From Staff Reports 

Mission Hospital filed documents on Dec. 15 in Buncombe County Superior Court signaling its intent to contend a North Carolina Department of Health and Human Services conditional decision to award AdventHealth’s hospital system the right to bring 67 new hospital beds to Buncombe, the Asheville Citizen Times reported on Dec. 22.

Hot on the heels of Mission Health, Novant Health filed documents on Dec. 19 in Buncombe Superior Court in a move indicating that it also will challenge a recent state-level decision allowing AdventHealth to bring 67 new acute care beds to Buncombe and, with them, a news hospital facility, the ACT reported on Dec. 23. 

For Mission, owned by HCA Healthcare, the documents’ filing constituted formally submitting a $50,000 cash bond in what will likely be a forthcoming case against NCDHHS and the Division of Health Service Regulation, the amount necessary to appeal the division’s decision, the ACT noted.

In Novant Health’s challenge, three filings from separate Novant entities ― Novant Health Asheville Medial Center LLC, Novant Health, Inc., and Surgery Partners ― show the hospital system has deposited a $50,000 bond to secure its place in the certificate of need appeals process, the ACT stated.

Mission Health, Novant Health and AdventHealth each submitted applications for a certificate of need from NCDHHS’ Division of Health Service Regulation to build 67 new acute care beds meant to serve residents of Buncombe, Graham, Yancey and Madison counties. 

Under state law, health care providers are required to obtain such a certificate before development or offering a new institutional health service.

On Nov. 22, each of the three contenders for the new hospital in Buncombe received a letter from the DHSR, noting that AdventHealth’s application was approved, and that AdventHealth has not yet received its certificate of need for the 67 beds, the ACT noted in its Dec. 23 edition.

The non-issuance of the CON is, in part, because Mission and Novant are moving to appeal the DHSR decision, the ACT added. Appealing is part of the CON process in North Carolina, with deposits due within 30 days of the decision.

AdventHealth, headquartered in Florida, scored state approval based partly on its application’s conformity with necessary standards, its geographical location — the hospital has expressed a desire to build on empty land once occupied by American Enka, where only an iconic clock tower remains — and its purported ability to establish a more competitive health care market in Buncombe.

AdventHealth also seemed to win — in a landslide — public support in both a public hearing on the certificate of need, and more than 4,000 written comments submitted by members of the public, health care-providers, elected officials and others.

Undeterred by all its lack of success — to date — in the process, Mission’s Dec. 15 filing sets it up to take exception with the state’s decision to select AdventHealth.

Mission’s lawyers — Memphis, Tenn.-headquartered Baker Donelson — wrote in a letter attached to the filings the following:

“MH Mission Hospital, LLLP has retained our firm to represent it in an administrative contested case appeal challenging the conditional approval of a certificate of need application by AdventHealth Asheville Inc. and Adventist System Sunbelt Healthcare Corporation.”

Also attached to the Mission filing was an outlined explanation of the certificate of need appeals process. It notes filing the $50,000 bond signaling an intent to contest the state’s decision is only the first step and does not actually mean an appeal case has started. Another party will have the option to file against the bond.

Meanwhile, Novant’s filing, as noted by the ACT, uses similar language to Mission in its filing, as follows:

“This bond is deposited with the clerk for the sole purpose of providing a bond satisfying the requirements of N.C. Gen. Stat. 131E-188(a1) regarding the decision by the North Carolina Department of Health and Human Services Division of Health Service Regulation, Healthcare Planning and Certificate of Need (“CON”) Section ... awarding a CON to AdventHealth Asheville, Inc. and Adventist Health System Sunbelt Healthcare Corporation ... to develop a new 67-bed hosptial pursuant to the need determination in the 2022 State Medical Facilities Plan.”

Novant and Mission, along with AdventHealth, intended to build a new hospital facility in Buncombe County, as follows:

• Mission proposed expanding its facilities at 509 Biltmore Ave.

• Novant Health Asheville Medical Center was proposed for a 17-acre site next to Biltmore Park in South Asheville.

• AdventHealth, which runs a hospital in Henderson County, plans (as noted earlier) to build at the old American Enka industrial site. "Appeals will likely slow down the process by which AdventHealth will actually receive the CON and therefore a go-ahead to start building,” the ACT noted. “Its proposed plan has the new hospital opening in 2025.”

According to the DHSR’s rules for the CON process in which entities are competing for a single certificate, an administrative law judge has up to 270 days to make a final decision about which applying entity will win.

Both Novant and Mission’s appeals are in the NCDHHS’ hands.

In a Dec. 22 email to the ACT, NCDHHS spokesperson 

Bailey Penington stated to the ACT the following:

“We can confirm that NCDHHS has received two petitions appealing the conditional approval of the Certificate of Need application of AdventHealth Asheville, Inc. and Adventist Health System Sunbelt Corporation (Project ID# B-12233-22) seeking to develop a new hospital with sixty-seven (67) acute care beds, one C-Section operating room and five procedure rooms in Buncombe County, North Carolina and denial of the applications of MH Mission Hospital and Novant Health Asheville Medical Center, as set forth in the Agency’s decision letters and required State Agency Findings issued on 22 November 2022. 

“These petitions were filed with the North Carolina Office of Administrative Hearings by MH Mission Hospital, LLLP and Novant Health Asheville Medical Center, Novant Health, Inc., and Surgery Partners, Inc.”

If the parties further disagree with the decision after it is made, the cases would go to the North Carolina Court of Appeals.

Another development also might affect this ongoing bid for 67 new hospital beds in Buncombe.

As previously reported by the ACT, reports created in response to the 2022 certificate of need process in Buncombe called into question whether or not those 67 beds were actually needed. 

UNC Health Care’s Pardee hospital in Hendersonville unveiled a document in August, stating the need for more beds -— listed in the 2022 State Medical Facilities Plan — was artificially inflated by the COVID-19 pandemic.

The DHSR wrote its own report soon after agreeing with Pardee, but allowing the certificate of need process to move forward regardless.