Certificate of Need Consultant in North Carolina
North Carolina runs one of the most active CON programs in the country, governed annually by the State Medical Facilities Plan (SMFP). PDA is headquartered in Raleigh and has prepared hundreds of applications under this framework — from acute-care beds and operating rooms to imaging equipment and post-acute services.
The North Carolina program
Reviewing agency: N.C. Department of Health and Human Services, Healthcare Planning and Certificate of Need Section (DHSR CON Section).
What's reviewable: Hospitals, nursing home and adult care home beds, ambulatory surgery centers, MRI and PET scanners, cardiac catheterization, gastrointestinal endoscopy rooms, dialysis stations, home health and hospice agencies. [VERIFY current thresholds against the State Medical Facilities Plan.]
Typical timeline: Typically 6–12 months from filing through public hearing, agency decision, and potential contested case — longer where competing applications or appeals are involved. [VERIFY.]
The SMFP publishes need determinations each year by service and county. Filings must document population-based need, financial feasibility, competition, and alignment with SMFP policies. Contested cases are heard by the North Carolina Office of Administrative Hearings, and losing parties often appeal to the Court of Appeals. Because North Carolina is a competitive-batch state, a strong application is only half the work — the other half is anticipating and rebutting every competitor's argument.
PDA in North Carolina
Our North Carolina work spans academic medical centers, community hospitals, ASCs, imaging centers, and post-acute providers. We have testified in contested cases, drafted SMFP petitions, and helped clients pivot their strategy when the annual plan shifts a need determination.
North Carolina CON frequently asked questions
Which projects require a CON in North Carolina?
- New hospitals, additional acute-care and psychiatric beds, ASCs and operating rooms, MRI, PET, cardiac cath, GI endoscopy, dialysis, home health and hospice offices, and nursing home beds — among others. Specific thresholds are set annually in the State Medical Facilities Plan. [VERIFY.]
How long does the North Carolina CON review take?
- The state review cycle is roughly 6–9 months from filing to decision, but contested cases at the Office of Administrative Hearings and appeals can extend the total timeline by a year or more. [VERIFY.]
What is the State Medical Facilities Plan?
- An annual plan issued by DHHS that identifies statewide need for regulated services and sets the policies and methodologies the CON Section applies. It is the starting point for any North Carolina CON strategy.
Turn a complex healthcare challenge into a clear plan.
Whether you're weighing a new service line, preparing a Certificate of Need, planning a facility investment, or aligning leadership on direction — we can help you see the path forward.
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