Pinnacle Health Servs. of N.C. LLC v. N.C. Dep't of Health & Hum. Servs.

CourtSupreme Court of North Carolina
DecidedOctober 17, 2025
Docket285A23
StatusPublished

This text of Pinnacle Health Servs. of N.C. LLC v. N.C. Dep't of Health & Hum. Servs. (Pinnacle Health Servs. of N.C. LLC v. N.C. Dep't of Health & Hum. Servs.) is published on Counsel Stack Legal Research, covering Supreme Court of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Pinnacle Health Servs. of N.C. LLC v. N.C. Dep't of Health & Hum. Servs., (N.C. 2025).

Opinion

IN THE SUPREME COURT OF NORTH CAROLINA

No. 285A23

Filed 17 October 2025

PINNACLE HEALTH SERVICES OF NORTH CAROLINA LLC d/b/a/ CARDINAL POINTS IMAGING OF THE CAROLINAS WAKE FOREST and OUTPATIENT IMAGING AFFILIATES LLC, petitioner

v. NC DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF HEALTH SERVICE REGULATION, HEALTH CARE PLANNING & CERTIFICATE OF NEED SECTION, respondent

and

DUKE UNIVERSITY HEALTH SYSTEM, INC., respondent-intervenor

Appeal pursuant to N.C.G.S. § 7A-30(2) (2023) and N.C.G.S. § 7A-32(b) (2023)

from the decision of a divided panel of the Court of Appeals, 290 N.C. App. 497 (2023),

affirming a final decision entered on 19 July 2022 by Administrative Law Judge

Melissa Owens Lassiter in the Office of Administrative Hearings. Heard in the

Supreme Court on 17 September 2024.

Fox Rothschild LLP, by Marcus C. Hewitt and Elizabeth Sims Hedrick, for petitioner-appellee.

Jeff Jackson, Attorney General, by Derek L. Hunter, Special Deputy Attorney General, for respondent-appellant.

Baker, Donelson, Bearman, Caldwell & Berkowitz, P.C., by Iain M. Stauffer and William F. Maddrey, for respondent-intervenor-appellant.

BERGER, Justice.

In North Carolina, health care providers cannot simply develop, acquire, or PINNACLE HEALTH SERVS. OF N.C. LLC V. N.C. DEP’T OF HEALTH & HUM. SERVS.

Opinion of the Court

expand health care facilities or services based on market demand. Instead, providers

must obtain a Certificate of Need (CON) from the North Carolina Department of

Health and Human Services (the Agency) before they can acquire or offer a “new

institutional health service.” NC Division of Health Service Regulation, Healthcare

Planning and Certificate of Need Section, Overview of Certificate of Need (last

modified Dec. 17, 2024), https://info.ncdhhs.gov/dhsr/coneed/overview.html. The

CON law is essentially a form of market control premised on the idea that

government restrictions on the unnecessary duplication of health service facilities

can rein in increasing health care costs. Each year, the Agency, using its

administrative judgment, prepares a State Medical Facilities Plan (SMFP) to

determine the need for additional health care services and facilities, and it awards

CONs accordingly. See Overview of Certificate of Need. In other words, instead of

allowing market preferences to determine the allocation of resources, the CON law

leaves these decisions to bureaucratic assessments.

The 2021 SMFP identified a need for one additional fixed magnetic resonance

imaging (MRI) scanner in Wake County.1 Both Duke University Health System Inc.

and Pinnacle Health Services of North Carolina, LLC d/b/a Cardinal Points Imaging

of the Carolinas Wake Forest and Outpatient Imaging Affiliates LLC (together,

Pinnacle) filed separate CON applications with the Agency’s Division of Health

1 One expert testified at the hearing that it would take at least eleven years to meet

the then-current need for fixed MRI scanners in Wake County under the CON distribution formula.

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Service Regulation, Healthcare Planning and Certificate of Need Section for the lone

fixed MRI scanner. Duke sought to place the scanner in its diagnostic center in

Raleigh, while Pinnacle proposed to place the scanner in a diagnostic center in Wake

Forest. Because the Agency could only approve one application under the distribution

formula, the Agency conducted a competitive review of both applications. Pinnacle’s

application was denied, and the Agency awarded the MRI scanner to Duke.

Pinnacle filed a contested case hearing in the Office of Administrative

Hearings alleging that the decision substantially prejudiced its rights and that the

Agency exceeded its authority and jurisdiction, acted erroneously, failed to follow

proper procedures, acted arbitrarily and capriciously, and failed to act as required by

rule or law. Following a hearing, the administrative law judge agreed, reversing the

Agency’s decision, and awarding the CON to Pinnacle.

Duke and the Agency appealed, arguing that the ALJ erred in reversing the

Agency’s comparative analysis review and that Pinnacle failed to demonstrate

substantial prejudice. Pinnacle Health Servs. of N.C. LLC v. N.C. Dep’t of Health &

Hum. Servs., 290 N.C. App. 497, 499 (2023). The Court of Appeals affirmed the

decision of the ALJ, holding that appellants failed to challenge the ALJ’s findings of

fact which precluded review on the merits. Id. at 503–04.

On appeal to this Court, appellants argue that both the Court of Appeals and

the ALJ incorrectly applied the standard of review and that appellants properly

challenged the ALJ’s findings of fact regarding the comparative analysis reversal and

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substantial prejudice determination.2 We affirm the Court of Appeals’ judgment in

part and reverse in part.

I. Factual and Procedural Background

Pinnacle operates medical imaging practices in Wake County. Duke provides

hospital care, medical care, education, and research across North Carolina. The

Agency is the entity responsible for the administration of North Carolina’s CON laws.

The 2021 SMFP issued by the Agency includes a methodology for determining

the need for additional fixed MRI scanners by service area. Pursuant to N.C.G.S. §

131E-183(a)(1), this determination limits the number of fixed MRI scanners that can

be approved. See N.C.G.S. § 131E-183(a)(1) (2023). And under the 2021 plan, the

2 This Court allowed Pinnacle’s petition for review of additional issues which included,

among other issues, whether the Agency met “its burden in the appellate courts under N.C. Gen. Stat. § 150B-51(b) to show that the ALJ’s decision had substantially prejudiced the Agency[.]” That subsection requires the party seeking judicial reversal or modification of an ALJ’s final decision to demonstrate that it “may have been prejudiced” by the decision. See N.C.G.S. § 150B-51(b) (2023). Although one could argue that it is unclear how the Agency, as a purportedly impartial administrative body, is “prejudiced” by a final decision awarding a CON to one qualified applicant over another, appellants failed to present any argument on this issue. The issue concerning the Agency’s ability to appeal, however, prompted this Court to request supplemental briefing from the parties to determine whether the Agency qualified as an “affected person” entitled to seek judicial review of an ALJ’s final decision under N.C.G.S. § 131E-188(c) or some other statutory provision. In their responses, Pinnacle and appellants agreed that this Court has jurisdiction over the Agency’s appeal. In fact, Pinnacle submitted the simple proposition that, under subsection 150B-43, every party to a contested case is entitled to judicial review. By making these assertions, Pinnacle effectively waived its challenges to the Agency’s ability to appeal. Accordingly, we proceed assuming that the Agency’s appeal is properly before this Court. The other issues raised in Pinnacle’s petition for review of additional issues are subsumed by those issues for which appellants noticed their appeals of right pursuant to now-repealed N.C.G.S. § 7A-30(2) (2023).

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Agency could approve only one additional fixed MRI scanner in Wake County.

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