ENKA, N.C. (828newsNOW) — When AdventHealth officials asked for feedback Wednesday night about their proposed hospital in Buncombe County, one of the first comments from the audience wasn’t about beds or permits — it was about food.

“We are serving crap to people in hospitals,” one resident said during a listening session at the Enka-Candler Library, urging AdventHealth to source produce from local farmers and offer healthier options for patients.

The exchange underscored the broader stakes surrounding the project: Buncombe County, home to more than 275,000 residents, has just one hospital — Mission Health in Asheville. AdventHealth’s plan would mark the first new hospital in the county in a century, promising to expand access, create competition and reshape the region’s health care landscape.

The $300 million proposal calls for a 222-bed facility on 30 acres in Weaverville, with an emergency department, intensive care, women’s services and specialty physician offices. Leaders said the hospital could generate more than 1,000 jobs once open.

“For a county of 275,000 people to have just one hospital, people feel like they don’t have enough options,” Graham Fields, an AdventHealth administrator, said. “The number of beds equates to scope and the ability to handle more serious situations like strokes and heart attacks.”

Behavioral health care was another recurring theme Wednesday. AdventHealth leaders noted that a third of the beds at their Hendersonville hospital are devoted to behavioral health, including inpatient units for women and adolescent girls. They said they hope to expand those services in Buncombe County through inpatient and outpatient programs.

Residents who turned out Wednesday also pressed the nonprofit on staffing levels.

“Between 4 to 1 and 5 to 1 from a med surge standpoint and then essentially a 2 to 1 in ICU and very often 1 to 1 in an ICU,” officials said.

The project, however, remains tied up in litigation. State regulators approved AdventHealth’s request for a 67-bed facility in 2022, but Mission Health’s parent company, HCA Healthcare, appealed the state’s approval. The case is now pending before the North Carolina Supreme Court.

AdventHealth leaders said they hope the court declines to hear the case by the end of the year, clearing the way for construction to begin. If that happens, the hospital could open in late 2027.

The health system is also seeking state approval to add 129 acute care beds to that facility, which would bring the total to 222 beds.

Across the region, schools, chambers of commerce, county governments and health advocates have lined up in support of the project. More than 5,000 residents have submitted letters backing the expansion, according to AdventHealth.

“This hospital will reflect the needs of the people it serves,” Fields said.