HCA vs. AdventHealth: North Carolina Supreme Court halts ruling in hospital turf war – Becker’s Hospital Review | Healthcare News

The North Carolina Supreme Court has temporarily halted a state appellate court ruling in an escalating certificate-of-need dispute between Asheville, N.C.-based Mission Health and Altamonte Springs, Fla.-based AdventHealth, underscoring a fierce competition to expand in Western North Carolina, according to The Carolina Journal. 

The July 26 court order granted Mission’s motion for a stay, pausing a decision that affirmed the North Carolina Department of Health and Human Services’ approval of AdventHealth’s proposal to build a new 67-bed hospital in Weaverville, N.C. The planned facility would serve Buncombe, Graham, Madison and Yancey counties.

Under state law, providers must obtain a CON before adding hospital beds. Mission Health, operated by Nashville, Tenn.-based HCA Healthcare, had proposed expanding its existing campus by the same number of beds and asked the state’s high court to intervene, arguing the case raises fundamental questions of administrative law.

Mission Health’s petition argued that courts have failed to clearly define what qualifies as “substantial prejudice” under the state’s Administrative Procedure Act, making it difficult to challenge the state department of health’s actions effectively.

The for-profit health system also alleged that state regulators quietly abandoned a longstanding policy requiring new hospitals to have at least one licensed general operating room — a requirement the AdventHealth proposal did not meet.

A spokesperson for HCA said in a statement to Becker’s, “We strongly believe Mission Hospital can best meet Western North Carolina’s growing need for complex medical and surgical care. Mission remains committed to acting in the best interest of the broader region and providing the area’s most advanced healthcare.”

Victoria Dunkle, a spokesperson for AdventHealth’s North Carolina market, said Mission Health’s Supreme Court appeal is a “deliberate attempt to delay what the community has clearly said it wants: healthcare choice and competition.” She added that AdventHealth plans to respond, and that “this continued legal maneuvering does not change the facts.”

The Weaverville hospital proposal is only one front in a larger rivalry. 

HCA and AdventHealth have clashed repeatedly over CON approvals, emergency department expansions and other growth efforts across the region.

AdventHealth’s planned hospital, now approved for 93 beds after a recent CON expansion, has received backing from state leaders, including North Carolina Gov. Josh Stein. In a Dec. 2 statement, Mr. Stein urged the health department to reject Mission Health’s proposal to “help people get higher-quality, more affordable care when they need it.”

The legal battle is unfolding alongside a separate lawsuit from Mr. Stein’s office against HCA, which alleges the system has reduced emergency and cancer services in violation of its 2019 asset purchase agreement with Mission Health. HCA denies the claims and says it is meeting its obligations.

With Mission Health’s Supreme Court petition pending and state healthcare policies potentially shifting under new political leadership, this hospital turf war could shape how competition, access and regulation intersect in North Carolina and potentially beyond.