Our annual list of North Carolina’s best hospitals examines data compiled from several sources to determine which medical centers provide the best care for their patients. We start by developing a comprehensive list of the state’s top-performing general acute care, adult hospitals with 50 or more beds.
The rankings are calculated using more than 25 metrics, including information provided by the U.S. Centers for Medicare & Medicaid Services. We look at patient-satisfaction surveys, as well as infection, readmission and death rates for common procedures. Other factors include safety report cards by the Washington, D.C.-based nonprofit The Leapfrog Group, distinction awards from insurer Blue Cross and Blue Shield and national performance ratings from U.S. News & World Report.
Taking so much data into consideration makes the rankings particularly tight. This year, the overall winner and the medical center coming in at No. 10 are separated by just five points; the separation between No. 1 and No. 20 was just 16 points.
Despite attempts to be as thorough as possible, our methodology can skew in favor of larger institutions, which earn more points based on national awards and performance rankings. Smaller hospitals tend to come up short, largely because some procedures aren’t performed often enough during the year to be considered, resulting in insufficient data.
Other factors such as health care system consolidation had an impact on this year’s rankings.
The federal data and Blue Cross and Blue Shield of North Carolina insurance distinctions were compiled in December 2019. Leapfrog safety scores and U.S. News & World Report rankings were updated in January.
— Harrison Miller
Beds: 730 | 2019 rank: 3 |
CEO: Chad Patrick
A perennial top performer led the way during its first year owned by Nashville, Tenn.-based HCA HealthCare, the biggest U.S. hospital operator. Management turnover followed the $1.5 billion sale that closed in February 2019 with Greg Lowe moving from HCA’s Richmond, Va., market to become president of a new N.C. division and Chad Patrick becoming CEO for the flagship. Mission was one of four N.C. hospitals named to IBM Watson Health’s list of the 50 top cardiovascular hospitals.
Under terms of Mission’s sale, the Nashville-based Gibbins Advisors consulting firm was hired to monitor HCA’s compliance with agreements it made in the transaction. Those commitments include replacing the hospital in Franklin, adding a 120-bed behavioral health center in Asheville and investing $232 million in existing sites. Gibbins reports to Dogwood Health Trust, a nonprofit foundation created by the Mission Health sale.
Moses Cone Hospital1
Beds: 529 | 2019 rank: 1 |
President: Terry Akin
Greensboro’s dominant hospital opened its $100 million Women & Children’s Center in late February, replacing the nearly 30-year-old Women’s Hospital. Nurses and patients helped design the space, which has its own entrance and 45 private rooms for neonatal babies. Industry groups again recognized Cone for various innovations, including programs to serve recent immigrants; partnering with Guilford County on a mental health crisis center; and starting a unit to support new health care ventures.
Parent Cone Health reached a new shared-services agreement with Atrium Health that loosens ties between the two systems, including moving CEO Akin off the Charlotte-based group’s payroll. The system posts annual revenue topping $2 billion and employs about 12,000.
UNC Rex Healthcare
Beds: 660 | 2019 rank: 1 |
President: Ernie Bovio
The division of Chapel Hill-based UNC Health plans to open five urgent-care centers in Wake County this year after renaming its nine UNC Rex locations as UNC Urgent Care. Last March, UNC Rex broke ground on a seven-story, 50-bed hospital in Holly Springs scheduled to be completed in 2021. It will offer an emergency department, labor and delivery services, and operating rooms for various surgeries. Next year, UNC Rex will open a four-story, $65 million cancer center on its west Raleigh campus. Demand is expected to continue to increase as the region’s population grows and ages.
UNC Rex Healthcare faces strong rivals in WakeMed and Duke University Health to expand and lure new customers in the Raleigh metro area, which grew by 20% between 2010-18 with more than 225,000 new residents, according to U.S. Census Bureau estimates.
CarolinaEast Medical Center
Beds: 350 | 2019 rank: 5 |
President/CEO: Raymond Leggett III
In January, the Craven County hospital opened the $38 million State Employees Credit Union Comprehensive Cancer Center, an 80,000-square-foot site. An adjacent $22 million diagnostic center is opening in March, a partnership with UNC Health Care to offer expanded cancer care services. The not-for-profit hospital’s cardiovascular care center was the state’s first to achieve an excellence accreditation from the American Heart Association.
