Three of the state's largest health systems are carrying their battle over hospital beds into overtime.

Earlier this month, regulators approved Rex Healthcare's plan to build a 50-bed hospital in Holly Springs and add a new tower on its main Raleigh campus for a heart and stroke facility. They also said WakeMed could add 51 beds — 22 at its Cary campus and 29 at its main campus on New Bern Avenue in Raleigh.

But regulators with the Department of Health and Human Services denied Rex's request to build a 40-bed hospital in Wakefield and WakeMed's application to add 79 beds on its main Raleigh campus.  And Winston-Salem-based Novant, which has been trying to enter the lucrative Triangle health care market, was shut out completely. It had hoped to put a 50-bed hospital in Holly Springs.

Now all three are appealing the ruling, a move that sets up a long legal fight that could postpone a final decision for several years.

Duke University Hospital's plans to renovate and expand the Duke Eye Center are moving forward.

The hospital last month filed for state approval of its project and plans a public hearing at 10 a.m. on Oct. 18 in the Brown Building on the Dix Hospital campus.

The project calls for adding 127,000 square feet to the existing space. Half of the new space will be dedicated to clinical services and half to physician and hospital administrative offices. In addition to the expansion, Duke plans to renovate part of the existing eye center.

Duke hopes to have the new facilities completed by July 2016. The cost is estimated at $71 million.

Last year, Duke received a $12 million donation toward the center from LC Industries, a Durham nonprofit and the country's largest employer of blind and visually impaired people.

Under the Certificate of Need laws, the state regulates major medical projects and expansions to help control health costs.
 

Wake County's largest hospital has won approval from state regulators to expand its rehabilitation facility.

The $2.4 million project will allow WakeMed to renovate existing space and add 14 rehab beds at its flagship campus in Raleigh. That will give WakeMed 98 rehab beds, allowing it to treat more patients and provide more specialized care.

Rehab services include helping patients recover after a stroke, traumatic injury or major surgery. Demand is surging, driven by this region's growing and aging population.

State regulators this week approved WakeMed's proposal and rejected bids from Duke Raleigh Hospital, UNC Hospitals in Chapel Hill and Johnston Memorial Hospital in Smithfield. At least one of those rival hospitals are likely to appeal, and a legal fight could at least delay when WakeMed starts its project.

Novant Health, a Winston-Salem hospital chain eager to expand into the Triangle, has suffered a setback in that effort.

Novant last year won permission from state regulators to build a surgery center in Holly Springs, its first major foothold in this region. But Raleigh hospitals WakeMed and Rex Healthcare appealed the decision, contending that Novant used inaccurate information in its application.

An administrative law judge recently agreed. The judge, Donald Overby, recommended that Novant's project should be denied, in part because Novant's "financial projections are not credible, reliable or reasonable."

He also determined that WakeMed's proposal to add operating rooms at its Cary campus was superior and should be approved.

Nearly two years after winning regulatory approval for Wake County's fifth hospital, WakeMed is moving ahead with plans to expand its medical campus in North Raleigh.

The Raleigh-based health system postponed construction of WakeMed North Hospital when the economy cooled and officials turned their attention to other expansion projects, including a $99 million patient tower and children's hospital at its main campus.

WakeMed will announce today that it expects to break ground on the 61-bed hospital focused on women's services this fall and open it in late 2013.

"We shuffled several projects last year, but the economy is coming around, we think," said WakeMed CEO Bill Atkinson. "The timing is very good" because the weaker construction market has reduced costs for materials and labor.

Cary Urology has won another victory in its fight to build a $9.8 million prostate-cancer center in east Raleigh.

The N.C. Division of Health & Human Services on Tuesday approved a ruling by state regulators last fall to allow the project to move ahead.

The UNC Health Care System opposed the initial decision, arguing that the new center would duplicate cancer services already provided at existing hospitals in the area.

UNC officials will decide within the next 30 days whether to continue appealing the decision, said spokeswoman Karen McCall. If UNC appeals again, the case would go to the N.C. Court of Appeals, and create further delays for the project.

The Triangle's three largest health systems have appealed a decision by state regulators that would allow a Winston-Salem chain to establish a foothold in Wake County's fast-growing medical market.

In July, regulators approved a plan by Novant Health to build a surgery center in Holly Springs with three operating rooms. Regulators also rejected applications by WakeMed, Rex Healthcare and Duke Raleigh Hospital to add the ORs at their facilities.

By appealing the ruling, the Raleigh hospitals are setting up a long legal fight that will postpone a final decision until at least next year.

The county's established health providers don't want to face a powerful new competitor on their home turf. Novant owns hospitals in the Triad and Charlotte markets, and has made it clear it wants to expand into this region.

Holly Springs, a fast-growing western Wake town that has been seeking a hospital, will get a surgery center instead.

State regulators today approved Novant Health’s application to build a surgery center with three operating rooms. It would be the first facility in Wake County for the Winston-Salem hospital chain.

Novant hopes this initial toehold will ultimately lead to the building of a new hospital in Holly Springs, said spokeswoman Kati Everett.

“We’re excited to be able to start honoring a commitment we made to folks several years ago,” she said.

Novant worked closely with Holly Springs officials on a previous proposal to build a $100 million community hospital in the town that would have included 41 beds and four operating rooms.

State regulators rejected the application last year, saying Novant didn't adequately demonstrate need for a hospital in Holly Springs, and that the project might not be cost-effective.

State regulators have approved Rex Healthcare's plan to build a $60.1 million cancer center at its main campus in Raleigh.

The five-story addition is part of a bigger expansion planned at Rex's campus. It's also the latest in a series of major medical projects underway or planned across the Triangle.

The N.C. Cancer Hospital at Rex will coordinate patient care with the $207 million N.C. Cancer Hospital in Chapel Hill, which the UNC Health Care System opened last fall. UNC bought Rex 10 years ago.

Rex, which is Wake County's second-largest hospital after WakeMed, is expanding its cancer services to handle increasing demand from this region's aging and growing population.

"This is exciting news for all of us, and especially for the many cancer patients who we serve," Rex CEO David Strong wrote in an e-mail to hospital employees today.

State regulators say that Wake County needs more than 100 new hospital beds, setting up a brawl among this region's largest medical providers.

To control health costs, the state puts limits on how many hospital beds are allocated by county each year, based on patient volume, projected population growth and other factors.

The proposed N.C. State Medical Facilities Plan includes 102 additional beds that will be needed in Wake County by 2013. The state's largest metropolitan area, Charlotte's Mecklenburg County, will need 101 beds, the plan states.

Wake's existing hospitals WakeMed, Rex and Duke Raleigh will apply to add the new beds on their campuses or to build new facilities. And outside providers that want to establish a foothold in the fast-growing market also will likely be contenders.