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Certificate of Need

Certificate of Need


Since the early 1980s, our firm has been at the forefront of Certificate of Need (CON) litigation and counseling.  We put this extensive experience to work for our clients by reviewing proposed projects, outlining the applicable regulatory framework, and suggesting alternatives to achieve the clients' goals in a compliant and less burdensome manner.

We also review draft CON applications for legal issues, assist in preparation of public hearing and written comments, and represent providers in appealing or defending the approval of CON decisions.  Our team also routinely submits notices of exemption, "no review" letters, and declaratory ruling requests on behalf of our clients and meets with regulators as needed to discuss proposals and evaluate the likely response to unique proposals.

Whether you are an established provider with experience with the CON process, or a potential competitor looking to enter the market, we can help you assess your options and work within the CON regulatory process.


Examples of past CON work include:

  • Represented the applicant in the landmark Britthaven, Inc. v. NCDHR (1995) case
  • Represented existing hospice provider in landmark North Carolina case that established substantial prejudice to existing providers when contested agency action allowed a competitor to expand without CON review
  • Represented hospitals, long term and post-acute care providers, dialysis providers, MRI providers, ASCs, and diagnostic centers in appeals of decisions in competitive CON reviews before the Office of Administrative Hearings and the North Carolina Court of Appeals
  • Defended approval of CON for new nursing home by three denied applicants in the longest ever CON contested case hearing before the North Carolina Office of Administrative Hearings and on appeal to the North Carolina Court of Appeals
  • Represented mobile MRI provider in appeal of State agency order to cease and desist providing services on military base in North Carolina without state agency approval
  • Represented nursing home operator/lessee against municipality owner/lessor in dispute over ownership of CON rights before North Carolina CON Agency
  • Formulated appropriate structures and transactions to facilitate changes of ownership without the need for a CON

* Past success does not indicate the likelihood of success in any future legal representation.


Each of our lawyer's e-mail address is provided with his or her biography. If you are not a current client of our firm, you should not e-mail our lawyers with any confidential information or any information about a specific legal matter, given that our firm may presently represent persons or companies who have interests that are adverse to you. If you are not a current client and you e-mail any lawyer in our firm, you do so without any expectation of confidentiality. We will not establish a professional relationship with you via e-mail. Instead, you should contact our firm by telephone so that we can determine whether we are in a position to consult with you about any legal matters before you share any confidential or sensitive information with us.