The North Carolina Office of Administrative Hearings has reaffirmed the approval of Mission Health’s certificate-of-need application for a $29 million freestanding emergency department in Candler, N.C., about 11 miles west of Asheville.
Mission Health, a division of Nashville, Tenn.-based HCA Healthcare, plans to use the facility to expand emergency care access for communities west of Asheville and help reduce the number of patients traveling to Mission Hospital’s main ER for emergency treatment.
The freestanding ED received state approval in 2023, but the decision was overturned following an appeal by Altamonte Springs, Fla.-based AdventHealth. An administrative judge had ruled that the North Carolina Department of Health and Human Services failed to hold a public hearing before granting the CON. The latest ruling reinstates Mission Health’s approval, clearing the path for the facility’s development.
“Mission respects the work of the administrative law judge in the CON appeal process, and we are gratified he has affirmed our CON application for the West Asheville ER,” Mission Health CEO Greg Lowe said in a March 14 news release shared with Becker’s. “This ER will help meet community needs and expand emergency care access in Buncombe County. We look forward to continuing to provide exceptional care with this new facility.”
This marks Mission Health’s second freestanding ED in the region in recent months; the system opened a similar facility in Arden, N.C., in November.
The CON dispute underscores ongoing competitive tensions between Mission Health and AdventHealth, both of which are vying for market share in Western North Carolina, a region experiencing rapid growth.
AdventHealth has consistently opposed HCA’s expansion efforts, filing multiple CON challenges against proposed freestanding EDs. HCA has countered with legal challenges of its own, including a recent dispute over AdventHealth’s planned hospital in Weaverville, which led to a trial in fall 2023. North Carolina officials recently approved AdventHealth’s CON application to add 26 beds to the Weaverville hospital.
