AdventHealth Weaverville Hospital Plans Move Forward But Bed Count Unclear

Plans to build an AdventHealth hospital on the US 25/70 corridor west of I-26 moved ahead after a key legal hurdle, but it is still unclear whether the facility will open with 67, 93, or as many as 222 beds, a decision that will shape services and jobs across Buncombe and neighboring counties.

AdventHealth was granted a Certificate of Need (CON) for 67 beds in 2022; that original approval included labor and delivery, intensive care unit beds, a full emergency department and surgical suites. The North Carolina CON law requires health providers to obtain approval from the Department of Health and Human Services before offering a new institutional health service. In December the N.C. Supreme Court declined review of the final appeal tied to the 2022 CON, closing that portion of the legal process and clearing the way to move forward with construction of the planned 67-bed hospital.

The company has pursued additional capacity. A proposal for 26 extra beds was granted in November 2024 but remains under appeal. In July 2025 AdventHealth submitted a CON application for a further 129 beds, which would bring the campus total to 222 beds if all approvals are granted. The DHHS review window for applications submitted Oct. 15, 2025 is 90-150 days, meaning regulators remain responsible for timing and final determinations on the larger expansion.

AdventHealth spokesperson Victoria Dunkle said the 222-bed option would enable expanded cardiac, stroke, advanced neonatal, trauma-capable emergency and comprehensive cancer services. Company materials emphasize "whole-person care" design elements and outline partnerships with local colleges and federally qualified health centers to support workforce development and equitable access. AdventHealth projects roughly $700 million in phased investment to build the Weaverville campus and estimates the project could create hundreds to thousands of jobs as programs expand.

Work at the Weaverville site has begun in stages: grading work is under way and an official groundbreaking was delayed by the legal process. AdventHealth held a community luncheon at the site in November 2025 to engage neighbors about the project and its potential regional economic impact.

For residents of Buncombe County, the unresolved bed count matters beyond construction timelines. A larger facility would broaden high-acuity care options locally, reducing travel for cardiac, stroke and neonatal services and potentially easing pressure on Asheville hospitals. It would also affect local hiring and training partnerships with community colleges and safety-net clinics. If appeals or DHHS rulings change, the scale of clinical services and job creation could shift.

Next steps hinge on pending appeals and DHHS decisions on the additional CON applications; regulators’ rulings will determine whether Weaverville opens with the initially approved 67 beds or with a significantly expanded scope of care.