Not giving up Hoke.

• Position: REGIONALREPORT East

North Carolina's fastest-growing county is poised to get its first hospital--make that two--now that Fayettevilie-based Cape Fear Valley Health System and Pinehurst-based FirstHealth of the Carolinas Inc. have agreed to a truce. Their clash began in 2010, when the N.C. Department of Health and Human Services gave both permission to build hospitals near Raeford in Hoke County. Both, of course, filed legal appeals challenging the need for the other.

Friction boiled over last year when FirstHealth which runs three hospitals with 582 beds--offered to drop its appeal, but its rival didn't. County commissioners passed a resolution condemning Cape Fear Valley--which runs five hospitals with 765 beds--for holding up the process, and the system changed its mind in April. "I think for us and for FirstHealth, we both wanted to get on with building our facilities," Cape Fear Valley CEO Mike Nagowski says. He wouldn't acknowledge competition between the two, but First Health director of communication Gretchen Kelly says, "We welcome competition for the benefit of the health system and our patients."

Both want to benefit from skyrocketing growth in the eastern part of Hoke, where they will build their hospitals about two miles apart along U.S. 401. The county's population jumped nearly 5% between 2010 and 2011 to more than 49,000, the Census estimates. That's the fastest growth rate in the state and eighth-fastest in the U.S. Most of it is fueled by Army expansion at Fort Bragg. The hospitals are expected to create hundreds of jobs, not including pharmacies and labs that might serve them. Construction has begun on FirstHealth's project and should start on Cape Fear Valley's this summer.

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Cape Fear Valley's hospital will be much larger, at least...