Amends GS 131E-176, which sets outs defined terms applicable to Article 9, Certificate of Need. Amends bed capacity to specify space used exclusively for inpatient care at a health care facility. Amends the definition of health service to exclude activities performed at a facility that does not meet the definition of a health service facility; removes ambulatory surgical facilities from the definition of health service facility. 

Amends GS 131E-184 by exempting from certificate of need review a new institutional health service it if receives prior written notice from the entity proposing the service for the development, acquisition, construction, expansion in number, or replacement of an operating room or gastrointestinal endoscopy room for which a certificate of need was issued to an ambulatory surgical facility before October 1, 2019. Makes conforming deletions in GS 131E-178.