Wednesday marks the deadline for health systems to submit proposals for an acute bed expansion in North Carolina.
Four major North Carolina health systems are vying to build or expand hospitals in Buncombe County. AdventHealth, Mission Health, Novant Health and UNC Health have all expressed interest in bids.
Whichever health system wins the bid will be able to expand its area of care to the region. This area covers 23 counties, including Buncombe, Haywood, Henderson and Jackson. Western North Carolina is a mountain region with a population of about 1.15 million people, accounting for about 11 percent of the state's total population.
The North Carolina Department of Health and Human Services (NCDHHS) included a need for 129 acute care beds in Buncombe County in 2025 in its latest State Medical Facilities Plan (SMFP).
UNC Health told Newsweek on Wednesday that it submitted a plan with the state's Certificate of Need office to develop UNC Health West Medical Center (UNC Health West), a new, 129-bed community hospital in Buncombe County.
The new facility plan includes emergency care, labor and delivery services, inpatient acute care and adult psychiatry services.
"UNC Health West builds on UNC Health Pardee's record of public service and proven experience and dedication to the western region and UNC Health's commitment to the health and wellness of our state, resulting in increased access and improved care for the residents of Buncombe and surrounding counties," UNC Health told Newsweek.
Novant Health announced in September that it submitted its proposal to build a hospital in western North Carolina.
The plan includes acute care beds, an emergency room, imaging and pharmacy services.
"We remain deeply committed to extending high-quality, compassionate care to Western North Carolina," a Novant Health spokesperson told Newsweek. "Over the past year, we've worked closely with the community and local physicians to grow our specialty care network in the region and have applied for a 34-bed hospital in Buncombe County."
Novant is based in Winston-Salem and has 19 hospitals and hundreds of outpatient locations and physicians' clinics in North Carolina and South Carolina.
Mission Health, part of HCA Healthcare, expressed its plan to apply for the 129 beds, confirming the plan to the Asheville Watchdog earlier this month.
AdventHealth has also thrown its hat in the ring. The health system said in July that this expansion "reflects the voices of the community and AdventHealth's commitment to delivering more access, more choice, and more whole-person care to Western North Carolina."
"This hospital is more than a location -- it is a vision," Brandon Nudd, president and CEO for AdventHealth Hendersonville and AdventHealth Polk, said in a statement. "It is a promise to Western North Carolina that more not-for-profit, whole-person care is not only coming but also evolving. These additional beds will allow us to meet the growing needs of our region and deliver the high-acuity, compassionate care our communities deserve."
AdventHealth is also building a hospital in Weaverville, North Carolina. This facility was approved by the NCDHHS in 2022 after the North Carolina State Medical Facilities Plan listed a need for 67 acute care beds to serve Buncombe, Graham, Madison and Yancey Counties.
Mission Health/HCA appealed the decision, leading to a legal battle in 2023 that has delayed the process. In November 2024, AdventHealth announced that the state approved an additional 26 beds for the Weaverville location.
Per North Carolina's Certificate of Need (CON) program, the major health construction projects require state approval. DHSR has from 90 to 150 days to review a CON application. Each application is reviewed against the review criteria in the CON Law and any applicable rules adopted by DHSR.