The Cape Fear Valley Medical Center is asking the state to bump up its trauma center designation, going from Level III to Level II.
The higher designation would allow the hospital to provide more local, timely trauma care.
“Our pursuit of a Level II designation reflects our commitment to advancing trauma care for our community, retaining more patients locally and relieving pressure on surrounding hospitals,” Chaka Jordan, Cape Fear Valley Health’s vice president of marketing and communications, told CityView.
Trauma centers — hospitals equipped to treat traumatic injuries like those from car crashes and shootings — are differentiated by level. The number of levels and what they mean depends on state regulations. Generally, the lower the trauma level number, the better equipped the trauma center is to care for complex traumatic injuries.
North Carolina’s trauma centers are designated Level I, II or III. Level I centers have the most resources, providing total in-house comprehensive care from treatment to rehabilitation for traumatic injuries. They also research trauma and traumatic injuries.
Level II trauma centers treat almost any traumatic injury, but have fewer resources for a patient’s total care than Level I facilities and do not conduct any research. Level III trauma centers only stabilize and diagnose patients before sending them to Level I or II facilities.
The Cape Fear Valley Medical Center has been a Level III trauma center since 2015. The closest trauma centers with a higher level are WakeMed’s Raleigh Campus in Raleigh, UNC Hospitals in Chapel Hill and Duke University Hospital in Durham. All are Level I facilities.
“As the only trauma center within a 75-mile radius that is not currently designated as Level I or II, our community faces significant challenges in accessing advanced trauma care, often requiring travel to facilities like tertiary care centers with over an hour’s drive. This delay in care can negatively impact patient outcomes,” Jordan said. “By achieving Level II designation, we can keep more patients locally, reduce the burden on surrounding hospitals and ensure that our community receives the best care possible.”
Jordan and Mike Nagowski, Cape Fear Valley Health’s CEO, said the medical center is often already comparable to many Level II trauma centers.
“Doctors in the room will tell you that many nights we already serve as a Level II and a Level I,” Nagowski said at the most recent Cape Fear Valley Health Board of Trustees meeting.
In 2024, Jordan said the medical center treated 2,820 trauma patients, an average of eight per day. The number only includes life-threatening traumatic injuries and not the number of patients treated at the medical center for less severe injuries like a broken arm.
“We retain the majority of trauma patients rather than transferring them, highlighting the community’s reliance on our services,” Jordan said. “The increasing volume of trauma cases in our area further underscores the necessity for a higher-level trauma facility.”
One of the main reasons the medical center can now seek an official higher trauma level is increased staffing and staff retention. It means the hospital can provide Level II trauma care with the consistency required of Level II trauma centers, Nagowski said.
Level II trauma centers must have a trauma team available 24/7 to provide care regardless of the severity of the traumatic injury that comes through their doors, according to state statute. Trauma team staff must include, among other positions, nurses, neurosurgeons and orthopedic surgeons specializing in trauma.
To meet these requirements, Cape Fear Valley Health has expanded neurosurgical coverage to be 24/7/365 and is adding a new neurosurgeon at the medical center. It has also hired another fellowship-trained orthopedic trauma surgeon, bringing its total to nine orthopedic surgeons. And Jordan said the health system is expanding the medical center’s cardiothoracic coverage to meet Level II requirements.
In total, the medical center retains nine full-time surgeons and 10 per diem surgeons, in addition to its surgical residents. These physicians are ready to respond to trauma cases alongside the medical center’s emergency department’s daily rotating staff of at least four attending physicians, three mid-level practitioners and six emergency medicine residents.
“We are proud of the progress made and remain focused on meeting the necessary standards to achieve this important milestone,” Jordan said.
The board of trustees signed a letter of commitment late last month to kick off what Nagowski said will be a 12- to 18-month process for the medical center to obtain its Level II designation. Next steps include data reviews and site visits from the state’s Office of Emergency Medical Services and the Mid Carolina Trauma Regional Advisory Committee.
“We’re very excited about this happening,” Nagowski said. “The last 10 years have been a great learning environment.”
The medical center expects to receive the designation by the end of 2026.
CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the News Foundation of Greater Fayetteville.