The locally controlled hospital system had net operating revenue of $427 million in the 2019 fiscal year. That makes it the smallest hospital among the 10 highest-ranking on this list. Leggett has worked for the system for 30 years, including 12 as CEO.
Duke University Hospital
Beds: 957 | 2019 rank: 7 |
President: Thomas Owens
Ranked among the top U.S. research hospitals, its affiliated medical school was awarded $385 million in grants from the National Institutes of Health in 2018 — the ninth most of any university. Duke University Hospital surgeons made history by completing the nation’s first “donation after circulatory death” adult heart transplant, a procedure performed after the heart stops beating. It’s one of five centers in the U.S. approved for the surgery. An 11-story tower in Durham is expected to open next year with adaptable beds to serve neurosciences, and solid organ and bone marrow transplants, with four floors dedicated to children’s inpatient services.
The Durham hospital has the most beds of the Triangle-area hospitals and leads in outpatient visits with 1.08 million, while UNC Hospitals has the most admissions. UNC Rex Healthcare ranks second in outpatient visits. While dominant in Durham County, it’s making a push into western Wake to complement its north Raleigh hospital.
Regional Hospital 2
Beds: 390 | 2019 rank: 11 |
CEO: Mickey Foster
In December, FirstHealth launched FirstHealth On the Go, a virtual care app that lets patients connect digitally with board-certified doctors 24 hours a day. FirstHealth says On the Go will help fill coverage gaps via virtual visits and online prescription refills. Next year, the not-for-profit authority will break ground on a four-story, $60 million cancer center on its main campus with completion expected in November 2022. In February, FirstHealth opened a Heart Failure Clinic in Pinehurst.
In July, Mickey Foster replaced retiring CEO David Kilarski, who had headed parent FirstHealth of the Carolinas since 2011. Foster, 47, had been senior vice president at Greensboro-based Cone Health. The system has nearly 5,000 employees and is licensed for four hospitals with 610 beds.
Atrium Health Carolinas
Medical Center 3
Beds: 907 | 2019 rank: 8 |
President, Central Division: Vicki Block
The flagship hospital of the state’s biggest health care system could add a medical school to its offerings, pending regulatory approval of a partnership agreement with Winston-Salem-based Wake Forest Baptist Health and Wake Forest University. Later this year, Atrium expects to open a nearby building for its Sanger Heart & Vascular Institute and another one for neurology and digestive health specialists. It’s part of a $1 billion capital budget disclosed in June 2018 that is sparking expansion across the Charlotte metro region.
Atrium also has big growth plans outside the Queen City. Like other N.C. systems, It has shown interest in Wilmington’s New Hanover Regional Medical Center, which is considering a potential ownership change. Atrium expects to close its $650 million agreement with Rome, Ga.’s Floyd Health System, gaining another Peach State foothold after the 2019 purchase of Macon, Ga.’s biggest hospital network.
Duke Regional Hospital
Beds: 369 | 2019 rank: 14 |
President: Katie Galbraith
Undergoing its largest expansion since opening in 1976, the Duke University-owned hospital is investing $102.4 million to expand its emergency department and add a behavioral health unit. With completion set for next year, the emergency department expansion will add 13 new private rooms, bringing the total to 49, and double its clinical decision unit capacity to 12 private rooms. The 112,000-square-foot behavioral health center will help consolidate services from both Duke Regional and Duke University hospitals, provide a 42-bed private inpatient unit, and create an emergency department.
In December, the hospital named Dr. Adia Ross as chief medical director, succeeding Dr. Barbara Griffith, who had served in the post since 2012. Ross has held various other key medical posts within the Duke system.
