First Take a look at North Carolina’s New Healthcare Alternatives in 2023 and Name for Petitions | Williams Mullen

Through North Carolina’s annual healthcare planning process, providers now have a first look at the opportunities likely to be identified for 2023 Certificate of Need (CON) proposals. The proposed State Medical Facility Plan (SMFP) is expected to include a series of needs assessments for new ambulatory health agencies and MRI scanners statewide.

Those interested in adding capabilities that have not been identified as needs have the ability to petition to request customized needs assessments. although July 27, 2022 is the deadline for petitions, Petitions should be prepared now to give petitioners time to offer presentations to members of the State Health Coordinating Council in the series of upcoming summer public hearings.

Home Health Agencies

The Home Health Agency (HHA) need is a culmination of the evolving planning landscape with early indications showing a need for one (1) new HHA in each of the following counties:

Brunswick Catawba Edgecombe Forsyth Granville Guilford
Montgomery Nash New Hanover Onslow Pitt Robeson


The need for magnetic resonance imaging (MRI) scanners is in the spotlight, with the state expected to identify several opportunities for vendors to seek CON licenses to acquire new MRI scanners in various areas of North Carolina in 2023, including:

Brunswick Cleveland Duplin Durham/Caswell New Hanover
Pitt/Greene/Hyde/Tyrell Randolph Stanly Wake


Although the last planning committee meeting included a verbal announcement that positron emission tomography (PET) scanners have “no need,” a published table shows needs in two (2) of the state’s health service areas. The 2021 SMFP included four (4) stationary PET scanner needs assessments, including the need for one (1) stationary PET scanner in each of the following service areas:

For Part 1 (Table 17F-1), application of step 4 of the methodology requires subtractions to balance placeholders for CON-approved scanners and needs assessments in previous SMFPs.

To calculate the needs assessment for the catchment area, add up all the facility deficits (column F) and adjust the total by the number of placeholders for CON-approved scanners and need statements in earlier SMFPs. The total is the needs assessment for an additional stationary PET scanner, except as provided in step 7 for both parts of the combined methodology (column G). (Emphasis added.)

Accordingly, a revised Table 17F-1 would reflect a subtraction or “-1” in each of the above healthcare areas for the CON-approved scanners pending development, and thus no PET requirement determinations in all areas of the state.

Beds for Nursing Homes and Adult Nursing Homes / Inpatient Beds for Hospices

Early indications show no need for new nursing homes and only 30 adult nursing home beds in Anson County and 20 adult nursing home beds in Swain County. As has been the case for years, providers who want to add bed capacity in the long term will have to purchase existing beds. Cumberland County is expected to need eight (8) inpatient hospice beds.

Beds in Psychiatric/Chemical Addiction Treatment Center

The needs methods for beds in psychiatric and chemical addiction treatment centers are no longer a feature of the SMFP, meaning providers are free to apply for CON approvals without waiting for needs assessments to be identified. Proposals remain subject to CON review, including the requirement to demonstrate necessity, but proposals may be submitted in any area of ​​the state according to the review schedule that will be included in the final SMFP.

OPs / cardiac catheters / linac

Early signs show no needs assessments for new operating rooms (ORs) across the country. Physician groups interested in additional OR capacity must file a summer petition to request a needs assessment for a potential new OR request in the coming year.

Cardiac catheterization devices (cardiac catheters) may be approved for development at hospital sites or at licensed outpatient surgical facilities (other than endoscopy-only facilities). The state forecasts a potential need for cardiac catheterization equipment in Johnston, New Hanover, Orange and Wayne counties. A need for linear accelerators (linacs) is proposed for service area 14, which includes Chatham and Orange Counties.

There’s more to come

Following the Long-Term Care and Behavioral Health Committee meeting in May, the State Health Coordinating Council (SHCC) will meet on June 1, 2022. A proposed SMFP will be made available to the public on or about July 1, 2022. SHCC will then hold the Summer Public Hearings in July to receive comments and petitions for adjustments to the needs provisions in the proposed SMFP. Ultimately, the proposed SMFP will be submitted to the governor for review and approval by the end of the year. With approval, the SMFP once again becomes the official document for planning health facilities and services in North Carolina for the year.

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