Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0272Alamance Alamance Regional Medical Center 2 3 9 -2 0 0 0 15,627.3 3 1,755

Alamance Total 2 3 9 -2 0 0 0

H0274Alexander Alexander Hospital (closed) 0 0 2 0 0 0 0 0.0

Alexander Total 0 0 2 0 0 0 0

H0108Alleghany Alleghany Memorial Hospital 0 0 2 0 0 0 0 349.6 4 1,500

Alleghany Total 0 0 2 0 0 0 0

H0082Anson Atrium Health Anson 0 0 1 0 0 0 0 42.5 4 1,500

Anson Total 0 0 1 0 0 0 0

H0099Ashe Ashe Memorial Hospital 0 0 2 0 0 0 0 1,376.5 4 1,500

Ashe Total 0 0 2 0 0 0 0

H0037Avery Charles A. Cannon, Jr. Memorial Hospital 0 0 2 0 0 0 0 311.6 4 1,500

H0077Watauga Watauga Medical Center 1 0 6 -1 0 0 0 6,703.9 4 1,500

Appalachian Regional Healthcare System Total 1 80 -1 0 0 0

Avery/Watauga Total 1 0 8 -1 0 0 0

H0188Beaufort Vidant Beaufort Hospital 1 0 5 -1 0 0 0 4,132.8 4 1,500

Beaufort Total 1 0 5 -1 0 0 0

H0268Bertie Vidant Bertie Hospital 0 0 2 0 0 0 0 319.2 4 1,500

Bertie Total 0 0 2 0 0 0 0

H0154Bladen Cape Fear Valley-Bladen County Hospital 0 0 2 0 0 0 0 244.3 4 1,500

Bladen Total 0 0 2 0 0 0 0

Brunswick Brunswick Surgery Center 0 0 0 0 0 1 0 0.0

H0150Brunswick J. Arthur Dosher Memorial Hospital 0 0 2 0 0 0 0 3,021.3 4 1,500

H0250Brunswick Novant Health Brunswick Medical Center 1 0 4 -1 0 0 0 8,327.5 4 1,500

Brunswick Total 1 0 6 -1 0 1 0

Buncombe Asheville SurgCare 0 0 0 0 0 5 0 0.0

AS0038Buncombe Orthopaedic Surgery Center of Asheville 0 3 0 0 0 -3 0 5,533.5 6 1,312

Orthopaedic Surgery Center of Asheville Total 0 03 0 0 2 0

AS0065Buncombe Asheville Eye Surgery Center 0 1 0 0 0 0 0 1,145.8 5 1,312

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0036Buncombe Mission Hospital 8 9 30 -2 -1 0 0 78,110.9 2 1,950

Buncombe/Madison/Yancey Total 8 13 30 -2 -1 2 0

AS0040Burke Surgery Center of Morganton Eye

Physicians

0 2 0 0 0 0 0 1,300.0 5 1,312

H0062Burke Carolinas HealthCare System Blue Ridge 1 0 9 -1 0 0 0 6,838.1 4 1,500

Burke Total 1 2 9 -1 0 0 0

AS0070Cabarrus Gateway Surgery Center 0 4 0 0 0 0 0 5,444.3 6 1,312

H0031Cabarrus Atrium Health Cabarrus 4 0 17 -2 0 0 0 27,515.9 3 1,755

Atrium Health Total 4 174 -2 0 0 0

AS0019Cabarrus Eye Surgery and Laser Clinic, Inc 0 2 0 0 0 0 0 3,165.8 5 1,312

Cabarrus Total 4 6 17 -2 0 0 0

AS0168Caldwell Prime Surgical Suites 0 3 0 0 0 0 0 0.0

H0061Caldwell Caldwell Memorial Hospital 1 0 4 -1 0 0 0 5,234.4 4 1,500

UNC Health Care Total 1 43 -1 0 0 0

Caldwell Total 1 3 4 -1 0 0 0

AS0061Carteret The Surgical Center of Morehead City 0 2 0 0 0 0 0 1,612.9 6 1,312

