HOLLY SPRINGS - A Winston-Salem hospital chain wants to build a 46-bed, $110 million hospital in Holly Springs, but it will face a battle to win state approval.

Novant Health, a nonprofit health-care company with nine hospitals in the Triad and Charlotte areas, announced plans Wednesday for a Holly Springs hospital to serve the town and southwest Wake County.

If Novant wins approval, it would hire 200 to 300 people and open in 2012. It plans to submit its application to state regulators Aug. 15.

Approval will likely be hard-fought because the plan would use up all the new hospital beds that state regulators have allocated for Wake County.

The state has said the county's hospital system can grow by 41 beds and four operating rooms this year, said Craig Smith, the assistant chief of the Certificate of Need Section of the N.C. Division of Health Service Regulation.

Wake County's existing hospitals, WakeMed, Rex Healthcare and Duke Health Raleigh, are bound to fight Novant's request.

"We're expecting a spirited debate," said Mark Billings, the chief operating officer of Novant's Presbyterian Healthcare South.

The beds up for grabs will likely be bid on by every hospital in Wake, said Steve Burriss, the vice president of ambulatory services for Rex.

"We do intend to apply for the 41 beds," Burriss said, citing the boom in births the hospital has seen in the last three years. "We have an urgent need for OB beds."

Representatives of WakeMed declined to comment on Novant's bid.

Novant's push into Wake County did not come as a surprise to Dawn Carter, president of Health Planning Source who consults for hospital systems across the state including Rex.

"A lot of us expected them to file [in Wake]. We just did not know where," she said.

Carter said Novant has been building similar community hospitals in Western North Carolina.

If Novant's bid is successful, it will grasp a toehold in a fast-growing region of the Triangle and take business from WakeMed's Cary Hospital, which Holly Springs Mayor Dick Sears called "Lil' WakeMed."

In 2006, town officials conducted a poll of citizens and found that a hospital in town was at the top of most people's wish list.

While Holly Springs has made no secret that it wants a real hospital, Sears said that Rex, WakeMed and Duke were not interested in building a full-service facility just for the town.

Sears said town officials have been talking to Novant for seven years. The company's plans for the town includes maternity services, a 24-hour emergency room and other services.

Sears said that the town did not offer any economic incentives to Novant beyond helping the company find suitable land.

At a news conference to announce Novant's decision, Billings said it's now up to Holly Springs' citizens to tell the state they want a hospital.

He guided them to a Web site: www.myhollyspringshospital.org.

"It's going to take each and every one of you to bring this hospital here," he said.