Holly Springs, a fast-growing western Wake town that has been seeking a hospital, will get a surgery center instead.

State regulators on Wednesday approved Novant Health's application to build a surgery center with three operating rooms. It would be the first facility in Wake County for the Winston-Salem hospital chain.

Novant hopes this initial toehold will lead to the building of a hospital in Holly Springs, spokeswoman Kati Everett said.

"We're excited to be able to start honoring a commitment we made to folks several years ago," she said.

Novant worked closely with Holly Springs officials on a previous proposal to build a $100 million community hospital in the town that would have included 41 beds and four operating rooms.

State regulators rejected the application last year, saying that Novant didn't adequately demonstrate need for a hospital in Holly Springs and that the project might not be cost-effective.

To control health costs, the state limits medical projects in each county, using patient volume, projected population growth and other factors.

Several hospitals applied for the operating rooms that were awarded to Novant.

Holly Springs Mayor Dick Sears said the town had been working closely with Rex Healthcare to add operating rooms to an urgent care facility for which the Raleigh hospital system already has approval.

"It's kind of a mixed bag a little bit," Sears said. "We were a little bit further down the road with Rex. But Novant is, I think, a wonderful facility, and I'm glad they have made some inroads into Wake County."

Both Sears and Everett said they expect one or more of the hospitals that filed competing applications to appeal the state's decision to award Novant the operating rooms. Appeals could trigger a long legal fight, delaying or derailing the project.

If the approval is not appealed, Novant expects the $8.2 million surgery center to open as early as October 2012. The 13,000-square-foot facility would be located at the intersection of N.C. 55 and Rosewood Centre Drive.

david.bracken@newsobserver.com or 919-829-4548