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2022 North Carolina State Medical Facilities Plan has Arrived
Monday, January 3, 2022

Governor Roy Cooper signed the 2022 North Carolina State Medical Facilities Plan (“SMFP”) on December 17, 2021. This SMFP became effective on January 1, 2022. The Governor has authority to modify the SMFP, but the 2022 SMFP was signed without any changes from the proposed SMFP submitted to him on October 28, 2021. The 2022 SMFP is dedicated to the memory of Dr. Christopher G. Ullrich, a Charlotte radiologist who served as a member of the North Carolina State Health Coordinating (“SHCC”), the Governor-appointed body that oversees the SMFP, since 2003. Dr. Ullrich was Chair of the SHCC from 2014 until his passing in August 2021.

The SMFP contains need determinations for a variety of health care services in North Carolina. These need determinations contain the dates on which certificate of need applications must be filed. These are absolute deadlines for which no exceptions are made. Below are the need determinations in the 2022 SMFP and their corresponding application deadlines:

Category of Asset

Number of Assets in the Need Determination

Service Area for which the Need Determination Applies

Application Deadline

Acute Care Services

Acute Care Beds

67

Buncombe/Graham/Madison/Yancey

June 15, 2022

Acute Care Beds

29

Cumberland County

Feb. 15, 2022

Acute Care Beds

68

Durham/Caswell

April 18, 2022

Acute Care Beds

65

Mecklenburg County

Oct. 17, 2022

Acute Care Beds

45

Wake County

Aug. 15, 2022

Operating rooms

1

Pitt/Greene/Hyde/Tyrrell

Feb. 15, 2022

Operating rooms

2

Wake County

Aug. 15, 2022

Technology and Equipment

MRI

1

Mecklenburg County

Oct. 17, 2022

MRI

1

Pasquotank/Camden/Currituck/Perquimans

Sept. 15, 2022

MRI

1

Pitt/Greene/Hyde/Tyrrell

Oct. 17, 2022

Fixed Cardiac Cath

1

Mecklenburg County

Aug. 15, 2022

Shared Fixed Cardiac Cath

1

Iredell County

Feb. 15, 2022

Linear Accelerator

1

Service Area 7 (Anson/Mecklenburg/Union)

Aug. 15, 2022

Linear Accelerator

1

Service Area 24 (Carteret/Craven/Jones/Pamlico)

April 18, 2022

Long-Term and Behavioral Health

Skilled Nursing Beds

36

Cabarrus County

July 15, 2022

Assisted Living Beds

10

Swain County

July 15, 2022

Hospice Inpatient Beds

10

Cumberland County

July 15, 2022

Other important deadlines to know:

March 2, 2022 is the deadline for petitions to the SHCC that have a statewide impact. For example, if a provider believes a change to a need methodology is necessary, it could make that proposal by filing a petition by the March deadline.

July 27, 2022 is the deadline for petitions to the SHCC for special need determinations. For example, if the standard need methodology did not produce a need determination for acute care beds in County A, but a provider believes such a need determination should be in the 2023 SMFP, it could submit a petition to the SHCC seeking such a need determination. If the petition were successful, anyone could apply to meet that need in 2023.

The 2022 SMFP also contains the dates for the meetings of the SHCC and its three committees: Acute Care Services; Long-Term and Behavioral Health; and Technology and Equipment. At present, the plan is to hold in person meetings in Raleigh, though that may change depending on evolving conditions with respect to the pandemic.

As readers of this blog may recall, on October 1, 2021, North Carolina’s CON law changed (Session Law 2021-129, Senate Bill 462) to increase the capital cost thresholds for several services:

Category

Old Threshold

New Threshold

Diagnostic Center

$500,000

$1.5 million

Major Medical Equipment

$750,000

$2 million

New Institutional Health Services

$2 million

$4 million

Some CON watchers predict these increases will mean fewer CON applications will be filed in the future, though because the law is so new, only time will tell how accurate the prediction is. In addition, the 2021 amendments also impose a "shot clock" specifying when the holder of a CON must execute or commit to a contract for design services for the project authorized by the CON.

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