H0222Carteret Carteret General Hospital 1 0 5 -1 0 0 0 6,552.2 4 1,500

Carteret Total 1 2 5 -1 0 0 0

AS0036Catawba Graystone Eye Surgery Center 0 2 0 0 0 1 0 4,264.7 5 1,312

AS0101Catawba Viewmont Surgery Center 0 3 0 0 0 0 0 2,239.5 5 1,312

H0053Catawba Frye Regional Medical Center 2 4 15 0 0 0 0 16,123.0 3 1,755

H0223Catawba Catawba Valley Medical Center 1 12 0 -1 0 0 0 14,595.5 4 1,500

Catawba Total 3 21 15 -1 0 1 0

H0007Chatham Chatham Hospital 0 0 2 0 0 0 0 985.6 4 1,500

Chatham Total 0 0 2 0 0 0 0

H0239Cherokee Erlanger Murphy Medical Center 0 0 4 0 0 0 0 4,707.0 4 1,500

Cherokee/Clay Total 0 0 4 0 0 0 0

H0063Chowan Vidant Chowan Hospital 0 0 3 0 0 0 0 1,080.8 4 1,500

Chowan Total 0 0 3 0 0 0 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

AS0062Cleveland Cleveland Ambulatory Services 0 4 0 0 0 0 0 757.6 5 1,312

H0024Cleveland Atrium Health Cleveland^ 1 0 8 -1 0 0 0 9,731.6 4 1,500

Atrium Health Total 1 84 -1 0 0 0

AS0049Cleveland Eye Surgery Center of Shelby 0 2 0 0 0 0 0 1,318.7 5 1,312

Cleveland Total 1 6 8 -1 0 0 0

H0045Columbus Columbus Regional Healthcare System 1 0 5 -1 0 0 0 2,689.8 4 1,500

Columbus Total 1 0 5 -1 0 0 0

H0201Craven CarolinaEast Medical Center 3 6 9 -1 0 0 0 14,476.1 4 1,500

Craven/Jones/Pamlico Total 3 6 9 -1 0 0 0

H0213Cumberland Cape Fear Valley Medical Center 5 0 14 -3 0 2 0 23,577.5 3 1,755

H0275Cumberland Highsmith-Rainey Specialty Hospital 0 0 3 0 0 -2 0 3,225.0 4 1,500

Cape Fear Valley Health System Total 5 170 -3 0 0 0

AS0006Cumberland Fayetteville Ambulatory Surgery Center 0 11 0 0 0 0 0 8,435.0 6 1,312

AS0159Cumberland Valleygate Dental Surgery Center*** 0 2 0 0 0 0 0 5,772.2 6 1,312

Cumberland Total 5 13 17 -3 0 0 0

AS0053Dare Sentara Kitty Hawk Ambulatory Surgery

Center (closed)*

0 0 0 0 0 0 0 0.0

H0273Dare The Outer Banks Hospital 1 0 3 -1 0 0 0 1,853.7 4 1,500

Dare/Currituck Total 1 0 3 -1 0 0 0

H0027Davidson Lexington Medical Center 0 0 4 0 0 0 0 4,465.2 4 1,500

H0112Davidson Novant Health Thomasville Medical Center 1 0 5 -1 0 0 0 5,892.6 4 1,500

Davidson Total 1 0 9 -1 0 0 0

H0171Davie Davie Medical Center 0 0 3 0 0 0 0 3,090.9 4 1,500

Davie Total 0 0 3 0 0 0 0

H0166Duplin Vidant Duplin Hospital 0 0 3 0 0 0 0 2,221.7 4 1,500

Duplin Total 0 0 3 0 0 0 0

Durham Arringdon Ambulatory Surgical Center 0 0 0 0 0 4 0 0.0

AS0041Durham James E. Davis Ambulatory Surgical Center 0 8 0 0 0 -4 0 6,329.3 5 1,312

