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On September 30, 2026, the North Carolina State Health Coordinating Council (SHCC) met to review and approve the final need determinations recommended for inclusion in the 2027 State Medical Facilities Plan (SMFP). The approved need determinations will direct the facilities, services, and equipment that may be pursued through North Carolina's Certificate of Need (CON) process during the upcoming planning cycles. Based on the final recommendations approved by the SHCC, opportunities exist for providers in several healthcare sectors, highlighted by acute care beds, major medical equipment, hospice services, rehabilitation services, and long-term care.
Recommended 2027 SMFP Need Determinations
The table below summarizes the need determinations approved by the SHCC and recommended for inclusion in the 2027 State Medical Facilities Plan.
| SMFP Asset | Service Area / HSA | Number Available |
| Acute Care Beds | Bertie | 2 |
| Cumberland | 86 | |
| Durham | 4 | |
| Forsyth/Yadkin | 179 | |
| Macon | 6 | |
| Onslow | 46 | |
| Orange | 73 | |
| Pitt/Greene/Hyde/Tyrrell | 60 | |
| Adult Care Home Beds | Alleghany County (HSA I) | 10 |
| Chowan County (HSA VI) | 30 | |
| Fixed Cardiac Cath Equipment | Alamance | 1 |
| Craven/Jones/Pamlico | 1 | |
| Durham | 1 | |
| Fixed MRI Scanner | Beaufort/Hyde | 1 |
| Chatham | 1 | |
| Cleveland | 1 | |
| Henderson | 1 | |
| Scotland | 1 | |
| Fixed PET Scanner | HSA II | 1 |
| HSA III | 1 | |
| HSA V | 2 | |
| Mobile PET Scanner | Statewide | 1 |
| Linear Accelerator | HSA I | 1 |
| HSA III | 1 | |
| HSA IV | 1 | |
| HSA V | 1 | |
| HSA VI | 1 | |
| Nursing Care Beds | Davie (HSA II) | 30 |
| Hoke (HSA V) | 20 |
Notable Changes from the Proposed 2027 SMFP
Several need determinations changed during the review process. The recommended acute care bed determinations now include a need for four acute care beds in Durham County, an increase in the Forsyth/Yadkin service area, and a minor adjustment to the Pitt/Greene/Hyde/Tyrrell service area. In addition, the proposed need determination for a hospice home care office in Gaston County was removed from the final recommendations. Additionally, inpatient rehabilitation beds will be removed from future SMFPs following their exemption from CON review effective October 1, 2026.
The largest continuing opportunities remain in acute care beds and cancer treatment services. The recommended plan identifies significant acute care bed need determinations in Cumberland County, Forsyth/Yadkin Counties, Orange County, and the Pitt/Greene/Hyde/Tyrrell service area. The plan also continues to identify linear accelerator opportunities across several Health Service Areas though the Committee approved a motion to reconvene the LINAC Workgroup during the 2028 SMFP planning cycle to evaluate potential revisions to the LINAC methodology.
What Happens Next?
With the SHCC approval complete, the recommended 2027 State Medical Facilities Plan will be forwarded to Governor Josh Stein for final review. Under North Carolina law, the Governor may approve the plan as recommended or make modifications before issuing final approval. The Governor's deadline for approval of the 2027 SMFP is December 31, 2026. Once approved, the need determinations contained in the plan will establish the Certificate of Need opportunities available for providers seeking to develop new facilities, services, or equipment in the state.
RPC will continue monitoring developments related to the 2027 SMFP and upcoming CON review schedules and deadlines.
Learn More About RPC’s CON Services Here