Patients at UNC Health Rex Holly Springs Hospital have sometimes waited more than 24 hours just to get a bed in the emergency department, and now the hospital is opening a seventh floor to try to fix that. A ribbon-cutting is set for 9 a.m. Thursday, marking the near-completion of a 24-bed expansion that will bring the facility's total to 74 patient beds. The new floor is expected to open within the coming weeks.
The project has been in the works since the hospital first opened in November 2021, according to WRAL. Roy Tempke, chief operating officer for UNC Health Rex Holly Springs Hospital, said the 24 additional beds will help alleviate stress in the emergency room, where wait times have become a persistent problem. UNC Health Rex officials told the station that people often have to wait more than 24 hours for a bed in the emergency department once they arrive. The hospital has hired 50 employees to staff the expansion, and plans call for adding another operating room as part of the buildout.
A Hospital Built for a Town That Outgrew It
When Holly Springs Hospital opened in 2021, it arrived as a $170 million investment spanning 242,000 square feet with 50 acute care beds, 6 ICU beds, and 3 operating rooms, according to UNC Health Rex. The facility was reportedly designed with shelled space anticipating future growth, and that growth arrived fast. Since opening, the hospital has recorded 34,463 emergency department visits, performed 4,503 surgeries, and delivered 1,121 babies, per WRAL's reporting.
Holly Springs now has roughly 48,000 residents and is the fastest-growing town in Wake County by percentage, with its population increasing 35% between 2020 and 2025, the station reports. The town's own fiscal year 2025–26 budget put the growth even higher, reporting a 24% jump over five years to between 51,000 and 54,000 residents, with projections estimating the population will reach 65,000 by 2030, according to the Town of Holly Springs. That surge has been fueled in part by Holly Springs' rise as a biomanufacturing hub, with multi-billion-dollar investments from companies including FUJIFILM Diosynth, Genentech, and Amgen drawing thousands of new workers to the area, as reported by Healthcare Brew.
State Filing Shows the Price Tag and Timeline
The expansion was formalized in March 2025, when UNC Health Rex submitted an $18.5 million Certificate of Need application to the North Carolina Department of Health and Human Services to construct the 24 observation beds on the hospital's seventh floor, with state approval granted for completion by late 2026. UNC Health Rex is not stopping at Holly Springs. The system also filed 2024 applications for a $485.5 million, 50-bed community hospital in Wake Forest and a $98.4 million, 106-bed tower expansion at its main Raleigh campus, according to Business North Carolina.
Beyond this expansion, UNC Health Rex has told WRAL it plans to add another patient tower at Holly Springs within five to 10 years, targeting roughly 2031. Getting there will mean navigating North Carolina's Certificate of Need law, which caps hospital bed allocations based on state need determinations and has historically triggered fierce legal opposition from rival health systems. UNC Health endured more than a decade of CON filings and legal appeals from competing systems before it won final permission to build the original 50-bed Holly Springs hospital, according to Carolina Public Press.
A Region-Wide Race for Beds
Holly Springs is just one front in a broader scramble for capacity across Wake County. In late 2024, four major health systems — UNC Health, Duke Health, WakeMed, and Novant Health — submitted competing proposals totaling more than $1 billion to build new hospitals and expand existing ones across the county's fastest-growing submarkets, according to Axios. In neighboring western Wake County, Duke Health, WakeMed, and Lifepoint Health took a different approach, partnering in 2023 to break ground on Peak Rehabilitation Hospital, a 52-bed inpatient facility in Apex.
The Holly Springs facility operates under the license of UNC Rex Hospital in Raleigh, which holds a 5-star Medicare quality rating, and earned its own Leapfrog Hospital Safety Grade of A in 2024. As the seventh floor prepares to open, hospital leaders are framing the expansion as a direct response to years of emergency department strain, one that officials hope will finally shorten the waits that have defined the hospital's first five years serving one of the state's fastest-growing towns.
