AdventHealth makes its most public case for building region’s second-largest hospital, but has yet to ask the state for permission

Months before it can get official permission from the state, Florida-based nonprofit AdventHealth is seeking public support for a 129-bed expansion of its already approved 93-bed new hospital under construction in northern Buncombe County.

Coupled with an earlier, pending certificate of need (CON) request to the state for 26 additional beds, AdventHealth will be proposing a total of 222 acute care beds for the new facility in Weaverville, making it — if approved by state regulators, and if it withstands possible challenges from Nashville-based for-profit HCA Healthcare — the second-largest hospital in western North Carolina and the first major competitor to HCA Mission Health’s near-monopoly on hospital services in Buncombe County.

Mission Hospital in Asheville has 682 licensed acute-care beds. UNC Health Pardee in Henderson County has 201. The Charles George VA Medical Center in Buncombe County has 119. AdventHealth already operates a 62-bed hospital in Henderson County, according to the Proposed 2026 State Medical Facilities Plan…

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