H0015Durham Duke University Hospital** 10 9 46 0 -1 2 0 133,311.4 1 1,950

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0233Durham Duke Regional Hospital 2 0 13 -2 0 0 0 22,099.9 3 1,755

Duke University Health System Total 12 5917 -2 -1 2 0

Durham Southpoint Surgery Center 0 0 0 0 0 2 0 0.0

H0075Durham North Carolina Specialty Hospital 0 0 4 0 0 0 0 10,775.4 4 1,500

NC Specialty Hospital Total 0 40 0 0 2 0

Durham Total 12 17 63 -2 -1 4 0

H0258Edgecombe Vidant Edgecombe Hospital 1 0 5 -1 0 0 0 2,800.5 4 1,500

Edgecombe Total 1 0 5 -1 0 0 0

AS0149Forsyth Novant Health Kernersville Outpatient

Surgery

0 2 0 0 0 0 0 1,929.9 5 1,312

AS0167Forsyth Novant Health Clemmons Outpatient

Surgery

0 2 0 0 0 0 0 0.0

H0209Forsyth Novant Health Forsyth Medical Center 5 6 24 -2 0 0 0 54,606.1 2 1,950

H0229Forsyth Novant Health Medical Park Hospital 0 0 10 0 0 0 0 17,981.3 3 1,755

Novant Health Total 5 3410 -2 0 0 0

AS0021Forsyth Wake Forest Baptist Health Outpatient

Surgery Center - Clemmons-C1****

0 3 0 0 0 0 0 2,250.0 6 1,312

H0011Forsyth North Carolina Baptist Hospital** 4 0 36 0 -2 11 0 96,231.4 1 1,950

Wake Forest Baptist Health Total 4 363 0 -2 11 0

AS0134Forsyth Piedmont Outpatient Surgery Center 0 2 0 0 0 0 0 1,764.8 5 1,312

Forsyth Triad Center for Surgery 0 0 0 0 0 2 0 0.0

Forsyth 2020 SMFP Need Determination 0 0 0 0 0 2 0 0.0

Forsyth Total 9 15 70 -2 -2 15 0

H0267-BFranklin Maria Parham Franklin 0 0 3 0 0 0 0 0.0

Franklin Same Day Surgery Center 0 0 0 0 0 2 0 0.0

Franklin Total 0 0 3 0 0 2 0

Gaston CaroMont Regional Medical Center -

Belmont

0 0 0 0 0 2 1 0.0

AS0037Gaston CaroMont Specialty Surgery 0 6 0 0 0 -2 0 1,749.4 5 1,312

H0105Gaston CaroMont Regional Medical Center 5 7 10 -4 0 0 -1 20,821.5 3 1,755

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

CaroMont Health Total 5 1013 -4 0 0 0

Gaston Total 5 13 10 -4 0 0 0

H0098Granville Granville Health System 0 0 3 0 0 0 0 1,137.2 4 1,500

Granville Total 0 0 3 0 0 0 0

AS0009Guilford Greensboro Specialty Surgical Center 0 3 0 0 0 0 0 790.7 6 1,312

AS0018Guilford Surgical Center of Greensboro 0 13 0 0 0 0 0 7,054.5 6 1,312

Surgical Care Affiliates Total 0 016 0 0 0 0

AS0047Guilford High Point Surgery Center 0 6 0 0 0 0 0 4,151.0 6 1,312

AS0152Guilford Premier Surgery Center 0 2 0 0 0 0 0 258.0 6 1,312

H0052Guilford High Point Regional Health 3 0 8 -1 0 0 0 11,709.2 4 1,500

Wake Forest Baptist Health Total 3 88 -1 0 0 0

AS0161Guilford Valleygate Dental Surgery Center of the

Triad***

0 2 0 0 0 0 0 1,828.5 6 1,312

AS0033Guilford Surgical Eye Center 0 4 0 0 0 0 0 1,542.8 5 1,312

