Thinking of converting semiprivate to private rooms, or renovating an existing facility to make it more home-like and family-friendly? Considering relocating existing skilled nursing beds to an adjacent county? Planning to convert existing CCRC beds for nursing care or relocate CCNC nursing beds to a sister community in a neighboring county? Some of these projects would require a certificate of need (CON) under North Carolina’s CON law, while others would not. Either way, a provider will almost always want to ask, “CON Section, may I?”

Substantial renovations, expansions or replacements of existing skilled nursing facilities and adult-care home facilities (even those in excess of $2 million) that do not result in a change in bed capacity and that involve (1) converting semiprivate resident rooms to private rooms, (2) implementing innovative and more home-like dining and living spaces, such as cafes and kitchenettes, and/or (3) renovating other common areas to improve residents’ quality of life, are specifically excluded from CON review, provided all of the conditions included in the statutory exemption are met. Even for such projects that do not require CON review, the prudent action plan begins with confirming a project’s exempt or no-review status from the get-go by first consulting with your CON attorney and then checking in with the CON Section. Indeed, written notice to the CON Section is required for a nursing facility or adult care home renovation project that falls within the above-mentioned exemption in order to demonstrate that the proposed project qualifies for the exemption.