Additional details have emerged about the proposals of three healthcare systems battling to reshape New Hanover County’s medical landscape. Newly released state filings reveal where the proposed facilities would be built and what services they would offer.

Atrium Health, Novant Health and UNC Health this month each submitted Certificate of Need (CON) applications seeking state approval for proposed hospitals tied to the 2026 State Medical Facilities Plan, which identified a need for 225 inpatient acute-care beds in New Hanover County.

The filings also included a joint proposal from UNC Health and Wilmington Health to establish a PET imaging center as part of a joint comprehensive oncology program. If approved, it would be the first freestanding PET service in New Hanover County.

The Division of Health Service Regulation, part of the N.C. Department of Health and Human Services, independently reviews applications and has 90 to 150 days to review them. DHSR may approve portions of more than one application, given that they do not exceed the 225-bed allocation. During the first 30 days of the review period, DHSR will accept written comments or letters of support for submitted CON applications, and those comments and letters can be filed here.

Atrium Health
Atrium Health is proposing a 42-bed community hospital at the intersection of Military Cutoff Road and Crooked Pine Road, near the Porters Neck area. The facility would offer “quick connecting access to I-140, I-40 and U.S. Highways 17 and 74,” according to the application.

The project, estimated to cost over $395 million, is anticipated to start in January 2027, pending CON approval. If approved, Atrium plans to open the hospital’s doors by January 2032 and would finance the project with accumulated reserves.

In addition to the hospital, Atrium included plans to develop a medical office building, which does not require CON approval. The medical office building is separate from the hospital proposal and would include a mix of primary and specialty care services, like cardiology, oncology, obstetrics/gynecology, and orthopedics. The location and scope of the project were not disclosed in the application, and Atrium plans to submit a CON exemption letter for the building this month, according to the application.

The proposed community hospital would be five stories and approximately 195,000 square feet with on-site parking. Of the 42 acute care beds in the proposal, 35 are medical/surgical, four are intensive care unit and three are labor/delivery/recovery/postpartum.

The hospital's services would include nursing, emergency, laboratory, radiology, pharmacy, physical therapy, speech therapy, GI endoscopy and surgery. The hospital would also offer inpatient dialysis and include a 24-hour emergency department with 16 treatment rooms.

Atrium Health owns 25 acute care hospital facilities in North Carolina and, according to the application, “Atrium Health managed and grew the New Hanover Regional Medical Center Physician Group to over 200 providers across more than a dozen specialties.” Atrium Health managed the New Hanover Regional Medical Center Physician Group from 2009 to 2020, before the hospital's sale to Novant Health in 2021. 

Atrium Health also manages the Columbus Regional Healthcare System, which has a presence in Brunswick County.

The application emphasizes the need for greater competition in the region's healthcare market, stating that “New Hanover County, with only one licensed hospital, is not a competitive healthcare market.”

“Providers in a competitive market are more likely to offer a wider range of services,” the application said, “and at a more affordable price to attract customers.”

The application comes with letters of support from nearly 200 providers. View the full application here.

Novant Health
Novant Health’s $236 million project would add 225 general acute-care beds to the county’s flagship hospital, Novant Health New Hanover Regional Medical Center (NH-NHRMC), by developing a new heart and vascular tower on the existing main campus.

The new 245,000-square-foot tower would include advanced operating rooms, cardiac catheterization labs, and electrophysiology labs, “creating a more streamlined experience for patients and families,” according to the application.

If approved, Novant Health expects the new patient tower to become operational in January 2030. Upon project approval and completion, NHRMC would have 999 licensed general acute-care beds.

“Novant Health’s recently approved master facility plan for the Wilmington region further demonstrates that NH-NHRMC is not merely responding to the 2026 SMFP need determination with an isolated bed proposal. Rather, the proposed additional beds are part of a broader, multiyear commitment to modernize and expand the region’s healthcare infrastructure."

Novant Health also plans to add a second, 80,000-square-foot heart and vascular medical building, with additional clinic space, offices for cardiovascular physicians and related outpatient services.

The application emphasized that the existing hospital is the region’s only Level II Trauma Center, a role that cannot be “replicated simply by adding beds at a new entrant hospital.” The proposed patient tower would reinforce Novant Health’s existing platform, the application said.

