Madison County, tucked in the mountains of western North Carolina, has no hospital and just three ambulances serving its roughly 22,000 people.
The ambulances frequently travel back and forth to Mission Hospital in Asheville, the largest and most central hospital in the region. Trips can take more than two hours, according to Mark Snelson, director of Madison Medics EMS, the local emergency medical service.
“When we get busy and all three of them are gone, we have no ambulances in our county,” he said.
Snelson and others in Madison County aren’t seeking more ambulances. They want a hospital closer than Mission. And the state agrees. In 2022, North Carolina Department of Health and Human Services officials said Madison and three other mountain counties needed 67 more acute care hospital beds. The state raised that to 93 beds in 2024, then to 222 by Oct. 15.
But the only indication of a new hospital thus far is a 25-acre field of graded dirt with a sign planted beside the highway reading “FUTURE HOME OF AdventHealth Weaverville.”
For the past three years, Mission Hospital’s owner has contested Florida-headquartered AdventHealth’s attempt to build the hospital on land bought for $7.5 million in rural Weaverville, just minutes south of Madison County. It was supposed to open this year, an event that would have defied the national trend of rural hospital closures.
The irony is that the very law that calls for the new hospital — the state’s certificate of need, …