Applications are due on 15 August 2011 for a Certificate of Need (“CON”) to develop up to 240 new nursing facility beds in Wake County, NC (which includes the City of Raleigh), as the result of a “need determination” for Wake County in the 2011 State Medical Facilities Plan. See the 2011 State Medical Facilities Plan at: http://www.ncdhhs.gov/dhsr/ncsmfp/2011/2011smfp.pdf.
North Carolina has one of the most restrictive Certificate of Need laws in the country, and the availability of 240 beds is a highly unusual opportunity for existing providers to expand and for new providers to enter the market. In North Carolina, no new nursing facilities or new nursing beds in existing facilities may be developed without a CON, and, with very limited exceptions, a CON for new nursing beds or facilities may only be granted when there is a need determination in the State Medical Facilities Plan (“SMFP”).
Although Wake County is one of the fastest growing areas of the State, there has not been a need determination for any new nursing beds in the County for over ten years. The need determination for 240 beds in 2011 was the result of a petition by a private nursing provider to override the standard methodology in the SMFP for determining need for new nursing beds. Despite Wake County’s high population growth, the standard methodology would have again resulted in a determination of no need for new beds; and only 90 new nursing beds are available in 2011 in all of the other counties in the state combined.
Since the review for the 240 available beds presents such an unusual opportunity to develop capacity in a high-growth county, there are expected to be numerous competing applications for the available nursing beds, and the agency decision on the applications will likely be appealed by the unsuccessful applicants. The applicant(s) who are ultimately allowed to develop additional facilities or beds will probably not be known for some time.