AS0063Guilford Piedmont Surgical Center 0 2 0 0 0 0 0 996.7 6 1,312

H0073Guilford Kindred Hospital - Greensboro 0 0 1 0 0 0 0 262.0 4 1,500

H0159Guilford Cone Health 4 13 29 0 -1 0 0 71,320.1 2 1,950

Guilford/Caswell Total 7 45 38 -1 -1 0 0

H0230Halifax Vidant North Hospital 0 0 6 0 0 0 0 3,546.7 4 1,500

Halifax/Northampton Total 0 0 6 0 0 0 0

H0224Harnett Betsy Johnson Hospital 0 0 7 0 0 0 0 4,430.6 4 1,500

Harnett Total 0 0 7 0 0 0 0

H0025Haywood Haywood Regional Medical Center 0 0 7 0 0 0 0 6,273.5 4 1,500

Haywood Total 0 0 7 0 0 0 0

Henderson Western Carolina Surgery Center 0 0 0 0 0 1 0 0.0

H0019Henderson AdventHealth Hendersonville 1 0 6 -1 0 -1 0 6,115.6 4 1,500

Adventist Health Total 1 60 -1 0 0 0

Henderson Pardee Partners ASC 0 0 0 0 0 2 0 0.0

H0161Henderson Margaret R. Pardee Memorial Hospital 0 0 10 0 0 -2 1 11,392.7 4 1,500

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

Margaret R. Pardee Memorial Hospital Total 0 100 0 0 0 1

Henderson Total 1 0 16 -1 0 0 1

H0001Hertford Vidant Roanoke-Chowan Hospital 1 0 5 -1 0 0 0 1,466.5 4 1,500

Hertford Total 1 0 5 -1 0 0 0

H0287Hoke FirstHealth Moore Regional Hospital -

Hoke Campus

0 0 1 0 0 1 0 316.5 4 1,500

H0288Hoke Cape Fear Valley Hoke Hospital 1 0 2 -1 0 0 0 2,004.4 4 1,500

Hoke Total 1 0 3 -1 0 1 0

H0248Iredell Davis Regional Medical Center 1 0 5 -1 0 0 0 2,430.9 4 1,500

H0259Iredell Lake Norman Regional Medical Center 1 2 7 -1 0 0 0 9,704.8 4 1,500

Community Health Systems Total 2 122 -2 0 0 0

Iredell Iredell Mooresville Campus ASC 0 0 0 0 0 1 0 0.0

AS0042Iredell Iredell Ambulatory Surgery Center 0 1 0 0 0 0 0 362.0 5 1,312

AS0050Iredell Iredell Surgical Center 0 4 0 0 0 0 0 731.0 5 1,312

H0164Iredell Iredell Memorial Hospital 1 0 10 -1 0 -1 0 11,773.8 4 1,500

Iredell Health System Total 1 105 -1 0 0 0

Iredell Total 3 7 22 -3 0 0 0

H0069Swain Swain Community Hospital 0 0 1 0 0 0 0 0.0

H0087Jackson Harris Regional Hospital 1 0 6 -1 0 0 0 5,426.5 4 1,500

Duke LifePoint Total 1 70 -1 0 0 0

Jackson/Graham/Swain Total 1 0 7 -1 0 0 0

H0151Johnston Johnston Health 2 0 8 -2 0 0 0 8,841.6 4 1,500

Johnston Total 2 0 8 -2 0 0 0

H0243Lee Central Carolina Hospital 1 0 6 -1 0 0 0 4,735.6 4 1,500

Lee Total 1 0 6 -1 0 0 0

H0043Lenoir UNC Lenoir Health Care 1 0 9 -1 0 0 0 4,553.4 4 1,500

Lenoir Total 1 0 9 -1 0 0 0

H0225Lincoln Atrium Health Lincoln 1 1 3 -1 0 0 0 3,369.5 4 1,500

Lincoln Total 1 1 3 -1 0 0 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0034Macon Angel Medical Center 1 0 4 -1 0 -1 0 1,287.3 4 1,500

