In Family Med. Imaging, LLC v. W. Va. Health Care Auth., 218 W. Va 624 S.E.2d 493 (2005) , two physicians were denied a certificate of need to provide ultrasound diagnostic services to patients referred to them by other physicians. One of the issues raised in the case was whether HCA relied upon the standard for acute care facilities in denying the certificate of need. The Court concluded that HCA did not rely on that standard, but instead relied upon the Ambulatory Care Centers standard. Ultimately, the Court affirmed the denial of the certificate of need.