Just more than a month after judges made what some saw as the final decision in a case over new hospital beds for Buncombe County and the surrounding region, Mission Hospital signaled in the state\u2019s highest court that it\u2019s not giving up a nearly three-year fight over which health system gets to expand in western North Carolina.\u00a0<\/p>\n
Attorneys for the HCA Healthcare-owned hospital filed a\u00a0motion<\/a>\u00a0Wednesday, asking for a temporary stay of a recent three-judge panel appeals court\u00a0ruling<\/a>\u00a0that allowed AdventHealth to move forward with bringing 67 acute care hospital beds to serve Buncombe, Graham, Madison and Yancey counties.<\/p>\n Florida-based nonprofit AdventHealth has since\u00a0started construction<\/a>\u00a0on a hospital in Weaverville.\u00a0\u00a0<\/p>\n Mission\u2019s argument revolves around what it says was \u201csubstantial prejudice\u201d in the DHSR\u2019s decision to reject Mission\u2019s application to install the 67 beds at its Asheville flagship hospital. Mission alleged substantial prejudice because \u201cDHHS did not allow eight attendees to speak at a certain time at the public hearing because they were purported employees of Mission Memorial or employees of one its affiliated hospitals or entities,\u201d according to a summary in the June 18 appellate court decision. That hearing was held shortly after AdventHealth, Mission and Novant Health applied for the 67 beds in spring 2022.<\/p>\n \u201cThe partial answers that the Court of Appeals has given are contradictory and confusing,\u201d Mission\u2019s attorneys wrote in a 42-page motion, arguing the appellate court failed to precisely define the criteria for a finding of \u201csubstantial prejudice.\u201d<\/p>\n Mission\u2019s argument is that the law around substantial prejudice\u00a0 \u201cis so incomprehensible that the Administrative Law Judge assigned to this case included a plea for clarification in his final decision. But the Court of Appeals ignored that plea.\u201d<\/p>\n \u201cBy deciding cases on a murky substantial-prejudice requirement, agencies can avoid judicial scrutiny of their errors. That is harmful to the regulated public and the jurisprudence of this state. Because the Court of Appeals refuses to answer the question, the only remedy is discretionary review by this Court.\u201d<\/p>\n Josh Stein, then the state\u2019s attorney general and Democratic candidate for governor, argued against awarding the beds to Mission\/HCA during the initial 2022 CON application process. \u201cI don\u2019t care which of the other two hospitals that applied get it,\u201d\u00a0he wrote<\/a>, referring to AdventHealth and Novant. \u201cI just want more competition for health care in Western North Carolina.\u201d<\/p>\n \u201cMission has almost no competition for acute care in Buncombe County,\u201d Stein wrote. He said the lack of competition \u201charms residents of Western North Carolina\u201d because it increases costs and reduces quality of local health care services.<\/p>\n Surgical operating room at issue<\/strong><\/p>\n Mission\u2019s attorneys also argued that the NCDHHS had changed a policy requiring new hospitals to have a general operating room. AdventHealth did not propose a general operating room in its original application, according to the motion. \u201cWhen the Department received Mission and Advent\u2019s applications, it assigned an analyst to review them. \u2026 The analyst decided on her own, without consulting her superiors, to change the Department\u2019s longstanding policy that required a general operating room for new hospitals.\u2019\u201d<\/p>\n \u201cMission respectfully asks this Court to decide whether the Department violated the [Administrative Procedure Act, which governs how state agencies operate] when it failed to explain its change in position, and then decide whether this error substantially prejudiced Mission,\u201d Mission\u2019s petition states.<\/p>\n According to AdventHealth\u2019s current\u00a0proposed plans<\/a>, the Weaverville hospital would have, \u201cA state-of-the-art Surgery Suite for general and specialty.\u201d<\/p>\n The motion uses both arguments \u2014 one against the judicial system and one against the health department \u2014 to contest decisions in several courts that the choice to let AdventHealth to build the beds was the right one.<\/p>\n \u201cNCDHHS is aware of the filing. NCDHHS does not comment on pending litigation,\u201d Hannah Jones, a department spokesperson, said when asked about Mission\u2019s newest argument, in which both the department and AdventHealth are defendants.\u00a0<\/p>\n This complex legal battle for beds is being staged on the field of certificate of need (CON) law, a North Carolina rule requiring that medical facilities ask the state\u2019s permission when they want to expand, add services, or buy expensive equipment.\u00a0<\/p>\n AdventHealth: \u201cDeliberate Intent to Delay\u201d<\/strong><\/p>\n AdventHealth won approval for the 67 acute care beds in late 2022 following a formal application and vetting process beginning that spring. But ever since, Mission has contested that decision, using the CON\u2019s appeal process.<\/p>\n \u201cMission\/HCA\u2019s filing of yet another appeal and decision to escalate this matter to the North Carolina Supreme Court is a deliberate attempt to delay what the community has clearly said it wants: health care choice and competition,\u201d Victoria Dunkle, a spokesperson for AdventHealth, wrote in an email.<\/p>\n \u00a0\u201cAdventHealth intends to file a response precisely describing why there is no merit to this latest action by Mission\/HCA. The North Carolina Court of Appeals has already upheld the State\u2019s approval of our Certificate of Need (CON) for a 67-bed hospital in Buncombe County, affirming the Department of Health and Human Services\u2019 original decision. Even Mission\/HCA has acknowledged that AdventHealth\u2019s hospital will eventually be built. We are disappointed that Mission\/HCA continues to choose this path.\u201d\u00a0<\/p>\n AdventHealth applied for and won another CON bid for 26 more acute care beds. Mission also opposed this bid, wrapping it up in a second legal battle. AdventHealth announced last month it plans to apply for another 129 beds this October, bringing the total beds intended for the planned Weaverville hospital to 222.<\/p>\n Mission did not respond to previous questions about whether it would apply for these 129 beds, but said Thursday it believed it was the best pick for health care services in the region.\u00a0\u201cWe strongly believe Mission Hospital can best meet Western North Carolina\u2019s growing need for complex medical and surgical care,\u201d Katie Czerwinski, a Mission\/HCA spokesperson, said when asked for comment on the motion. \u201cMission remains committed to acting in the best interest of the broader region and providing the area\u2019s most advanced healthcare.\u201d<\/p>\n Currently,\u00a034 other states<\/a>\u00a0have CON laws similar to North Carolina\u2019s. While some argue these laws cap unnecessary\u00a0medical service bloat<\/a>, others say they favor larger health care systems because of the complex and difficult approval process that doesn\u2019t really improve access to or quality of health care.\u00a0<\/p>\n Asheville Watchdog welcomes thoughtful reader comments on this story, which has been republished on\u00a0our Facebook page.<\/a>\u00a0Please submit your comments there.<\/p>\n Asheville Watchd<\/a>o<\/a>g<\/a>\u00a0is 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\u2019s 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\/<\/a>.<\/p>\n Republish This Story<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/07\/AdventHealth-Buncombe-scaled.jpeg.webp\")
An aerial view photo shows the Weaverville site where AdventHealth is proposing to build a 222-bed hospital in the coming years. Credit: AdventHealth<\/a><\/p>\n
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