North Carolina Certificate of Need applications by service and county
1,600+ North Carolina applications in the file since 2016, grouped by what was requested and where. Counts are taken from the file dated October 29, 2026. 83% of decided applications were approved. The median application took about four months from filing to decision.
By service or type
The fifteen largest groups, using North Carolina's own categories where the state prints them.
| Service or type | Rows | Approved | Denied | Approval rate | Median days to decision |
|---|---|---|---|---|---|
| Dialysis | 563 | 533 | 20 | 96% | 95 |
| Imaging, MRI | 128 | 80 | 47 | 63% | 158 |
| Outpatient surgery | 115 | 85 | 29 | 75% | 145 |
| Nursing home beds | 109 | 98 | 10 | 91% | 113 |
| Acute care beds | 96 | 82 | 13 | 86% | 161 |
| Other or not stated | 78 | 72 | 2 | 97% | 99 |
| Adult care home beds | 71 | 49 | 18 | 73% | 139 |
| Operating rooms | 68 | 45 | 22 | 67% | 161 |
| Imaging, PET | 51 | 23 | 27 | 46% | 161 |
| Acute care hospital | 43 | 28 | 15 | 65% | 161 |
| Diagnostic center | 41 | 40 | 1 | 98% | 96 |
| Hospice | 38 | 12 | 26 | 32% | 163 |
| Radiation therapy | 36 | 31 | 5 | 86% | 102 |
| Home health | 35 | 10 | 23 | 30% | 160 |
| Cardiac catheterization | 31 | 26 | 4 | 87% | 104 |
By county
The fifteen counties with the most applications.
| County | Rows | Approved | Denied | Approval rate | Median days to decision |
|---|---|---|---|---|---|
| Wake | 250 | 185 | 60 | 76% | 145 |
| Mecklenburg | 227 | 190 | 34 | 85% | 114 |
| Durham | 83 | 71 | 11 | 87% | 122 |
| Guilford | 82 | 71 | 10 | 88% | 102 |
| Forsyth | 72 | 57 | 15 | 79% | 113 |
| New Hanover | 60 | 38 | 21 | 64% | 159 |
| Buncombe | 57 | 37 | 18 | 67% | 154 |
| Cumberland | 52 | 46 | 5 | 90% | 116 |
| Orange | 40 | 37 | 3 | 92% | 102 |
| Johnston | 35 | 31 | 4 | 89% | 140 |
| Gaston | 34 | 30 | 3 | 91% | 106 |
| Pitt | 34 | 29 | 5 | 85% | 108 |
| Brunswick | 33 | 26 | 7 | 79% | 136 |
| Union | 32 | 31 | 1 | 97% | 105 |
| Alamance | 32 | 25 | 6 | 81% | 98 |
The most recent decisions
| Number | Applicant | Service or type | County | Decided | Outcome |
|---|---|---|---|---|---|
| F-012775-26 | The Presbyterian Hospital and Novant Health, Inc. | Emergency department | Mecklenburg | Sep 28, 2026 | Approved |
| C-012769-26 | Hospice of Henderson County, Inc. | Hospice | McDowell | Sep 25, 2026 | Denied |
| Q-012771-26 | Liberty Healthcare Properties of Pitt County, LLC. Liberty Commons of Pitt County, LLC | Nursing home beds | Pitt | Sep 25, 2026 | Denied |
| C-012772-26 | Bristol Hospice-North Carolina, LLC; Bristol Hospice, LLC | Hospice | McDowell | Sep 25, 2026 | Denied |
| C-012773-26 | VITAS Healthcare Corporation of North Carolina VITAS Healthcare Corporation | Hospice | McDowell | Sep 25, 2026 | Denied |
| C-012774-26 | AdventHealth Home Health and Hospice, Inc.; Adventist Health System Sunbelt Healthcare Corporation | Hospice | McDowell | Sep 25, 2026 | Denied |
| F-012776-26 | Belmont Radiation Oncology, LLC and CaroMont Health, Inc. | Radiation therapy | Gaston | Sep 25, 2026 | Approved |
| C-012777-26 | PruittHealth Hospice, Inc. | Hospice | McDowell | Sep 25, 2026 | Approved |
| C-012779-26 | Affinity Care Hospice of NC II, LLC | Hospice | McDowell | Sep 25, 2026 | Denied |
| C-012781-26 | Hospice & Palliative Care Charlotte Region | Hospice | McDowell | Sep 25, 2026 | Denied |
| C-012783-26 | Well Care Hospice of McDowell, Inc. | Hospice | McDowell | Sep 25, 2026 | Denied |
| F-012784-26 | Atrium Health Radiation Therapy Center, LLC; The Charlotte-Mecklenburg Hospital Authority | Radiation therapy | Gaston | Sep 25, 2026 | Denied |
Numbers link to the state document for that decision where one is posted. Approval rate counts approvals and denials only and is shown where a group has at least five decided applications.
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