H0193Macon Highlands-Cashiers Hospital 0 0 2 0 0 0 0 0.0

Mission Health Total 1 60 -1 0 -1 0

Macon Total 1 0 6 -1 0 -1 0

H0078Martin Martin General Hospital 0 0 2 0 0 0 0 1,761.2 4 1,500

Martin Total 0 0 2 0 0 0 0

H0097McDowell Mission Hospital McDowell 1 0 3 -1 0 0 0 2,481.1 4 1,500

McDowell Total 1 0 3 -1 0 0 0

Mecklenburg Atrium Health Huntersville Surgery Center 0 0 0 0 0 1 0 0.0

AS0058Mecklenburg Carolina Center for Specialty Surgery 0 2 0 0 0 1 0 1,979.0 6 1,312

H0042Mecklenburg Atrium Health Pineville 3 0 9 -2 0 3 0 19,386.0 3 1,755

H0071Mecklenburg Carolinas Medical Center/Center for

Mental Health

9 11 42 -4 -1 2 0 120,858.1 1 1,950

H0255Mecklenburg Atrium Health University City 1 1 7 -1 0 -1 0 9,956.9 4 1,500

Atrium Health Total 13 5814 -7 -1 6 0

Mecklenburg Novant Health Ballantyne Medical Center 0 0 0 0 0 2 1 0.0

AS0068Mecklenburg SouthPark Surgery Center 0 6 0 0 0 0 0 9,321.7 5 1,312

AS0098Mecklenburg Novant Health Ballantyne Outpatient

Surgery

0 2 0 0 0 -2 0 1,853.3 6 1,312

AS0124Mecklenburg Novant Health Huntersville Outpatient

Surgery

0 2 0 0 0 0 0 2,832.5 5 1,312

AS0136Mecklenburg Matthews Surgery Center 0 2 0 0 0 0 0 2,842.7 6 1,312

H0010Mecklenburg Novant Health Presbyterian Medical Center 6 6 28 -3 0 -1 0 61,637.1 2 1,950

H0270Mecklenburg Novant Health Matthews Medical Center 2 0 6 -2 0 0 0 10,536.6 4 1,500

H0282Mecklenburg Novant Health Huntersville Medical Center 1 0 6 -1 0 1 1 10,127.0 4 1,500

H0290Mecklenburg Novant Health Mint Hill Medical Center 1 0 3 -1 0 1 0 1,785.6 4 1,500

Novant Health Total 10 4318 -7 0 1 2

AS0026Mecklenburg Charlotte Surgery Center-Museum Campus 0 6 0 0 0 0 0 9,228.3 6 1,312

AS0166Mecklenburg Charlotte Surgery Center-Wendover

Campus

0 6 0 0 0 0 0 208.8 6 1,312

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

Surgical Care Affiliates Total 0 012 0 0 0 0

AS0148Mecklenburg Mallard Creek Surgery Center 0 2 0 0 0 0 0 2,799.3 6 1,312

Mecklenburg Metrolina Vascular Access Care 0 0 0 0 0 1 0 0.0

AS0164Mecklenburg Valleygate Dental Surgery Center

Charlotte, LLC***

0 2 0 0 0 0 0 1,696.0 6 1,312

Mecklenburg 2019 SMFP Need Determination 0 0 0 0 0 2 0 0.0

Mecklenburg 2020 SMFP Need Determination 0 0 0 0 0 12 0 0.0

Mecklenburg Total 23 48 101 -14 -1 22 2

H0169Mitchell Blue Ridge Regional Hospital 0 0 3 0 0 0 0 899.0 4 1,500

Mitchell Total 0 0 3 0 0 0 0

H0003Montgomery FirstHealth Montgomery Memorial Hospital 0 0 2 0 0 0 0 148.4 4 1,500

