State health regulators in North Carolina have agreed to allow three local medical groups to add a combined total of eight operating rooms in the Triad.

Forsyth Medical Center, Triad Center for Surgery and Wake Forest Baptist Medical Center applied for the additional operating rooms through the state’s certificate-of-need format.

A certificate of need, or CON, is required before a health-care system or provider can build a facility, buy equipment or offer a surgical procedure.

On Oct. 26, 2018, the N.C. Division of Human Service Regulation approved allowing Wake Forest Baptist to add two operating rooms, giving it 49 altogether. The medical center had sought to add four operating rooms.

Regulators also agreed to allow Triad Center for Surgery to open an ambulatory surgical facility with two operating and three procedure rooms. Procedure rooms are used for providing minor, nonsurgical care that doesn’t require a full-scale operating room.

Regulators denied Forsyth Medical’s request to add two operating rooms, which would have given the facility a total of 35.

Forsyth Medical appealed the decision in December 2018. Wake Forest Baptist and Triad Center for Surgery appealed the granting of permission for each other’s operating-room expansions. Wake Forest Baptist also appealed the decision to allow it only two additional operating rooms.

Regulators agreed to a settlement in which Wake Forest Baptist would get four operating rooms and Triad Center for Surgery and Forsyth two each.

The cost to add the four Wake Forest Baptist operating rooms is estimated at just under $10 million. The Triad Center for Surgery project would cost $7.2 million, while adding the two operating rooms would cost Forsyth Medical $4.2 million.

The hospitals filed their applications in the operating-room category, while Triad Center for Surgery filed in the ambulatory surgical facility category. The separate filings likely were a key determining factor in which projects gained state regulatory approval.

Ambulatory surgical centers have become a popular option for hospitals wanting to add surgical space, typically off-campus but often still tethered to on-campus infrastructure fees.

For example, Wake Forest Baptist recently opened an outpatient center off of Peace Haven Road in Clemmons.

Novant Health Inc., the parent company of Forsyth Medical Center has plans to build a $13.7 million multispecialty ambulatory surgical center in Clemmons that state regulators approved in May 2017.

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Richard Craver

rcraver@wsjournal.com 336-727-7376 @rcraverWSJ

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