Beds: 929 | 2019 rank: 9 |
President: Janet Hadar
As part of UNC Health’s plans to build more than 1 million square feet of new space in the Triangle by 2022, UNC Hospitals kicked off construction on a seven-story, $290 million surgical tower that will be the largest building on the UNC Medical Campus when it opens in 2022. The system also will begin construction on a second patient tower in Hillsborough for the UNC Rehabilitation Hospital, which is moving from Chapel Hill along with 50 new acute-care beds. Also opening this year will be the six-story UNC Eastowne Medical Office Building in Chapel Hill to house specialty practices such as cardiology, endocrinology, hematology and more. In January, UNC Health cut the ribbon on its Panther Creek medical building in Cary, which offers surgical and imaging services and various specialty practices.
Last June, the system-operated N.C. Children’s Hospital suspended complex pediatric heart surgeries after a New York Times investigation revealed high mortality rates from the medical center’s procedures in 2016 and 2017. State and federal officials reviewed the hospital and found it compliant with regulations, and an advisory board cleared it to resume heart surgeries in September.
Novant Health Forsyth
Medical Center 4
Beds: 921 | 2019 rank: 19 |
President/COO: Chad Setliff
The Winston-Salem hospital jumped in the rankings more than any other hospital. It announced a $181 million capital project that includes a first phase of improved patient rooms, expanded women’s and children’s services, and the design of a future critical care tower. It is the north tower’s first major upgrade since 2007. In October, the hospital opened a dedicated obstetrics emergency department, providing full-service maternity, emergency labor and child delivery services.
Novant Health has about 29,000 workers and operates 640 locations in four states. It dominates the western Triad’s health care market along with rival Wake Forest Baptist Health, which is planning a partnership with Charlotte-based Atrium Health. It is also competes with Atrium in the Charlotte metro area.
11 New Hanover Regional Medical Center
Beds: 769 | 2019 rank: 18 | President/CEO: John Gizdic
12 (tie) Novant Health Presbyterian Medical Center
Beds: 597 | 2019 rank: 14 | President/COO: Paula Vincent
12 (tie) Atrium Health Cabarrus
Beds: 457 | 2019 rank: 6 | President: Phyllis Wingate
14 CaroMont Regional Medical Center
Beds: 435 | 2019 rank: 4 | President/CEO: Chris Peek
15 Novant Health Matthews Medical Center
Beds: 146 | 2019 rank: 17 | President/COO: Roland Bibeau
16 (tie) Cape Fear Valley Medical Center
Beds: 666 | 2019 rank: 14 | CEO: Michael Nagowski
16 (tie) Wake Forest Baptist Medical Center
Beds: 885 | 2018 rank: 9 | CEO: Julie Ann Freischlag
16 (tie) Wake Forest Baptist Health
High Point Regional Medical Center
Beds: 351 | 2019 rank: 13 | CEO: James Hoekstra
19 Vidant Medical Center
Beds: 909 | 2019 rank: 22 | President: Brian Floyd
20 (tie) Atriun Health Pineville
Beds: 235 | 2019 rank: 11 | President: Christopher Hummer
20 (tie) WakeMed Raleigh Campus
Beds: 726 | 2019 rank: 22 | CEO: Donald Gintzig
22 (tie) WakeMed Cary Hospital
Beds: 156 | 2019 rank: 19 | SVP/Admin: Thomas Gough
22 (tie) Duke Raleigh Hospital
Beds: 186 | 2019 rank: 31 | President: David Zaas
22 (tie) FRYE Regional Medical Center
a Duke Lifepoint Hospital
Beds: 335 | 2019 rank: 19 | CEO: Garfield Atchison
25 Atrium Health Union
Beds: 249 | 2019 rank: 27 | President: Michael Lutes
25 (tie) Novant Health Huntersville Medical Center
Beds: 91 | 2018 rank: n/a | President: Mike Riley
1 Includes The Moses Cone Hospital (529 beds), Wesley Long (Greensboro, 204 beds) and Annie Penn Hospital (Reidsville, 110 beds)
2 Includes FirstHealth Moore Regional (Pinehurst, 402 beds) FirstHealth (Richmond, 99 beds)
3 Includes Atrium Health Carolinas Medical Center (907 beds) Atrium Health Mercy (173 beds)
4 Includes Novant Health Forsyth (921 beds) Kernersville Medical Center (50 beds)