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Johnston Health and UNC Health Care are in partnership talks in which UNC, a state-owned health system, would own part of the Johnston County system. 

The Smithfield-based system, which includes a 199-bed nonprofit hospital as well an outpatient campus in Clayton, is facing "tough challenges" as it looks to adapt to changes in the health care industry, according to CEO and president of Johnston Health Chuck Elliott.

"Health care is rapidly changing, and health care systems like ours must be forward-looking to continue to provide care close to our patients' homes in the most efficient way possible," Elliott said in a statement. "We believe partnerships will play an important role in our ability to do so."

The exact ownership percentage is still being negotiated but it will likely be less than 50 percent, says David Strong, chief operating officer of System Affiliations at UNC Health Care.

Johnston Health has grown its net patient service revenue from $122 million in 2009 to $146 million in 2011. By comparison, all entities directly under the UNC Health Care banner operate on nearly $2 billion per year, according to the Triangle Business Journal.

Johnston Health started looking for a partner in November 2011. UNC Health Care was in the final three in the running for the partnership, along with WakeMed Health & Hospitals and Vidant Health, Suzette Rodriguez, community relations specialist for Johnston Health, the Herald Sun notes.