The North Carolina Supreme Court has agreed to hear two certificate-of-need cases in which AdventHealth is challenging state decisions involving Mission Health and the North Carolina Department of Health and Human Services, CarolinaCoastOnline reported Oct. 26.
One of the disputes is over a CON that state regulators gave Mission for a freestanding emergency department in Candler. AdventHealth Hendersonville challenged the approval because regulators never held a public hearing before issuing it.
In 2024, the North Carolina Court of Appeals found that regulators skipped the required hearing. It also ruled that the error didn’t automatically mean AdventHealth suffered substantial prejudice. When the case went back down, an administrative law judge granted summary judgment to Mission and DHHS.
A unanimous Court of Appeals panel upheld that outcome March 4. In his opinion, Judge John called AdventHealth’s prediction that an in-person hearing would have drawn significant community participation speculative. Mr. Arrowood also wrote that lost revenue and reduced services aren’t enough to show substantial prejudice.
In its petition, AdventHealth’s legal team argued that the missed hearing itself caused harm. The lawyers asked the justices to decide whether state law gives “affected persons” the right to challenge CON decisions. They also called the prejudice standard for noncompetitive reviews vague.
The appeals follow the Supreme Court’s October 2025 ruling in Pinnacle Health Services v. NC DHHS. That ruling held that providers denied a CON after a competitive review must show both agency error and substantial prejudice.
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