By Ted Clifford
UNC Health, the University of North Carolina’s hospital system, has applied for permission to open a 92-bed hospital near downtown Asheville. North Carolina’s state-owned nonprofit health provider, which already has a management agreement with UNCHealth Pardee in Henderson County, made the request to the North Carolina Department of Health and Human Services under the state’s Certificate of Need (CON) requirement, which requires regulatory approval.
The move comes as UNC continues to appeal DHHS’s decision in March to award 95 beds to Mission Hospital and 34 to Novant Health. UNC’s latest application, submitted June 15, was for a separate set of beds that DHHS made available this year through the CON process.
That decision by state regulators to award 95 more beds to Mission Hospital, despite years of high-profile controversies and repeated safety sanctions by the federal Centers for Medicare and Medicaid Services, surprised local officials who had highlighted the need for alternative providers.
“We look across the state at areas that we identify as having some gaps. We think that there should be more choice in that region, we think that patients are asking for more access, for more options in terms of care, and especially in terms of higher level care that UNC Health can provide,” said Alan Wolf, director of media relations at UNC Health.
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Asheville Watchdog reached out to Mission Health, Advent Health and Novant Health to ask if they also submitted applications for the 92 beds. The deadline for this most recent CON was June 15. A hearing on the applications is scheduled for August, with a ruling expected in December, Wolf said.
UNC’s proposed facility would offer a range of services including emergency care, intensive care, neonatology, labor and delivery, cardiology, gastroenterology, radiology, psychiatry, speech pathology, physical therapy, and occupational therapy.
The proposed site for the hospital is near Westgate Mall and Patton Avenue near Asheville’s downtown. UNC currently has a letter of intent to buy six parcels totaling 21.5 acres of land to develop the hospital, Wolf said.
UNC Health’s new proposal offers a similar range of services to its proposal, in conjunction with its affiliate UNC Health Pardee, that was rejected by DHHS earlier this year, but in a smaller facility and in a different location than the one proposed for the last round of CON applications. One of the comments in last year’s denial from the CON agency was that the proposed location was too close to UNC Health Pardee. The new site is 10 miles north of the previously proposed spot.
Last year the state opened the bidding process after giving approval to add 129 additional hospital beds to serve residents of Buncombe, Graham, Madison and Yancey counties. UNC applied for the UNC Health West Medical Center to build a 129-bed facility in Buncombe County. Florida-based AdventHealth proposed adding the beds to its already approved new facility in Weaverville. Novant Health, based in Winston-Salem, received approval to develop the Novant Health Asheville Medical Center, a 34-bed hospital in Arden. The remainder of the beds were awarded to Mission Hospital.
Novant also applying for expansion
Novant Health confirmed that they also applied for 20 acute care beds from this most recent CON. If approved, these acute care beds would be folded into the Novant Health Asheville Medical Center, which is being built on a 24-acre site in the Biltmore Park Town Square shopping mall.
In their report rejecting UNC’s application for the previous CON, regulators cited the “scope of services” offered as well as project’s “financial feasibility.” AdventHealth is also appealing.
UNC Health already has a presence in the region through a long-term management agreement with UNC Health Pardee, a 222-bed community hospital based in Hendersonville. UNC Health Pardee is owned by Henderson County, with decision-making power held by a local board of directors and Henderson County Commissioners. The UNC relationship with the Margaret R. Pardee Memorial Hospital, initiated in 2011, was extended in 2024 for an additional 15 years. The hospital was renamed UNC Health Pardee in 2023.
As an academic health-system, UNC Health also operates the UNC Health Sciences campus at the Mountain Area Health Education Center (MAHEC), which trains doctors and other healthcare providers.
Dissatisfaction with current options as well as a growing and aging population has motivated UNC to continue to try and expand into Buncombe County.
“As these communities grow, our goal is to grow along with them to ensure increased access to care, closer to home,” said Dr. Cristy Page, CEO of UNC Health.
While other healthcare providers like UNC, Advent and Novant have tried to expand their foothold in the region, Mission’s dominance over the western North Carolina health market was recently expanded when regulators awarded them 95 beds that were earmarked for the region through the CON.
Despite conditional approval from NCDHHS to build its capacity up to 828 patients by 2031, a nearly 13 percent increase, an analysis by the Watchdog found that Mission projected only increasing its staff by 3.7 percent in the next seven years.
Since being purchased by the Nashville-based healthcare provider HCA in 2019, Mission has struggled with an exodus of physicians and nurses, understaffing, and maintaining federal standards of care. Since 2021, regulators at the Centers for Medicare and Medicaid Services have issued four Immediate Jeopardy warnings to Mission Hospital connected to nine patient deaths. This sanction, the most severe warning the agency can issue, threatens that a facility might lose access to Medicare and Medicaid funding due to lapses in patient care.
[This article was updated to clarify the relationship between UNC Health, which is state-owned, and UNC Health Pardee, which is owned by Henderson County. UNC Health manages UNC Health Pardee under a long-term affiliation agreement.]
[Correction: An earlier version of this article incorrectly stated that a hearing for UNC Health’s CON application was scheduled for December. The hearing is scheduled for August, with a final decision expected in December.]
Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Ted Clifford is The Watchdog’s investigative reporter focusing on healthcare. He can be reached at tclifford@avlwatchdog.org. The Watchdog’s local reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.
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