Asheville Business -- June 19, 2026: A massive commercial shift is brewing on Patton Avenue. UNC Health has officially filed a Certificate of Need (CON) application with state regulators for a proposed 92-bed acute care hospital, dubbed UNC Health West. While the medical expansion is a major healthcare story, the real estate strategy behind it is shaking up the local business community: the health system is targeting the prominent Westgate Shopping Center site.
The Real Estate Play
According to state filings, UNC Health has secured a letter of intent to purchase six parcels totaling nearly 22 acres at the Westgate site. The projected cost for the entire hospital project is a staggering $747.4 million.
For current commercial tenants at Westgate, the news brings a mix of anticipation and caution. Property management has already notified business owners of the pending sale. However, early indications suggest that existing retail and business operations won't face immediate disruption.
One Westgate business owner, speaking on the condition of anonymity, noted that tenants were told the property purchase is being treated as a long-term asset. The owner has no immediate plans to do anything with it other than what it is doing now, the tenant shared. Because a hospital project of this scale requires years of regulatory approvals and construction, any physical transformation of the plaza is likely a long-term play, with UNC Health projecting an opening date of late 2032 if approved.
The Corporate Battle for Buncombe County
The filing is the latest move in a highly competitive multi-billion-dollar chess match between North Carolina’s largest healthcare systems. Because the state utilizes a strict Certificate of Need (CON) process to prevent the over-saturation of hospital beds, systems must fiercely compete for state-allocated quotas.
UNC Health’s regional strategy is currently running on two parallel tracks:
The South Asheville Track: UNC Health and AdventHealth are currently appealing a state decision from late 2025 that initially favored expansions by Mission Hospital (HCA Healthcare) and Novant Health. A decision on that appeal is expected by early 2027.
The Westgate Track: This new 92-bed application is an entirely separate bid under the state’s 2026 allocation pool.
UNC Health officials have clarified that they are aggressively pursuing both paths but will hedge their bets based on regulatory outcomes. A spokesperson confirmed that the system will ultimately develop only one acute care hospital in Buncombe County, depending on which project secures final state approval.
The project is structured as a joint partnership between Chapel Hill-based UNC Health and Hendersonville’s UNC Health Pardee. System executives emphasized that the Westgate location would dramatically increase non-profit healthcare access for a five-county mountain footprint, including Buncombe, Madison, Yancey, Graham, and Clay counties.
Economic Outlook
If approved, the $747.4 million capital investment would represent one of the largest economic development projects in Asheville’s recent history, radically altering the commercial landscape of the Patton Avenue corridor and creating hundreds of high-wage healthcare and construction jobs over the next decade.
State regulators will review the application in the coming months, with public hearings expected later this year. For continuous, daily regional updates on this developing story and more local business breakthroughs, readers can check wnctimes.