NC Supreme Court to Hear AdventHealth's CON Challenges to Mission Health

North Carolina's Supreme Court agreed to hear two discretionary appeals from AdventHealth Hendersonville challenging certificates of need (CON) that state regulators awarded to HCA-owned Mission Health, including a $29 million freestanding emergency department in Candler. Lower courts had rejected AdventHealth's arguments, though a 2024 appellate ruling found regulators failed to hold a required public hearing before awarding the Candler CON. AdventHealth is asking the court to clarify what a competitor must prove to successfully challenge a "noncompetitive" CON review, building on the court's 2025 standard for competitive reviews. A ruling favoring AdventHealth could make CON awards easier to contest statewide, affecting hospitals and ambulatory surgical centers alike.