So when he started having chest pains on a Saturday morning in August 2008, Veringer just stayed home.

The closest hospital to his Holly Springs home - 11 miles north in Cary - isn't equipped to perform heart surgery. Verniger, 55, didn't want to drive all the way to Raleigh.

"He was too stubborn to let me take him," said Sue Veringer, his wife.

Veringer's heart attack didn't kill him. He worries the next one will - especially if he has to go the distance. There are others like him.

For years, health companies and elected officials have tried to convince state regulators that this fast-growing western Wake County town is ready for a hospital.

But in 2009, the N.C. Division of Health Service Regulation rejected a proposal by Novant Health to build a $100 million community hospital in Holly Springs that would have included 41 beds and four operating rooms.

The state said Novant didn't adequately demonstrate need for a hospital in Holly Springs, and that the project might not be cost-effective.

The rejection came despite the fact Holly Springs' population has grown more than 20-fold in 20 years, to 23,000. "In 1990 we had 800 residents and no doctor," said Mayor Dick Sears.

There are currently no hospitals and close to 100,000 residents in a roughly 25-mile radius that includes Fuquay-Varina, Holly Springs and Angier, in northern Harnett County.

The closest hospitals to the area, besides ones in Raleigh, include Cary, which is nine miles from Holly Springs Town Hall; Durham and Dunn, 32 miles; Sanford, 35 miles; and Smithfield, 39 miles.

The lack of service has health care companies clammoring to drop anchor in the town. Meanwhile, town officials have taken up the push.

Competition

The Division of Health Service Regulation assesses the need for hospital beds throughout the state in an effort to minimize duplication of health facilities and keep health costs down.

After the state rejected Novant's bid for a hospital in Holly Springs in 2009, the town of Holly Springs unsuccessfully petitioned the state to add 42 new hospital beds in Wake County to its 2010 medical facilities plan.

Novant last month decided to try again. It is proposing an $8.2 million surgery center in Holly Springs with three operating rooms that are up for bid from the state.

Rex Hospitals of Raleigh also made a bid on the three ORs, and says it wants to place two of those at an outpatient facility under construction in Holly Springs.

Applicants should know by this summer who won the bid, though legal appeals could postpone an answer until next year.

Nearby competitors are quick to question the demand.

Stan Taylor, vice president of corporate planning for WakeMed Health & Hospitals says WakeMed Cary already serves the Holly Springs area. Rather than battle with Rex and Novant, WakeMed wants to spend $5.9 million to add three operating rooms to the nine that are already at its Cary hospital. "You don't need a $1 million hospital on every street corner," Taylor said.

Tell that to Veringer.

His 2008 heart attack was his fourth one, and he expects to have more. The rejected Novant hospital would have been less than two miles from his double-wide trailer.

None of the existing or proposed medical facilities in Holly Springs will necessarily save his life when the next one comes.

"With heart attacks, only two hospitals can intervene on a 24-hour basis," said Brent Myers, medical director for Wake County EMS. Rex Hospital in Raleigh and WakeMed Raleigh are the only hospitals that have a cardiac cath lab with interventional capability.

Indeed, the hospital proposed in Holly Springs wouldn't be equipped to do heart surgery. Evolving to that level of service could take years, if not decades.

But having a community hospital in Holly Springs might have been enough to get Veringer out the door in the first place to seek treatment. And a local hospital might have given him a quicker diagnosis, a quicker launch to Raleigh, and a place close to home to recover.

"If they would've had a hospital right down the road, I would have probably gone right when I started having chest pains," Veringer said.

Instead, he waited two days.

The runaround

Veringer arrived at work on a Monday morning. His chest pains from the weekend were worse.

So he went to an urgent care center next to a Walmart, down the road from the empty Novant hospital lot.

The doctor there told him to go to WakeMed's Apex Healthplex, nine miles north.

After assessing Veringer, doctors in Apex put him in an ambulance to WakeMed Raleigh, 20 miles east.

More than four hours after he left work for the urgent care center, he entered surgery at WakeMed Raleigh to have three stents put into his heart.

"The doctor said I was very lucky," Veringer said.

Veringer isn't the only one ready to see a hospital come to town.

"Four times I've had mortality staring me in the face, and have had to get from southern Wake County to a hospital," said Holly Springs town clerk Joni Powell, 48, who has suffered two heart attacks and two strokes.

"When you have an emergency in southern Wake County, you have to go to up [N.C.] 55 and across [U.S.] 1," she said. "These are major routes, and if you try to get there at lunchtime or during rush hour, it's painfully slow."

After her latest stroke, on Oct. 15, 2008, Powell called her husband Donald Powell, an emergency medical technician with Holly Springs.

He was sitting at Rex Hospital in Raleigh, having driven another Wake County patient there in an ambulance.

All he could do was tell his wife to go to the urgent care clinic. An ambulance had to be called from Garner.

"When they were loading me in the ambulance, I remember seeing the lot where the Novant hospital was proposed to be built, about 600 feet away," Powell said. "I would have already been at the hospital if the state said we could've had those beds.

"As it was, I was just at the starting point."