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New report highlights the challenges of growing North Carolina's health workforce
The NC Center on the Workforce for Health says North Carolina needs to train more nurses, nursing assistance, and emergency medical technicians while retaining people who already work in those professions.
Business Owners Have a Window. Most Aren't Ready to Use It. by Tully Ryan
I spend my working life on both sides of a business sale. As an M&A advisor based in Wilmington, I help lower middle market owners across North Carolina, South Carolina and Virginia sell what they've built. As the founder and CEO of IQExit, I work with the bankers, wealth advisors, CPAs and attorneys who sit beside those owners for years before a sale ever comes up. From both seats, I keep seeing the same thing. The market is ready for our owners. Too many of our owners aren't ready for the market. Start with our own backyard. Wilmington's metro area added more than 12,000 residents between July 2024 and July 2025, a 2.6% jump that ranked seventh in the country. It also posted the highest job growth rate of any metro in North Carolina. I see the same pattern in the growth markets I work in across the Southeast. New residents mean new customers and new workers. They also mean new buyers: people who moved here from corporate jobs and want to own something, private equity groups looking for add-ons in HVAC, electrical, landscaping and other trade services, and younger entrepreneurs who would rather buy a running business than start one from scratch. The ownership numbers are hard to ignore. About half of North Carolina's small businesses have an owner who is 55 or older, and roughly 85% of those owners have no succession plan, according to the North Carolina Employee Ownership Center. Nationally, more than half of Baby Boomer business owners have no documented transition plan. That isn't a crisis yet. It's a timing problem. A lot of businesses will change hands over the next decade, and the prepared ones will get the better buyers and the better terms. Buyers have money and they're using it. But an active market doesn't mean a fast one. The IBBA's latest Market Pulse survey found that Main Street deals took six to 10 months from engagement to close in the second quarter, and lower middle market deals took 11 to 12 months. That clock starts after the owner decides to sell. In my experience, the real preparation has to start years before. Two clocks, two playbooks When I sit down with an owner or their advisor, my first question isn't “What's it worth?” It's “When?” The answer puts the owner in one of two groups. If the owner wants out within 24 months, we're in execution mode. There's no time to rebuild the business. The work is cleaning up what a buyer will test: three years of financials that tie to the tax returns, an add-back schedule you can prove, customer and vendor contracts in writing, a lease that can be assigned, and a price the market will actually pay. The goal is certainty to close. If the exit is two to five years away, the owner has something worth more than time. They have choices. That window is where most value gets built, and most owners waste it by waiting. What kills deals In the lower middle market, deals rarely die over the headline price. They die in diligence, or they get retraded late in the process. I see the same causes again and again. The owner is the business. If every key customer relationship runs through the owner's cell phone, a buyer sees risk and a lender sees more of it. The books don't hold up. Buyers spot weak accounting fast. Statements that get revised mid-process, a revolving door in the bookkeeper's chair, revenue tracked on a side spreadsheet, and margins that slip while sales climb with no clear reason all make a buyer nervous. So does an owner who pushes back when asked for documents. And plenty of private owners run personal expenses through the company. Add-backs are normal. Add-backs you can't document turn into a lower offer. The real estate isn't sorted out. Many owners hold their building in a separate LLC. That's fine, but the lease terms or the property sale should be settled before a buyer shows up, not halfway through diligence. Revenue sits in too few hands. Picture a contractor with 40% of its work coming from one builder, or a service company running on handshake deals. Buyers will still look, but the terms shift toward more seller financing, an earnout, or less cash at closing. Owners and advisors: if your exit is three to five years out • Get a baseline now. Find out where the business really stands today: what a buyer would pay, who that buyer is likely to be, and which gaps would hurt you in diligence. You can't fix what you haven't measured, and the answer is often different from what the owner expects. • Make yourself less necessary. Spend the next few years building a manager or small team that can run daily operations and own customer relationships. Put handshake deals into written contracts. A business that runs without its owner is worth more and is far easier to finance. • Clean the books for three straight years. Buyers and lenders look back at least three years. Separate personal expenses, keep the financials tied to the tax returns, track every add-back as you go, and settle the real estate plan early. A word to CPAs CPAs often see a sale coming before anyone else, and you're usually the most trusted voice an owner has. Year-end meetings are the right time to start this conversation. Here's what I'd ask every CPA to do this season with business owner clients over 55: • Ask the timing question. “Do you see yourself owning this business in five years? If not, who takes it over?” Write down the answer and bring it up again at next year's meeting. • Run a proof of cash and review revenue recognition. Make sure the cash in the bank ties to the revenue on the books. Pay close attention to contractors with work in progress and to companies selling memberships or service plans. These issues are easy to fix with years of lead time and painful to fix a month before closing. • Pair the tax return with an exit readiness review. Invite clients to complete IQExit's Exit Readiness Intelligence (ERI) process as part of year-end planning. It gives you and the client a shared picture of readiness gaps and an indicative value range, and the results come back to you as the advisor. That turns a tax meeting into a planning relationship, and it puts you in position to bring in tax and M&A help early, when choices like purchase price allocation can still save the client real money. Changing the conversation For bankers, wealth advisors and attorneys, the hard part is raising the subject without seeming to nudge a client toward the door. I understand that. Nobody wants to tell a 60-year-old owner it's time to sell. So don't. Ask a different question: “If a buyer called tomorrow, what would they find?” That's a planning question, not a pitch, and it's useful whether the exit is two years out or 15. It's the question we built IQExit to help advisors answer. Whether you're in Wilmington, Raleigh, Charleston, Richmond or anywhere else, owners have a real opening right now. The buyers are out there and so is the capital. The owners who come out ahead will be the ones who start getting ready before they're ready to sell.
