The arrival of a new year in North Carolina brings with it a new State Medical Facilities Plan (“SMFP”). The SMFP is the annual planning document issued by the North Carolina Department of Health and Human Services, and signed by the Governor, setting forth need determinations for a range of health care facilities, services, and equipment in North Carolina. While not all health care facilities, services and equipment are regulated by the SMFP, many are, so providers who wish to grow must consider the annual need determinations before they can expand. For example, a hospital cannot add acute care beds unless there is need for more beds in the county where the hospital is located. Similarly, providers may not acquire additional MRI scanners unless there is a need in the SMFP. If there is a need for additional services, providers may then file certificate of need applications seeking State approval to add the service. Thus, to add or expand many health care facilities, services and equipment, North Carolina has a two-tier regulatory structure: the determination of a service area need in the SMFP is the initial level, followed by a CON review and approval process. Navigating North Carolina’s complex regulatory world requires experience, perseverance, and resources.

According to the 2023 SMFP, there are multiple need determinations across the State in a variety of areas. Here are some highlights for providers eager to serve the growing population of the nation’s ninth largest state:

Acute Care Beds:

The following counties have need determinations for additional acute care beds in 2023:

Operating Rooms:

The following counties and service areas have need determinations for additional operating rooms in 2023. For the multi-county Health Service Areas I-VI, a need exists for one dedicated vascular access OR in each of the listed Health Service Areas.

Dialysis Stations:

Mecklenburg County shows a need for 6 dialysis stations in a licensed nursing home facility. This is the first time the SMFP has included such a need determination specific to nursing homes.

Adult Care Home Beds:

Home Health Services:

2023 shows an unprecedented need for more Medicare-certified home health agencies in the following counties:

Fixed MRI Scanners:

2023 will be an especially busy year for MRI scanner CON applications, as shown in the table below.

Mobile MRI Scanners:

For the first time in many years, the SMFP includes a need determination for mobile MRI scanners.

Fixed Cardiac Catheterization Equipment:

Shared Fixed Cardiac Catheterization Equipment:

Linear Accelerators:

Dedicated Fixed PET Scanners:

The foregoing need determinations reflect North Carolina’s strong growth trajectory and demand for increased health care services.