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Public Comment Open on 3 Proposals for 67 New Hospital Beds in Buncombe County

Would you like to comment on the three applications that were submitted to provide 67 acute care hospital beds in Buncombe County to serve that county as well as the counties of Yancey, Madison, and Graham? The opportunity for the public to comment on the various applications is July 1 through August 1 at 5pm, and there are multiple ways to do that, which will be described later in this post. But first you will need to understand who submitted the applications and what each application includes.

Three organizations have submitted applications to the NC Division of Health Service Regulation for the Certificate of Need (CON) to provide these beds, Advent Health, HCA-owned Mission Hospital, and Novant Health in partnership with Surgery Partners, Inc. Mission Hospital is proposing to expand the number of beds at their existing facility, whereas Advent Health and Novant Health are planning to build new standalone hospitals. Below is a high-level comparison of the applications.

It is much more difficult to provide a succinct comparison of the services and facilities that each application contains because they vary widely, which likely explains why their costs range from $125.0M to $328.7M and the deadlines vary by 2 years.

You can comment on the applications by:

Attending the Department of Health Services Regulation’s public hearing on August 12 at 9:30a.m. at Asheville-Buncombe Technical Community College Asheville Campus, 19 Tech Drive, in the Ferguson Building’s Ferguson Auditorium.

Mailing a letter to:

Healthcare Planning and Certificate of Need Section

Division of Health Service Regulation

2704 Mail service Center

Raleigh, NC 27699-2704


Emailing your comments as an attachment to

Attending the Town Hall style forum to be hosted by the Mountain Maladies Facebook group and Take Medicine Back to be held on Facebook on July 14 starting at 6pm. You can indicate your plan to participate with this link.

You can download and review the exact wording of each of the actual applications, but note, the shortest application is 867 pages (Advent Health) and the longest is 1,349 pages (Novant Health). It may sound daunting, but the documents are searchable, informative, and the incorporated letters of support make for interesting reading.

AdventHealth Buncombe Certificate of Need Application
Download PDF • 130.11MB

Mission Hospital Buncombe Certificate of Need Application
Download PDF • 257.98MB

Novant Health Buncombe Certificate of Need Application
Download PDF • 489.44MB

Various news outlets have published summaries of the applications, see the list of links below, some of which require subscriptions:

If you are curious about how the state determined the need for the additional 67 beds, it is contained in the North Carolina 2022 State Medical Facilities Plan, effective January 1, 2002. The beds are intended to serve the needs in Buncombe, Graham, Madison, and Yancey Counties. You can download the facilities plan here.

The public does not always have a chance to comment on such a major change in healthcare options, so please consider submitting your own comments.


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