventHealth approved
More: AdventHealth wins bid to open new Buncombe hospital; Mission, Novant weigh next steps
More: Buncombe hospital expansion bid gets 4K support letters. Which got the most?
Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.
This article originally appeared on Asheville Citizen Times: AdventHealth announces site for Weaverville hospital, but court approval not yet granted
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