Montgomery Total 0 0 2 0 0 0 0

AS0022Moore The Eye Surgery Center of the Carolinas 0 3 0 0 0 0 0 2,067.3 5 1,312

AS0069Moore Surgery Center of Pinehurst 0 6 0 0 0 0 0 5,299.0 6 1,312

H0100Moore FirstHealth Moore Regional Hospital and

Pinehurst Treatment Center

2 0 15 0 0 0 0 22,786.6 3 1,755

Moore Total 2 9 15 0 0 0 0

H0228Nash Nash General Hospital 1 0 13 -1 0 0 0 13,377.9 4 1,500

Nash Total 1 0 13 -1 0 0 0

New Hanover Wilmington ASC 0 0 0 0 0 1 0 0.0

New Hanover Wilmington Eye Surgery Center 0 0 0 0 0 2 0 0.0

AS0055New Hanover Wilmington SurgCare 0 7 0 0 0 3 0 6,407.2 5 1,312

H0221New Hanover New Hanover Regional Medical Center 5 4 29 -3 -1 4 0 70,049.4 2 1,950

New Hanover Total 5 11 29 -3 -1 10 0

H0048Onslow Onslow Memorial Hospital 1 4 5 -1 0 0 0 6,958.4 4 1,500

Onslow Total 1 4 5 -1 0 0 0

Orange North Chapel Hill Surgery Center 0 0 0 0 0 2 0 0.0

H0157Orange University of North Carolina Hospitals 3 11 32 -3 -2 5 0 100,512.6 1 1,950

UNC Health Care Total 3 3211 -3 -2 7 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

Orange Duke Health Orange Ambulatory Surgical

Center

0 0 0 0 0 2 0 0.0

Orange 2020 SMFP Need Determination 0 0 0 0 0 3 0 0.0

Orange Total 3 11 32 -3 -2 12 0

H0054Pasquotank Sentara Albemarle Medical Center 2 0 8 -2 0 0 0 4,108.1 4 1,500

Pasq-Cam-Cur-Gates-Perq Total 2 0 8 -2 0 0 0

H0115Pender Pender Memorial Hospital 0 0 2 0 0 0 0 230.4 4 1,500

Pender Total 0 0 2 0 0 0 0

H0066Person Person Memorial Hospital 1 0 4 -1 0 0 0 506.2 4 1,500

Person Total 1 0 4 -1 0 0 0

AS0012Pitt Vidant SurgiCenter 0 10 0 0 0 0 0 14,529.8 6 1,312

H0104Pitt Vidant Medical Center 7 0 26 -4 -1 0 0 44,772.0 1 1,950

Vidant Health Total 7 2610 -4 -1 0 0

Pitt/Greene/Hyde/Tyrrell Total 7 10 26 -4 -1 0 0

H0079Polk St. Luke's Hospital 0 0 3 0 0 0 0 1,365.3 4 1,500

Polk Total 0 0 3 0 0 0 0

H0013Randolph Randolph Hospital 1 2 5 -1 0 0 0 5,811.9 4 1,500

Randolph Total 1 2 5 -1 0 0 0

H0158Richmond FirstHealth Moore Regional Hospital -

Richmond

1 0 3 -1 0 0 0 1,924.2 4 1,500

Richmond Total 1 0 3 -1 0 0 0

AS0150Robeson The Surgery Center at Southeastern Health

Park

0 4 0 0 0 0 0 1,166.4 5 1,312

H0064Robeson Southeastern Regional Medical Center 2 0 5 -1 0 0 0 7,572.8 4 1,500

Southeastern Health Total 2 54 -1 0 0 0

Robeson Total 2 4 5 -1 0 0 0

H0023Rockingham Annie Penn Hospital 0 0 4 0 0 0 0 2,695.7 4 1,500

H0072Rockingham UNC Rockingham Hospital 1 0 5 -1 0 0 0 1,978.5 4 1,500

Rockingham Total 1 0 9 -1 0 0 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0040Rowan Novant Health Rowan Medical Center 2 3 8 -2 0 0 0 12,511.2 4 1,500

