The Triangle's three main health systems are once again in a heated battle, this time over which hospital can expand core services.
North Carolina tightly regulates health services and caps the number of licensed acute care beds in a county or service area. N.C. Department of Health and Human Services regulates health services through the Division of Health Service Regulation. In Wake County, it is increasing the cap on licensed acute care beds by 44 to 1,553.
UNC Health, Duke Health, and WakeMed Health all applied for these beds broken down as follows:
- Duke Raleigh Hospital: 41 acute care beds, estimated $14 million budget
- UNC/Rex Hospital: 44 acute care beds, estimated $8.7 million budget
- WakeMed Cary: 9 acute care beds, estimated $1.8 million budget
- WakeMed North: 35 acute care beds, estimated $158 million budget (also applying for 15 observation beds which are regulated differently from acute care beds)
Regulators will consider which applications best serve Wake County's needs and then allocate the beds. Hospitals could see their applications partially approved, but regulators will approve no more than a total of 44 beds.
The state regulates a variety of equipment, services, and facilities, but these acute care beds are among the most highly coveted because they serve as the backbone of any hospital. These beds are effectively the capacity of any hospital, so if a hospital wants more inpatients, it needs more licensed beds. From a business perspective, patients — especially those with private insurance — are the customers of a hospital.
Regardless of the initial award, it is nearly certain that the hospitals that lose their bid will file an appeal. That process is handled by the Office of Administrative Hearings, and can take months to be resolved. For example, on Aug. 15, 2022, WakeMed filed an application to develop a new 31-bed hospital in Garner. It received initial approval on Jan. 27, but final approval after appeals came on July 14, nearly a year after the initial application.
The cost to add new beds can vary widely. The proposed budget for that new Garner hospital is $214 million because it will require significant new construction. The budgets in this latest application are relatively low because hospitals can add these licensed beds in existing or renovated space.
Editor's Note: This story has been corrected to reflect the estimated budget for the WakeMed North Application. The correct proposed budget is $158 million.
