Cape Fear Valley Health is asking the state’s permission to relocate all 11 operating rooms at its Fayetteville Ambulatory Surgery Center to its main campus.
Three of the surgical center’s operating rooms would move to the Cape Fear Valley Medical Center, according to the health system’s application to the N.C. Department of Health and Human Services’ Division of Health Service Regulation. The other eight would move to a new medical office building on Melrose Road.
The project is expected to cost over $18.3 million. Once complete in January 2028, the medical center’s campus would have 28 operating rooms.
“Our existing operating rooms are consistently operating at high utilization levels, limiting flexibility for urgent, add-on, and trauma-related cases,” Daniel Weatherly, Cape Fear Valley Health’s chief executive officer, wrote in a letter of support for the proposal.
State health regulators will review the plans and determine whether Cape Fear Valley Health can move forward under North Carolina’s Certificate of Need law. The law requires health care providers to get state approval before building or expanding their operations. State health officials have up to 150 days to determine whether a provider’s plans are cost-effective and will be used by the community.
As part of the review process, the state is accepting written comments on the proposal until June 1. A public hearing will also be held at noon on June 16 in the meeting room of the Cliffdale Regional Branch Library.
Physicians currently practicing at the Fayetteville Ambulatory Surgery Center have already submitted letters of approval for the move as part of the health system’s application.
Rising demand for surgery at the medical center is exceeding its current operating room capacity, driving the need to transfer some from other facilities, Cape Fear Valley Health said in its application. Last year, the medical center saw almost 12,300 surgical cases, a 4.7% increase from 2024.
Some of the increased demand stems from the hospital’s 2024 expansion, the health system wrote, which nearly doubled the number of beds in its intensive care and step-down units.
Cape Fear Valley Medical Center’s emergency department is consistently among the 25 busiest in the country, according to data compiled by Becker’s Hospital Review. In 2025, the hospital’s emergency department had over 122,900 visits, ranking 21st in the country for total visits. The only North Carolina hospital with more visits was WakeMed in Raleigh.
“On a daily basis, our emergency department manages a high volume of critically ill and injured patients, many of whom require urgent or emergency surgical intervention,” Chris Tolley, an emergency medicine physician at the medical center, wrote in a letter of support. “Timely access to operating room capacity is essential to ensuring safe, efficient, and high-quality care for these patients.”
The health system said it is also filling in gaps created by renovations to Fort Bragg’s Womack Army Medical Center. The renovations, which started in January, will increase the Army hospital’s number of operating rooms from 12 to 14. During construction, which is expected to take more than three years, the hospital will only have six functioning operating rooms, Cape Fear Valley Health said in its application.
Cape Fear Valley Health predicts the closure will increase the number of surgical cases at its medical center by 150 per month until Womack’s new operating rooms are online.
The medical center has the staff to tackle the demand, but not the space, according to Cape Fear Valley Health. Over the past two years, the medical center added 32 new surgical physicians and projects another 37 will join the hospital by 2028.
Surgical training for the health system’s growing pool of residents and Methodist University Cape Fear Valley Health School of Medicine students will also require more operating rooms, the health system wrote. The medical school’s inaugural class of 64 students starts in July.
“Adequate operating room availability is fundamental not only to patient access and quality outcomes, but also to ensuring appropriate procedural exposure and hands-on training for medical students, residents, and fellows,” Dr. Donald Maharty, Cape Fear Valley Health’s vice president for medical education and the medical school’s senior associate dean for graduate medical education, wrote in a letter of support for the proposal.
Cape Fear Valley Health’s proposal comes amid plans to expand the medical center’s surgery and adult emergency departments. It is also building a new pediatric emergency department.