Rowan Total 2 3 8 -2 0 0 0

H0039Rutherford Rutherford Regional Medical Center 0 0 5 0 0 0 0 2,302.1 4 1,500

Rutherford Total 0 0 5 0 0 0 0

H0067Sampson Sampson Regional Medical Center 0 0 8 0 0 0 0 2,473.5 4 1,500

Sampson Total 0 0 8 0 0 0 0

H0107Scotland Scotland Memorial Hospital 1 0 5 -1 0 0 0 7,310.9 4 1,500

Scotland Total 1 0 5 -1 0 0 0

H0008Stanly Atrium Health Stanly 1 0 5 -1 0 0 0 2,211.1 4 1,500

Stanly Total 1 0 5 -1 0 0 0

H0165Stokes LifeBrite Community Hospital of Stokes 0 2 2 0 0 0 0 122.7 4 1,500

Stokes Total 0 2 2 0 0 0 0

H0049Surry Hugh Chatham Memorial Hospital 1 0 5 -1 0 0 0 5,845.9 4 1,500

H0184Surry Northern Regional Hospital 1 0 4 -1 0 0 0 2,966.7 4 1,500

Surry Total 2 0 9 -2 0 0 0

H0111Transylvania Transylvania Regional Hospital 0 0 4 0 0 0 0 1,541.8 4 1,500

Transylvania Total 0 0 4 0 0 0 0

AS0132Union Union West Surgery Center 0 2 0 0 0 1 0 1,627.0 5 1,312

H0050Union Atrium Health Union 2 0 6 -2 0 0 0 9,136.7 4 1,500

Atrium Health Total 2 62 -2 0 1 0

AS0120Union Presbyterian SameDay Surgery Center-

Monroe

0 1 0 0 0 0 0 0.0

Union Total 2 3 6 -2 0 1 0

H0267-AVance Maria Parham Health 0 0 5 0 0 -1 0 4,197.8 4 1,500

Vance/Warren Total 0 0 5 0 0 -1 0

Wake Duke Health Green Level Ambulatory

Surgery Center

0 0 0 0 0 1 0 0.0

H0238Wake Duke Raleigh Hospital 0 0 15 0 0 0 0 29,103.0 3 1,755

Duke University Health System Total 0 150 0 0 1 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

