Four major healthcare systems are competing to build 92 new acute care beds in Buncombe County.

AdventHealth, Novant Health, Mission Hospital, and UNC Health West have each filed a certificate of need application with the North Carolina Department of Health and Human Services.

Getting deja vu? This is nearly the same fight these four systems just had, when in March, the NCDHHS approved a 95-bed expansion for Mission Hospital and a new 34-bed facility for Novant Health — both AdventHealth and UNC Health appealed the decision.

Here's what each is proposing this go round:

AdventHealth | Grow its Weaverville hospital by 92 beds, a $273 million project finishing as early as 2030.

Novant Health | Add 20 beds to its Arden campus for ~$100 million, done by 2031.

Mission Hospital | Develop 92 beds for ~$67 million, wrapping construction in 2032.

UNC Health West | This is the boldest plan, proposing a new $747.3 million 92-bed hospital at the Westgate Shopping Center, which UNC Health recently purchased for $19.95 million. The project would be completed in summer 2032.

Want to weigh in? The state is holding a public hearing on Wednesday, August 19 at 10 a.m. at A-B Tech's Ferguson Auditorium, and you can also submit written comments through Friday, July 31.