Additionally, the application targeted a statement on UNC Health's Wilmington hospital website that New Hanover County residents routinely travel for specialty care.

“The actual utilization data (from the state) do not support that broad claim,” the application said. “Historical patient origin data show that New Hanover County residents overwhelmingly receive acute care services in New Hanover County. From (fiscal year) 2021 through (fiscal year) 2024, between 92.4% and 93.4% of New Hanover County residents who required acute care hospital admission received that care in New Hanover County.”

The application included numerous letters of support from physicians, residents, community organizations, businesses, local governments and medical providers. They included the city of Wilmington, New Hanover County, EmergeOrtho, the Greater Wilmington Chamber of Commerce, Wilmington Health and UNCW.

View the full application here.

UNC Health
UNC Health’s proposed seven-story, 150-bed community hospital, expected to cost $852.7 million, will take up 48.5 acres on a 62-acre tract at the intersection of Shipyard Boulevard and 17th Street.

UNC Health’s targeted opening date for the hospital is July 2031, according to the application. The project will be funded with “accumulated reserves and assets.”

The 543,000-square-foot hospital, to be called the UNC Health Wilmington Medical Center, is proposed to include nursing, emergency, laboratory, radiology, pharmacy, physical therapy, occupational therapy, speech therapy, GI endoscopy and surgical services. It will include a 24-hour emergency department with 28 treatment rooms.

According to the application, if approved, “UNC Health Wilmington will be the first new provider of inpatient acute care bed services in New Hanover County in nearly six decades.”

The hospital would include 124 medical/surgical beds, 12 intensive care unit beds and 14 labor, delivery, recovery and postpartum beds.

The first floor would include the hospital's proposed imaging services, as well as support services and emergency services. The second floor would include surgical services, catheterization services and services related to women’s and obstetrics care. The third floor would include the hospital’s intensive care unit, inpatient dialysis services and physical, occupational and speech rehabilitation services.

The fourth floor would include the hospital's 12-bed psychiatric unit, and the fifth, sixth and seventh floors would include medical/surgical acute care beds.

The application said that the proposed project “is also distinctly different from other applications for a new hospital because UNC Health  has the support of Wilmington Health.” Wilmington Health physicians will serve on the hospital's medical staff and in leadership roles, according to the application.

According to the application, as of June 10, a Change.org petition created by a Wilmington resident in support of UNC Health’s proposed hospital had garnered over 1,800 signatures. The application emphasized the need for more healthcare competition in New Hanover County and emphasized its public academic health system.

The application also emphasized UNC Health’s plans to integrate Onslow Memorial Hospital into its network, beginning July 1, creating a unified network in the area.

View the full application here.

UNC Health And Wilmington Health
Wilmington Health and UNC Health are committing to a comprehensive oncology program. As part of the June 15 CON deadline, Coastal Cancer Care & Imaging LLC, a wholly owned subsidiary of UNC Health, applied for one freestanding fixed PET scanner.

The project is a joint venture between UNC Health and Wilmington Health and would develop a freestanding diagnostic imaging center at the intersection of Silver Stream Lane and Medical Center Drive. If approved, UNC Health expects to start services by June 2028 and would be the first freestanding PET service in New Hanover County.

The CON-exempt medical office building would be a single-story structure adjacent to Wilmington Health’s existing medical office building at Silver Stream Lane, and would house the oncology program, including hematology/oncology and infusion services.

According to the application, upon submission, Coastal Cancer Care & Imaging, previously wholly owned by UNC Health, will be jointly owned by UNC Health and Wilmington Health, with ownership split 51% and 49%, respectively.

The projected cost of the PET scanner project is $5.3 million, to be provided by UNC Health. That cost includes construction of the new building ($2.25 million), medical equipment ($1.2 million) and other expenses.

A medical office building would house the proposed PET scanner and support diagnosis and treatment for oncology patients. The imaging department would occupy about 3,800 square feet, with the remaining space consisting of exam rooms, clinical practice space and other services. According to the application, upon opening, the PET scanner would perform scans from 8 a.m. to 5 p.m. Monday through Friday.

Positron emission tomography (PET) imaging is a type of nuclear medicine imaging used to detect cancers, heart disease and gastrointestinal, endocrine and neurological disorders, as well as other abnormalities in the body.

View the full application here.