North Carolina SB 1040: Repeal CON for ASCs and Inpatient Rehab.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 2
SENATE BILL 1040
Health Care Committee Substitute Adopted 5/13/26

Short Title: Repeal CON for ASCs and Inpatient Rehab. (Public)
Sponsors:
Referred to:
May 4, 2026
*S1040-v-2*
A BILL TO BE ENTITLED 1
AN ACT REPEALING CERTIFICATE OF NEED LAWS FOR AMBULATORY SURGICAL 2
FACILITIES AND FOR INPATIENT REHABILITATION SERVICES, FACILITIES, 3
AND BEDS; APPROPRIATING FUNDS TO THE DEPARTMENT OF HEALTH AND 4
HUMAN SERVICES TO IMPLEMENT THESE CHANGES AND DEVELOP A PLAN 5
FOR THE PHASED ELIMINATION OF THE STATE'S REMAINING CERTIFICATE OF 6
NEED LAWS; AND DELETING OBSOLETE DEFINITIONS FOR BEHAVIORAL 7
HEALTH FACILITIES THAT ARE NO LONGER SUBJECT TO CERTIFICATE OF 8
NEED REVIEW. 9
The General Assembly of North Carolina enacts: 10
SECTION 1. G.S. 131E-176 reads as rewritten: 11
"§ 131E-176. Definitions. 12
The following definitions apply in this Article: 13
... 14
(1b) Ambulatory surgical facility. – A facility designed for the provision of a 15
specialty ambulatory surgical program or a multispecialty ambulatory surgical 16
program. An ambulatory surgical facility serves patients who require local, 17
regional, or general anesthesia and a period of post-operative observation. An 18
ambulatory surgical facility may only admit patients for a period of less than 19
24 hours and shall provide at least one designated operating room or 20
gastrointestinal endoscopy room and at least one designated recovery room, 21
have available the necessary equipment and trained personnel to handle 22
emergencies, provide adequate quality assurance and assessment by an 23
evaluation and review committee, and maintain adequate medical records for 24
each patient. An ambulatory surgical facility may be operated as a part of a 25
physician's or dentist's office so long as the facility is licensed under Part 4 of 26
Article 6 of this Chapter, but the performance of incidental, limited 27
ambulatory surgical procedures that do not constitute an ambulatory surgical 28
program and that are performed in a physician's or dentist's office does not 29
make that office an ambulatory surgical facility. 30
(1c) Ambulatory surgical program. – A formal program for providing on a 31
same-day basis those surgical procedures that require local, regional, or 32
general anesthesia and a period of post-operative observation to patients 33
whose admission for more than 24 hours is determined, prior to surgery or 34
gastrointestinal endoscopy, to be medically unnecessary. 35
... 36

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 1040-Second Edition
(7d) Gastrointestinal endoscopy room. – A room in a licensed health service 1
facility used for the performance of procedures that require the insertion of a 2
flexible endoscope into a gastrointestinal orifice to visualize the 3
gastrointestinal lining and adjacent organs for diagnostic or therapeutic 4
purposes. 5
... 6
(9b) Health service facility. – A hospital; long-term care hospital; rehabilitation 7
facility; nursing home facility; adult care home; kidney disease treatment 8
center, including freestanding hemodialysis units; intermediate care facility 9
for individuals with intellectual disabilities; home health agency office; 10
diagnostic center; or hospice office, hospice inpatient facility, or hospice 11
residential care facility; or ambulatory surgical facility. This term does not 12
include a qualified urban ambulatory surgical facility. 13
(9c) Health service facility bed. – A bed licensed for use in a health service facility 14
in the categories of (i) acute care beds; (ii) rehabilitation beds; (iii) nursing 15
home beds; (iv) (iii) intermediate care beds for individuals with intellectual 16
disabilities; (v) (iv) hospice inpatient facility beds; (vi) (v) hospice residential 17
care facility beds; (vii) (vi) adult care home beds; and (viii) (vii) long-term 18
care hospital beds. 19
... 20
(13d) Hospital. – A public or private institution that is primarily engaged in 21
providing to inpatients, by or under supervision of physicians, diagnostic 22
services and therapeutic services for medical diagnosis, treatment, and care of 23
injured, disabled, or sick persons, or rehabilitation services for the 24
rehabilitation of injured, disabled, or sick persons. The term includes all 25
facilities licensed pursuant to G.S. 131E-77, except rehabilitation facilities 26
and long-term care hospitals. 27
... 28
(15a) Multispecialty ambulatory surgical program. – A formal program for 29
providing on a same-day basis surgical procedures for at least three of the 30
following specialty areas: gynecology, otolaryngology, plastic surgery, 31
general surgery, ophthalmology, orthopedic, or oral surgery. 32
... 33
(16) New institutional health services. – Any of the following: 34
... 35
b. Except with respect to qualified urban ambulatory surgical facilities 36
and except as otherwise provided in G.S. 131E-184(e), the obligation 37
by any person of a capital