Despite some harsh rhetoric and a looming deadline, officials from FirstHealth say they are trying to do what is in the best interest of the citizens of Hoke County, not just the hospital.

Friday, Charles T. Frock, CEO of Pinehurst-based FirstHealth of the Carolinas, reiterated a proposal made a day earlier that called for FirstHealth and Cape Fear Valley Medical Center to move forward with their plans to build in Hoke County.

"What is important is getting services to Hoke County, and the state has created a pathway for both organizations to do that," Frock said. "They've removed the barriers, removed the time element and said to each of us, 'Go ahead and do what you need to do.'"

Thursday's proposal by FirstHealth was for both sides to drop any appeal to the state's decision to allow both organizations to build hospitals in Hoke County, as well as to drop all past appeals and move forward with construction. The appeal, which was made through the media, was met with harsh words from Mike Nagowski, CEO of Cape Fear Valley Health Systems.

"I was surprised and disappointed at FirstHealth's public statements about appealing the state's CON decision," Nagowski said in a statement. "I thought we were having productive conversations; however, this leads me to believe otherwise."

When contacted Friday, a spokesperson from Cape Fear Valley declined to elaborate.

In the statement, Nagowski said Cape Fear has demonstrated its commitment to the residents of Hoke County with a $92 million investment in the form of a full-service hospital and outpatient center, while questioning FirstHealth's commitment.

"FirstHealth, on the other hand, has had the opportunity to build a hospital in Hoke County for 10 years," he said. "Yet the best they can do for the residents of Hoke County in an era of health care reform is an eight-bed way station. We have demonstrated our commitment to the citizens of Hoke County, and we fully intend to build Hoke County's only full-service hospital."

In September, the state approved both hospitals' plans to build in Hoke County.

Both sides are nearing a Wednesday deadline to appeal the state's ruling.

No appeal has been filed, but based on the recent rhetoric it appears more likely that both sides will appeal.

"From what they choose to say or not say, it suggests to us pretty strongly that they intend to appeal," Frock said. "And all we can do is to protect our ability to maintain our application and our standing, and probably will have to do likewise."

FirstHealth wants to build an eight-bed hospital at a projected cost of $34.1 million, according to state officials. It would be completed in October 2012.

The FirstHealth Hoke Community Hospital would have an emergency room staffed by Pinehurst-based Moore Regional Hospital physicians, 24 hours a day, seven days a week.

In addition to the emergency beds, the hospital would include eight inpatient beds, an overnight observation unit and one operating room, full laboratory services, state-of-the-art imaging technology, diagnostic cardiology and transport options via critical care transport or helicopter.

The hospital would be built to allow for expansion. Future plans for the 30-acre medical complex site on U.S. 401 include medical office space and other health care-related services and facilities.

Fayetteville-based Cape Fear Valley has asked the state for permission to build a 41-bed hospital on U.S. 401.

The health care system also plans to build an imaging center in Hoke and expand its primary care facility in the county.

The projected cost of the new hospital is $92 million, according to state officials. It would open in October 2013.

FirstHealth began providing health services in Hoke County in the early 1990s with physician practices. Soon after that, FirstHealth constructed a multi-million-dollar family care center and Center for Health and Fitness in Raeford. Dental care services were added for Medicaid-eligible children, and FirstHealth began coordinating specialist visits to enhance the scope of offerings available to residents.

In 2009, the state approved applications from both health care providers to build hospitals within 10 miles of each other - FirstHealth Hoke Commun-ity Hospital on U.S. 401 in Raeford and Cape Fear's in Cumberland County near the Hoke County line.

Both health care systems filed legal appeals seeking to block each other, asserting that the state was wrong in its decision to allow both to build hospitals so close together.

Thursday, Frock called for both sides to drop the appeals from 2009.

He said Friday that if the appeals are filed, it doesn't close the door on talks between the two hospital systems.

"Our offer, or what we feel is the right decision, holds after the deadline as well as before," he said.

Contact Tom Embrey at tembrey@thepilot.com.