There are still plans to open an AdventHealth hospital in Weaverville, but the number of potential beds is still in question.

While a public discussion occurred during December regarding the hospital, a decision on whether it has 67 or 93 or 222 beds is still forthcoming. 

The North Carolina Certificate of Need (CON) Law requires health care providers to obtain a CON from the Department of Health and Human Services before developing or offering a “new institutional health service,” according to the DHHS website. AdventHealth was granted a CON for 67 beds in 2022 and the original CON included labor and delivery, ICU beds, a full emergency department and surgical suites. Progress was slowed on starting the project, due to legal issues. In December, the N.C. Supreme Court made the decision to decline review of the final appeal related to the State’s approval of AdventHealth’s initial Certificate of Need for its proposed Weaverville hospital.

According to a press release, “The Court’s action brings the legal process to a close after three years and allows AdventHealth, a faith-based, not-for-profit, to move forward with construction of the planned 67-bed hospital, expanding access to care for families across Buncombe, Graham, Madison, Yancey and surrounding counties.”

AdventHealth’s proposal for 26 additional beds was granted in November 2024, but this decision is under appeal.

The court’s decision in December was only on the first CON. Besides the proposal for 26 additional beds, AdventHealth also submitted a CON for an additional 129 beds in July 2025, which would bring the total to 222 beds if each CON is granted. The overview page on the DHHS site states that the agency has 90 to 150 days from the date applications are submitted, which was Oct. 15, 2025, to review and render its decision on the additional 129 beds. 

“AdventHealth’s 222-bed hospital would create the scope and scale to bring higher acuity care to patients in Western North Carolina and will lead to another option for tertiary care and trauma services in the region,” AdventHealth Spokesperson Victoria Dunkle said. “Adding 129 beds to the approved 93-bed hospital in Weaverville will allow AdventHealth to develop an interventional cardiology program and stroke center, a trauma-capable emergency department, advanced neonatal care and a comprehensive cancer program.”

While grading work has begun on the spot where the new hospital will be located off US 25/70 in Weaverville, just west of I-26, AdventHealth was not able to officially break ground in 2025 due to the legal process. In November 2025, AdventHealth held a luncheon at the site as a “thank you” to the community.

The proposed expansion will assist AdventHealth in caring for residents in Buncombe, Graham, Madison and Yancey counties, it has said. That coverage area has only one current hospital and the new facility will be the first new hospital in this service area in more than 100 years.

“Expansion makes it possible to develop a more robust cardiac program anchored by a cardiac catheterization lab, with capacity to grow into higher-acuity cardiac services as the region needs them,” Dunkle said. “It supports the build-out of a comprehensive cancer program, including medical oncology and radiation oncology, so no patient must travel past the hospital for essential cancer care. The increased scale strengthens readiness for trauma care, enabling EMS partners to bring more patients directly to the facility and ensuring rapid response for life-threatening emergencies. With more beds, the hospital can expand maternity, surgical and inpatient services for a growing and aging population and provide future specialty programs aligned with regional demand.”

AdventHealth is a faith-based, not-for-profit organization that has spent several years meeting with groups and leaders in the community asking what kinds of health care is needed. The hospital in Weaverville would, according to Dunkle, bring advanced emergency, inpatient, cardiac, cancer and surgical care closer to people in Buncombe, Graham, Madison and Yancey counties, reducing patients’ burden of travel and improving outcomes for time-sensitive conditions.

“People across our mountain communities have been very open with AdventHealth about their needs. They tell us they deserve close, reliable access to high-quality care, yet many families travel long distances for advanced services, face gaps in specialty care and endure extended wait times,” Dunkle said. “Through these relationships, we have learned more about the region’s unique health needs. The people in these communities want choice and competition – specifically additional options for emergency and specialty care. They want this access to care in a convenient location.”

Dunkle answered several questions about the new hospital:

Whole-person care drives every design decision, from natural light and quiet spaces to technology that helps families stay involved even when they cannot be physically present. Care teams are trained to see each patient as a whole person, listening with compassion and supporting their healing in body, mind and spirit. Whole-person care isn’t an added layer; it is foundational to how AdventHealth helps people feel whole, beginning the moment they walk through our doors.

How do you envision this project improving health care access and reducing wait times or transfer needs across Western North Carolina?

By offering expanded inpatient capacity, advanced specialty care and tertiary capabilities, the hospital will significantly reduce the number of patients who must leave their community for care. It will help shorten wait times across emergency, cardiac, oncology and surgical care by providing another high-acuity access point in a region that has long lacked sufficient capacity. Proximity to advanced emergency and trauma-capable care means EMS teams can transport patients more efficiently, improving survival and freeing local resources for additional calls. Ultimately, this project ensures people receive timely, connected and high-quality care in the communities where they live, work and raise their families.

How does AdventHealth assess and plan for equitable access — including rural residents, seniors and underserved communities?

AdventHealth’s planning is grounded in regional health-needs assessments, community listening sessions and direct engagement with local leaders — honoring the stories of access barriers that our community has shared for years. The shaping of AdventHealth’s new hospital in Weaverville has included ongoing outreach and partnerships with numerous Federally Qualified Health Centers (FQHC). These relationships have provided a source for understanding in our commitment to considering and addressing the needs of underserved communities. Services and programs are designed to reduce those barriers, including long travel distances, lack of transportation, limited specialty options and mobility challenges for seniors. Financial assistance ensures cost is not a barrier to essential care, and integrated supports such as spiritual care, behavioral health and language access help patients feel understood and safe. By striving to place tertiary care in a location intentionally selected for rural accessibility, AdventHealth reinforces its commitment to equity across every ZIP code.

What workforce considerations are you planning for — from recruitment and training to partnerships with local colleges and universities?

The project begins with the creation of approximately 1,300 new jobs in phase one, with continued growth as tertiary programs expand. AdventHealth is partnering with local colleges, universities and technical programs to build training pathways for nursing, allied health and support roles to help young people across the region build careers close to home. AdventHealth is also partnering with local school systems throughout the region to create pipelines for students interested in health care careers. Recruitment focuses on individuals who feel called to serve, supporting a culture centered on compassion, safety and whole-person care. Team members will be supported with advanced clinical technology, professional development opportunities and a culture grounded in belonging and well-being.

What does this project mean in terms of local jobs, long-term investment and economic impact for the Weaverville and Buncombe County area?

The Weaverville campus represents a projected $700 million+ investment in realistic, achievable stages, as it grows through its planned phases, signaling a long-term commitment to the region’s health and vitality. It will create hundreds of clinical, operational and support positions in the first phase alone, with meaningful growth as tertiary programs expand and additional beds come online. As a major economic anchor, the hospital will stimulate nearby business growth, housing development, educational partnerships and community infrastructure. This project also serves as a committed partner in addressing regional health priorities, investing in programs that support mental health, chronic disease management, food access and whole-person well-being.