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12.12.2019 Governor Cooper Signs Off on the 2020 State Medical Facilities Plan By: Joy Heath & Anderson M. Shackelford

The North Carolina State Health Coordinating Council’s (SHCC) months-long planning cycle came to an end earlier this month, culminating in Governor Roy Cooper signing the final version of the 2020 State Medical Facilities Plan (SMFP) into effect on December 4, 2019.  As before, the SMFP defines the development opportunities for Certificate of Need (CON)-regulated health care facilities and services for the ensuing year.  Given the SMFP’s broad implications across the health care delivery spectrum, 2020 is primed to be a busy year for North Carolina’s health care providers.

Acute Care Facilities and Services

The 2020 SMFP will allow providers to pursue new operating room (OR) capacity in some of the most populous counties of the State, with OR needs identified in Forsyth (2), Mecklenburg (12), and Wake (3) Counties.  Hospitals in these markets are likely to pursue expansion of their inpatient operating suites and/or seek to develop additional hospital outpatient department capacity, while physician groups will undoubtedly seek to develop or expand ambulatory surgery centers.

There is also a need for additional acute care beds in various counties, with bed needs identified in Forsyth (68), Gaston (64), Mecklenburg (126), Moore (25), and New Hanover (36) Counties.  As we predicted in our June 13, 2019 Health Care Update, there is a unique combination of OR and acute care bed needs in Mecklenburg and Forsyth Counties which will present the rare opportunity for a new provider to establish a hospital in one of those markets.  Alternatively, an existing provider could seek to establish a satellite hospital campus to complement its current capabilities.

As for dialysis providers, new in 2020 is the SHCC’s departure from the longstanding Semiannual Dialysis Report, which previously identified needs for dialysis stations two times per year.  Effective with the 2020 SMFP – and over the objections of several dialysis providers – the determination of county- and facility-level dialysis needs are subsumed into an annual health care planning process like that undertaken for other CON-regulated health care facilities and services.  This new planning process has yielded a county-level need determination for dialysis stations in Orange County, which was determined to need four (4) stations (required to be located on the campus of an acute care hospital).  There was also a plethora of facility-level need determinations identified, providing development opportunities for an additional 877 stations across 120 existing dialysis facilities.

There is no need identified for burn intensive care services, open heart surgery services, transplantation services, or inpatient rehabilitation beds in 2020.

Long-Term Care Facilities and Services

Like the 2019 SMFP, the 2020 SMFP identifies only limited development opportunities in the long-term care space.  Adult care home bed development opportunities are limited to several rural counties, with 100 beds available in Gates County, 90 in Pamlico County, 50 in Surry County, and 80 in Tyrrell County.  There was again no need identified for skilled nursing facility beds, relegating providers to acquiring existing capacity to develop new facilities or expand existing facilities.  See our free PowerPoint on buying, selling, and relocating long-term care beds in North Carolina, accessible here.

While the 2020 SMFP does not offer any CON opportunities in home health, it does present the opportunity to apply for a hospice home care office in Rowan County, as well as the opportunity to develop eight (8) hospice inpatient beds in Cumberland County.

Further, the 2020 SMFP identifies needs for child/adolescent chemical dependency treatment beds in the Central Region (30 beds) and Western Region (3 beds), and for adult chemical dependency treatment beds in the Eastern Region (1 bed) and in Forsyth County (32 beds, which are limited to certain circumstances that benefit indigent and/or uninsured individuals).  There are also several child/adolescent psychiatric beds needs across the State.

Technology and Equipment

As for Technology and Equipment, there are numerous development opportunities in 2020 as compared to prior years.  The upcoming year presents several opportunities to acquire fixed MRI scanners, with need determinations in the Alamance, Durham/Caswell, Guilford, Mecklenburg, and Watauga County Service Areas.  There is also an opportunity to acquire a fixed PET scanner in Robeson County, a unit of shared fixed cardiac catheterization equipment in Henderson County, and a gamma knife in Health Service Area III (which includes Mecklenburg County and surrounding Counties).

There is no need identified for linear accelerators or lithotripters in 2020.

As North Carolina’s health care providers implement plans for growth and market strategy, the 2020 SMFP will prove a vital point of reference.  For more information about the opportunities available in the 2020 SMFP, please contact Joy Heath at 919.981.4001 or jheath@williamsmullen.com, or Anderson Shackelford at 919.981.4312 or ashackelford@williamsmullen.com.