Two faith-based, nonprofit health systems are pushing back against Nashville, Tenn.-based HCA Healthcare's expansions in Western North Carolina and Central Virginia, two high-growth areas that are seeing increased competition among providers.
Virginia
Cincinnati-based Bon Secours Mercy Health, a 49-hospital, Catholic system, has a prominent presence in Central Virginia and has pushed back against HCA's plans to build a $21 million ambulatory surgery center with three operating rooms in Hanover, Va.
In June, HCA received approval to build the ASC. Virginia's state department of health had previously rejected two separate certificate-of-need applications from the for-profit system to build a hospital and a freestanding emergency facility in the area.
HCA is planning for the Hanover ASC to be first piece of a larger expansion, which would also include a 60-bed hospital, a freestanding emergency room, a second medical office building and a potential 90-bed hospital expansion.
Construction of the ASC is expected to begin in 2026 and be completed in 2027. But HCA would still need to get approval from state officials to build the other planned facilities.
Hanover is a wealthy area of Virginia in which the population is growing, and Bon Secours claims HCA is trying to take away market share from its existing hospital in the area. HCA argues that it is expanding access to care close to where its patients live and work.
"The surgical center would significantly benefit our patients by improving access to high-quality surgical services from their preferred health system at a location much closer to home," a spokesperson for HCA told Becker's.
Earlier this month, Bon Secours broke ground on a 10-bed, freestanding emergency facility in Hanover. The system intends to use the facility to treat patients in need of emergency care and transfer those needing inpatient care to Bon Secours Memorial Regional Medical Center in Mechanicsville, Va., for direct admission, bypassing the hospital emergency department.
"These expanded emergency and imaging services will help to decompress high volumes on the main campus of our award-winning Bon Secours Memorial Regional Medical Center while also improving medic reliability and emergency transport times for the Hanover community and beyond," John Emery, president of Bon Secours' Memorial Regional and Rappahannock General hospitals, said.
North Carolina
Altamonte Springs, Fla.-based AdventHealth, which operates more than 50 hospitals across multiple states, aims to curtail HCA's growth in Western North Carolina, appealing several of Mission Health's recent CON applications to build a freestanding emergency facility.
Last fall, AdventHealth Hendersonville and AdventHealth Asheville appealed the CON application for Mission's planned $29 million freestanding ED in Candler, N.C. HCA pushed back against the appeal, arguing that emergency rooms across the country are seeing a rise in patients and longer wait times post-pandemic.
"This ER is an imminent solution to help meet the needs of our community and bring additional access to emergency care in Buncombe County," a spokesperson for Mission told Becker's last October. "It is disappointing other hospitals that regularly send their patients to Mission for a higher level of care would actively work to stop better access to emergent care for our communities."
AdventHealth, a Seventh-day Adventist nonprofit system, in May received approval to build a $254 million, 67-bed community hospital in Weaverville, N.C. Mission previously appealed the state's initial approval of the hospital, leading to a trial last fall. Winston-Salem, N.C.-based Novant Health also wanted to build a 67-bed hospital in the area, but dropped out of the process.
"We are confident in the state's decision to award AdventHealth Asheville the CON for the new hospital," Brandon Nudd, president and CEO of AdventHealth Hendersonville, said in a news release. "With the purchase of the property in Weaverville, we are ready to move forward building this hospital."
HCA said it was "disappointed" in the office of administrative hearings' decision to uphold the awarding of 67 acute care beds to AdventHealth.
"This will not solve the need to transport high-level, critical care patients out of the area when our region's advanced care beds — only available at Mission Hospital – are full," a spokesperson for Mission said in a May 13 statement to Becker's. "Mission Health remains committed to providing the region's most advanced healthcare and will continue to take our community's evolving health needs into account as we look to the future."