Raleigh, N.C. — Representatives from three area health care providers made their pitches to state regulators Monday for 41 new acute-care hospital beds that planners say are needed in Wake County.

In a hearing room filled with more than 250 people, it was clear that a lot is at stake. It was the last chance for hospitals and their supporters to make the case that each of them is the one that should be allocated the new beds and the income that comes with them.

“In Wake County we need more full service hospitals not Band-Aid stations,” said Michael McKillip, a project analyst with the state Department of Health and Human Services. The department’s Division of Health Services Regulation decides who gets the 41 beds, as well as six operating rooms it says the county needs. To build the facilities, a hospital must have what is called a certificate of need.

WakeMed, Rex Hospital and a proposed Holly springs Hospital are the three making the pitch.

“Health care facilities and beds are very expensive. They're also mostly paid for ... by taxpayer dollars, by the government,” McKillip said. That is why the state regulates the beds to be built, basing the decision on population and growth projections.

Each facility had its supporters.

“I wish to profess my support of the hospital in our area, the Holly Springs Hospital,” Fuquay-Varina Mayor John Byrnes said.

“I just worked all weekend, and the department was busy, with people lying around waiting to go to the floor. We need those extra beds,” said Dr. Damian F. McHugh, an emergency room physician at Rex Healthcare.

“We have the highest utilization rate in the county. On any given day, patients are not able to get into the beds that we have,” WakeMed CEO William Atkinson said.

“It's a difficult decision, but we're used to it,” the health department’s McKillip said. He said the agency hopes to have a decision by the end of January.

The operating rooms are also a subject of competition. Orthopaedic Surgery Center of Raleigh wants to open four rooms. Blue Ridge Surgery Center wants two. WakeMed wants to add two at its WakeMed North Healthplex, which is where it wants to put the 41 new beds, and two at WakeMed Cary.

Southern Surgical Center wants to add four operating rooms and a room for minor procedures. Holly Springs Hospital wants four operating rooms.