Wake Raleigh Orthopaedic Surgery Center-West

Cary

0 0 0 0 0 1 0 0.0

Wake Rex Hospital Holly Springs 0 0 0 0 0 3 1 0.0

AS0129Wake Rex Surgery Center of Cary 0 4 0 0 0 0 0 5,042.4 6 1,312

AS0143Wake Raleigh Orthopaedic Surgery Center 0 4 0 0 0 -1 0 7,532.6 6 1,312

AS0160Wake Rex Surgery Center of Wakefield 0 2 0 0 0 0 0 2,770.3 6 1,312

H0065Wake Rex Hospital 3 0 25 -3 0 -1 0 52,686.3 2 1,950

UNC Health Care Total 3 2510 -3 0 2 1

Wake WakeMed Surgery Center-Cary 0 0 0 0 0 1 0 0.0

Wake WakeMed Surgery Center-North Raleigh 0 0 0 0 0 1 0 0.0

AS0137Wake Capital City Surgery Center 0 8 0 0 0 -1 0 6,851.6 6 1,312

H0199Wake WakeMed 8 0 20 -4 -1 -1 0 49,128.6 2 1,950

H0276Wake WakeMed Cary Hospital 2 0 9 -2 0 1 0 9,371.6 4 1,500

WakeMed Total 10 298 -6 -1 1 0

Wake Ortho NC ASC 0 0 0 0 0 1 0 0.0

Wake RAC Surgery Center 0 0 0 0 0 1 0 0.0

AS0162Wake Surgical Center for Dental Professionals of

NC***

0 2 0 0 0 0 0 392.4 6 1,312

AS0029Wake Blue Ridge Surgery Center 0 6 0 0 0 0 0 8,679.9 5 1,312

AS0034Wake Raleigh Plastic Surgery Center 0 1 0 0 0 0 0 957.0 6 1,312

AS0142Wake Triangle Orthopaedics Surgery Center 0 2 0 0 0 0 0 4,170.5 6 1,312

AS0155Wake Holly Springs Surgery Center 0 3 0 0 0 0 0 2,401.8 6 1,312

Wake 2019 SMFP Need Determination 0 0 0 0 0 2 0 0.0

Wake 2020 SMFP Need Determination 0 0 0 0 0 3 0 0.0

Wake Total 13 32 69 -9 -1 11 1

H0006Washington Washington Regional Medical Center 0 0 2 0 0 0 0 0.0

Washington Total 0 0 2 0 0 0 0

H0257Wayne Wayne UNC Health Care 1 2 11 -1 0 0 0 11,073.6 4 1,500

Wayne Total 1 2 11 -1 0 0 0

DRAFT - 5/19/2020

Service Area License Facility

Inpatient

ORs

Ambulatory

ORs

Shared

ORs

Excluded

C-Section

ORs

Excluded

Trauma/

Burn ORsCON

Adjustments

CONs for

Excluded

C-Section

ORs

Total

Surgical

Hours for

Grouping

Table 6A: Operating Room Inventory and Grouping (Combined Data for Hospitals and Ambulatory Surgical Facilities)

Group

Standard

Hours per

OR per

Year

Case data for 10/1/2018 through 9/30/2019 as reported on the 2020 Hospital and Ambulatory Surgical Facility License Renewal Applications

A B C D E F G H I J K L M

H0153Wilkes Wilkes Medical Center 1 1 4 -1 0 0 0 4,033.1 4 1,500

Wilkes Total 1 1 4 -1 0 0 0

AS0005Wilson Wilson Medical Center 0 4 0 0 0 0 0 0.0

H0210Wilson Wilson Medical Center 1 0 9 -1 0 0 0 3,918.0 4 1,500

Duke LifePoint Total 1 94 -1 0 0 0

AS0007Wilson Wilson OB-GYN 0 1 0 0 0 0 0 44.5 6 1,312

Wilson Total 1 5 9 -1 0 0 0

H0155Yadkin Yadkin Valley Community Hospital

(closed)*

0 0 2 0 0 0 0 0.0

Yadkin Total 0 0 2 0 0 0 0

* This facility is a legacy medical care facility based on G.S. 131E-176-(14f).

** Duke University Hospital has 16 licensed operating rooms (ORs) approved under Policy AC-3 (J-008030-07). North Carolina Baptist Hospital

has certificates of need (G-008460-10 & G-011519-18) for 11 ORs approved under Policy AC-3. These 27 ORs are counted when determining OR need.

*** This is a dental single-specialty ambulatory surgery demonstration project that is in the inventory but is not included in the need determination calculations.

**** All ORs have been relocated from Plastic Surgery Center of NC to a facility formerly identified as Clemmons Medical Park Ambulatory Surgical Center in previous SMFPs. The new

facility retains Plastic Surgery Center's license number. Procedures reported are for Plastic Surgery Center.

^ Atrium Health Cleveland and Atrium Health Kings Mountain are consolidated under the Atrium Health Cleveland license, effective August 1, 2019.

Grand Total 157 320 906 -98 -11 80 4

DRAFT - 5/19/2020