AdventHealth will take over management of community-owned St. Luke’s Hospital in Polk County in October.
The deal includes the Columbus hospital’s satellite physicians offices and clinics. This serves as yet another addition to AdventHealth’s growing presence in Western North Carolina’s health care system.
St. Luke’s is a 25-bed critical access hospital — a designation the Centers for Medicare and Medicaid give to hospitals that provide services to rural, underserved regions. In October, St. Luke’s Hospital will officially become AdventHealth Polk.
Despite the hospital’s name, St. Luke’s Hospital had no religious affiliation prior to this deal with AdventHealth, a Florida-based nonprofit under the Seventh Day Adventist Church that operates 50 hospitals across nine states.
Atrium Health has managed the hospital for more than a decade. According to members of St. Luke’s Hospital’s board, Atrium Health is downsizing operations and taking less of an interest in managing rural hospitals.
St. Luke’s Hospital and AdventHealth entered into a 20-year lease agreement, with an option to extend another 20 years at the end of the contract. Financial details are not yet available, with governmental and regulatory approvals still pending.
“We want to keep this hospital in our community for a long, long time, and this partnership with Advent helps us guarantee that we’ve got a hospital in our community for the next 40 years,” Bill Miller, chair of St. Luke’s Hospital’s board of trustees, told Carolina Public Press.
“AdventHealth provided the best opportunity to meet our two goals: the first is that we are not interested in selling St. Luke’s, and the second is that we don’t want to turn into an urgent care.”
AdventHealth has agreed to bring new service lines and expand health infrastructure in Polk County, according to Paul Beiler, who serves on the county Board of Commissioners and the hospital’s board of trustees. The hospital launched an expanded cardiology program recently, and the board hopes that AdventHealth will continue progress in this direction.
AdventHealth spokesperson Victoria Dunkle says AdventHealth plans to build a new outpatient surgery center in Polk County, which will increase access to surgical and physician care, as well as expanded lab and imaging services.
Beiler says AdventHealth is working with St. Luke’s to retain as much of its staff as possible.
AdventHealth manages AdventHealth Hendersonville, formerly Park Ridge Health, in adjacent Henderson County, just 25 miles away from St. Luke’s Hospital.
Polk County infrastructure is influenced by the area’s unique geographical location. Polk County, just southeast of Henderson County along Interstate 26, straddles the Eastern Continental Divide. Columbus, the location of the hospital and the county seat, is in the highest part of the Piedmont, along with the neighboring town of Tryon. But to the west on the Henderson County line is Saluda, well into the mountains and roughly a 1,000 feet higher in elevation than the eastern Polk County towns.
“A lot of folks here in Polk County already go up the mountain, as we say, to Hendersonville to go to AdventHealth,” Joshua Kennedy, Polk County Health and Human Services director, told CPP.
“So having those kinds of resources available here will be very beneficial, especially to our large population of older adults.”
One focus in the boardroom has been on ensuring that some of the shared services between Henderson County and Polk County would be located in Polk, Belier said.
A partnership with AdventHealth will give St. Luke’s access to economies of scale in terms of Advent’s supplies and resources, according to county Health and Human Services director Kennedy.
“There is an inherent threat to rural hospitals in the medical world right now,” Marche Pittman, Polk County manager, told CPP.
“Small rural hospitals cannot afford the risk of not being attached to bigger companies. St. Luke’s has been doing relatively well in the last few years, but we do not want to take that chance.”
Polk move expands presence in WNC
Next month, AdventHealth plans to open AdventHealth Medical Group Multispeciality in Graham County, providing primary care, walk-in care, and imaging services, according to spokesperson Victoria Dunkle. Graham is located in the state’s far southwestern corner on the Tennessee line and does not currently have its own hospital.
In 2025, AdventHealth plans to add 40,000 square feet of clinical space in Buncombe, Haywood, Transylvania, and Henderson counties, cementing the health system’s position in Western North Carolina.
AdventHealth was selected by community members and approved by the state to open a 42-bed hospital in Weaverville, in Buncombe County north of Asheville. Advent purchased the land for the facility in March.
However, Tennessee-based hospital chain HCA has appealed that decision, delaying construction of AdventHealth Buncombe for at least two years.
For-profit HCA operates the Asheville-based Mission Health system, which owns hospitals in Buncombe, Transylvania, McDowell, Mitchell, Jackson and Macon counties, as well as other health facilities across the region.
“We strongly believe Mission Hospital can best meet Western North Carolina’s growing need for complex medical and surgical care,” Nancy Lindell, HCA spokesperson, wrote CPP in an email.
“Last year Mission accepted over 10,000 transfers from other hospitals because those patients needed services available only at Mission Hospital. Meanwhile, other hospitals in our region have unutilized beds, but they continue to send patients to Mission. We consider it a privilege to care for our region’s sickest patients but need more beds to do so.”
State Sen. Julie Mayfield, D-Buncombe, sees another motivation behind HCA’s appeals.
“HCA likes its monopoly,” Mayfield told CPP.
“They’re going to do everything they can to hold onto it and keep any and all competition out of Western North Carolina. They win when they are the only thing in town. People have no other option, and they’re taking advantage of that. My view is that they’re not actually interested in keeping people healthy. Their interest is in getting us into their hospitals.”
HCA is currently the target of lawsuits from the North Carolina Department of Justice and several Western North Carolina governments over alleged breaches of the company’s obligations under its purchase agreement for formerly nonprofit Mission Health in 2019.
Advent Health’s own operations in North Carolina have not been immune from controversy. Whistleblowers at its Hendersonville brought a federal lawsuit against the nonprofit in 2012 over fraud allegations, which was joined by multiple state governments and the U.S. Department of Justice. At the time Advent settled the lawsuit for more than $118 million in 2015, various news media reported that it was the largest settlement by a hospital group in history.
While Mission/HCA and Advent are two of major players in Western North Carolina health care, they are not alone. UNC Health operates Pardee Hospital and related facilities alongside Advent in Henderson County, as well as UNC Blue Ridge Hospital in Burke County, Caldwell Memorial in Caldwell County and multiple facilities under the Appalachian Health Care group based in Watauga County.
Duke Lifepoint has hospitals in Rutherford, Haywood, Jackson and Swain counties. Chattanooga-based Erlanger owns a hospital in Cherokee County. Atrium Wake Forest Baptist operates hospitals in Wilkes and Alleghany counties. The Eastern Band of Cherokee Indians has a tribal hospital in Swain County.
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