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The North Carolina State Health Coordinating Council (SHCC) has published need determinations ahead of releasing the initial draft of the 2027 State Medical Facilities Plan (SMFP). Summarizing the initial determinations and the process to formalize the 2027 Plan, this blog post addresses:
- The SMFP process
- The assets available under the SMFP
- The next steps and timing around:
- Public comments
- Committee review and approval
- Formal sign-off and implementation of the final 2027 SMFP
SMFP Process
The SMFP is a controlling document for the certificate of need (CON) process in North Carolina. It has data for each existing or approved facility and service, describes projection methods and policies, and provides other data relevant to need projections. Unless it projects a need in a county or planning area for CON-reviewable facilities and healthcare services, there can be no CON application. Health care providers and facilities in North Carolina can only gain approval for assets the SMFP shows are needed. These need calculations and methodologies are discussed and reviewed by members of each responsible committee:
- Acute Care Services Committee
- Long Term and Behavioral Health Committee
- Technology and Equipment Committee
- Hospice Home Care Workgroup
Development of the SMFP is a continuous process with several opportunities for public comment. Two of these opportunities are the spring and summer petition periods. The spring petition period is intended for requests with potential statewide effect, including requests for addition, deletion or revision of methods for determining need. The summer petition period is for requests for changes in the need determinations in the published draft SMFP. Members of the public can also submit general comments about need determinations during the summer petition period. Both spring and summer petitions and comments are published on the Agency website and given a two-week public comment period for others to respond to individual petitions. Each petition is assigned to a SHCC committee for discussion and recommendation.
Services with a Proposed Need after the Initial Meetings
The table below summarizes the needs published in the minutes from the first round of SHCC meetings[1] which took place between April 7 and May 14, 2026. The table shows a preliminary determination of the need for acute care beds in 9 service areas, 5 of which need over 50 beds. There is also a need for several categories of major medical equipment, and adult care beds.
| SMFP Asset | Service Area / HSA | Number Available |
| Acute Care Beds | Alamance County | 27 |
| Buncombe/Clay/Graham/Madison/Yancey Counties | 48 | |
| Cumberland County | 40 | |
| Durham County | 90 | |
| Forsyth/Yadkin Counties | 86 | |
| Mecklenburg County | 86 | |
| Onslow County | 24 | |
| Orange County | 52 | |
| Wake County | 85 | |
| Adult Care Home Beds | Alleghany County (HSA I) | 10 |
| Chowan County (HSA VI) | 30 | |
| Fixed Cardiac Cath Equipment | Alamance | 1 |
| Cabarrus | 1 | |
| Craven/Jones/Pamlico | 1 | |
| Durham | 1 | |
| Fixed MRI Scanner | Beaufort/Hyde | 1 |
| Chatham | 1 | |
| Cleveland | 1 | |
| Henderson | 1 | |
| Mitchell | 1 | |
| Scotland | 1 | |
| Watauga | 1 | |
| Fixed PET Scanner | HSA II | 1 |
| HSA III | 1 | |
| HSA V | 2 | |
| Hospice Home Care Office | Gaston County | 1 |
| Inpatient Rehab Beds | HSA III | 20 |
| Linear Accelerator | HSA I | 2 |
| HSA III | 7 | |
| HSA IV | 2 | |
| HSA V | 2 | |
| HSA VI | 1 | |
| Nursing Care Beds | Davie (HSA II) | 30 |
| Hoke (HSA V) | 20 |
Summer Petitions and Comments
The summer petition and comment window for the 2027 North Carolina State Medical Facilities Plan (SMFP) will occur right after the State Health Coordinating Council (SHCC) publishes the Proposed 2027 SMFP on or about July 1, 2026. Providers and members of the public can submit formal petitions requesting specific changes to the draft need determinations (such as adjusting acute care bed allocations, hospice office needs, or major medical equipment counts). All summer petitions are due by July 22, 2026. Following a brief period when the Agency publishes these submissions, a public comment window opens, letting competing providers file responses or letters of opposition. This public comment window closes on August 5th, 2026. All petitions and comments are then sent to the SHCC subcommittees which review the materials and vote on recommendations during their public meetings in early September. The final need determinations will include not only the area and quantity of need but also the deadline for application and timeline for each review period.
Completion and Final Sign-Off
The SHCC meeting for a final vote on recommendations for the 2027 SMFP is scheduled for September 30, 2026. The SHCC recommendation will then be sent to Governor Josh Stein who may approve it as recommended or make any changes the Governor deems appropriate. The deadline for the Governor’s final approval is December 31, 2026.
NC 2027 SMFP Timeline
[1] Meeting Minutes from SHCC Committee Meetings. Available at: https://info.ncdhhs.gov/dhsr/mfp/pdf/2026/committeemeet.html#shcc
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