Mission Health has requested a judge reconsider the state’s decision to allow non-profit hospital system AdventHealth to bring 26 acute care beds to Buncombe County, potentially delaying the construction of a hospital in Weaverville meant to open in 2027.

Mission Health, owned by for-profit Nashville-based HCA Healthcare, filed an appeal Dec. 20 to the North Carolina Office of Administrative Hearings, stating that the 26 beds were erroneously granted to AdventHealth. Mission, Novant Health, and AdventHealth, each applied in June for the 26 beds through the state’s mandatory Certificate of Need (CON) program. AdventHealth won the application last November, which would allow it to expand its planned Weaverville hospital from 67 beds to 93. 

Mission’s appeal, brought against the North Carolina Department of Health and Human Services and the Division of Health Service Regulation, says those agencies’ decisions curbed Mission’s expansion efforts.

“By denying Mission a CON for the Mission Application, the Agency’s Decision prevents Mission from expanding Mission Hospital to meet the needs of Mission’s existing and future patients and therefore directly limits Mission’s ability to engage in its lawful business,” the appeal said.

“AdventHealth is disappointed that our community will again face delays in receiving access to health care choice,” AdventHealth spokesperson Victoria Dunkle said Monday. “HCA/Mission’s appeal of the State’s decision to award the CON for 26 additional acute care hospital beds to AdventHealth will push back the timeframe for bringing those beds to the people of Buncombe, Graham, Madison, and Yancey counties.”

AdventHealth is confident that the state’s decision will be upheld and the company will continue with the design and architectural planning of the hospital  in the meantime, “so we are ready to add these beds and expand care for our community as soon as we receive a decision on this appeal,” Dunkle said.

Mission’s appeal also chastised DHHS and DHSR for granting AdventHealth the beds because, it said, AdventHealth’s application didn’t adhere to a number of rules.

“AdventHealth has failed to define its patient population to be served, failed to exclude patient populations it will not serve, failed to consider the impact of its existing hospital in Henderson County, and provided utilization projections which are unreasonable and undocumented,” Mission argued in one part of the appeal. 

“Had the Agency properly considered the written comments submitted during the review, it would have found both the AdventHealth Application and the Novant Health Application non-conforming with multiple of the Statutory Review Criteria, which would have rendered both the AdventHealth Application and the Novant Health Application unapprovable.”

Reached for comment, Mission spokesperson Nancy Lindell said, “We strongly believe Mission Hospital can best meet western North Carolina’s growing need for complex medical and surgical care. If we had been awarded the beds, Mission Hospital could have had these beds available in the shortest period of time, beds which are desperately needed by our community. Mission remains committed to acting in the best interest of the broader region and providing the area’s most advanced healthcare.”

An Office of Administrative Hearings judge will have at least 120 days to decide the case, according to a clerk there.

But even then, the battle might not be over. 

Following the judge’s decision, AdventHealth or Mission could appeal to the North Carolina Court of Appeals, the clerk said.

The appeal is yet another step in a years-long process. 

AdventHealth, Mission Health, and Novant Health applied to build a 67-bed Buncombe hospital in June 2022, a bid AdventHealth ultimately won, despite pushback from the other two systems. The victory created the first hospital competition in Buncombe County since Memorial Mission Hospital merged with Asheville’s St. Joseph’s Hospital in 1998.

AdventHealth paid $7.5 million in February 2024 for four adjoining parcels comprising 25.45 acres on Ollie Weaver Road along US 25-70, just west of I-26, according to property records. The hospital is meant to serve patients in Buncombe, Graham, Madison, and Yancey counties. 

In May, Administrative Law Judge Michael C. Byrne concluded in a 50-page decision that the DHSR was correct when it chose AdventHealth over Mission and Novant Health

Following Byrne’s conclusion, AdventHealth confirmed it would pursue the additional 26 acute care beds through a separate CON application.

In February 2024, Mission was sanctioned with immediate jeopardy by the U.S. Centers for Medicare & Medicaid Services. A federal report found 14 patients were put in danger and four died between 2022 and 2023 as a result of deficiencies in care at the hospital. The hospital corrected issues causing that sanction.

HCA and Mission Health also face a lawsuit by former North Carolina Attorney General Josh Stein, who was elected governor last year. The lawsuit alleges that they violated commitments they made in 2019 when HCA purchased Mission Health for $1.5 billion. Those commitments, part of the deal’s asset purchase agreement, regarded cancer care and emergency services at Mission Hospital. Lawyers for HCA countered that it never promised to provide quality healthcare at Mission.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@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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