North Carolina flag football rankings: USA TODAY Sports Super 10, Week 8
In North Carolina's final regular season rankings, these teams sit atop this week’s Super 10 flag football rankings.
“The Politics of Abuse”: Survivor of Childhood Sexual Abuse Shares How State Court Impacts Those Seeking Justice
Through the statewide tour, Trout and local advocates continued conversations about the barriers survivors face and the role North Carolina's legislature and courts play in addressing them.
North Carolina's Carter Faith believes in country music
LOS ANGELES — Carter Faith has read the articles about Gen Z turning away from humanity's oldest vices, and she's here to say those articles don't speak for her. "Yeah,
Duke Health, CaroMont Health seek to jointly build, operate 2 Charlotte-area hospitals
Duke Health and CaroMont Health are partnering to build a pair of new hospitals in North Carolina’s fast-growing Mecklenburg County, the nonprofits shared Wednesday. | The pair filed Certificate of Needs with the state to build two hospitals comprising 200 beds in fast-growing North Carolina's Mecklenburg County.
Animosity in North Carolina, and MA shooting stars
In this edition of Health Care Inc., we examine the controversy around the health plan covering North Carolina's public workers and retirees, and more.
NC's State Health Plan moves to block Atrium program it calls an 'unlawful pricing scheme'
North Carolina's State Health Plan announced Friday it had requested a temporary restraining order in Wake County Superior Court to halt Atrium Health’s new “affordability program.”
Should Bill Belichick Remain as North Carolina's Head Coach?
Should Bill Belichick stay with the North Carolina Tar Heels moving forward?
Analyst Believes UNC Will Miss Second Straight Bowl Game
With Bill Belichick in the hot seat, analysts clash over whether he can salvage North Carolina's postseason hopes.
Beyond the Headlines: Don Davis discusses health care, rural needs and District 1 race
U.S. Rep. Don Davis sat down with News 12 for a wide-ranging Beyond the Headlines interview about issues affecting North Carolina's 1st Congressional District a
Steve Belichick reportedly resigns as North Carolina's defensive coordinator
North Carolina U.S. Senate Candidates ramp up campaign efforts as midterm nears
With the midterm elections around the corner, North Carolina's U.S. Senate candidates, Republican Michael Whatley and Democrat Roy Cooper are continuing campaign efforts in North Carolina and Texas.
Will North Carolina's US Senate race feature any debates this year?
If you’re an undecided voter, you might want to compare the candidates side by side on a debate stage, or in sit-down interviews with your local TV station, or perhaps at public events where they make speeches. This year, you might not find any of those opportunities to get to know Roy Cooper and Michael Whatley.
Cumberland County school board moves to end minority business program
Cumberland County Schools plans to repeal minority- and women-owned business contracting policies after changes included in North Carolina's budget.
Mapping North Carolina’s Climate Health Risks
From the Blue Ridge Mountains to the Atlantic coast, North Carolina's geography does more than shape its landscape. It may also influence the health risks people face.At Duke University School of Medicine, researchers are combining climate data, geographic information, and real-world health records to better understand how environmental conditions affect health and why some communities face greater risks than others.
How a federal grant brought mental health services into schools across 6 North Carolina school districts
North Carolina's Project AWARE has helped school districts across the state build comprehensive behavioral and mental health support systems.
Public Voting Opens Sept. 1 for the North Carolina Small Business Center Network's Inaugural 'Startup Showdown'
/PRNewswire/ -- After months of intensive business training, mentorship and pitch coaching, 17 of North Carolina's most promising entrepreneurs are preparing...
Political shifts make NC-11 more competitive than ever, analysts say
Republicans in North Carolina's 11th Congressional District are just days away from choosing a candidate to replace U.S. Rep. Chuck Edwards on the ballot.
Bill Belichick Announces His Son, Steve, Is On Medical Leave
North Carolina football coach Bill Belichick revealed Thursday morning that his son, Steve, has been placed on medical leave. Steve Belichick is entering his second season as North Carolina's defensive coordinator. Although the program struggled in 2025, his defense was one of two units in the ACC ...
The Newest Federally Recognized Tribe Wants Better Healthcare. It May Be On Its Own.
North Carolina's Robeson County, where most of the tribe’s citizens live, ranks as one of the worst counties in the U.S. for health disparities. After securing federal recognition, Lumbee tribal leaders will have to decide how to address them.
North Carolina GM Michael Lombardi placed on administrative leave
North Carolina's general manager Michael Lombardi has been placed on paid administrative leave.
State Health Plan board to vote on major coverage changes for 750,000 NC members
Big changes could be coming to North Carolina's State Health Plan. A key vote Friday could affect coverage and costs for nearly 750,000 members.
NC’s first full budget since 2023 reflects transformed health policy landscape
North Carolina's first full budget since 2023 reflects Medicaid expansion, Healthy Opportunities Pilot funding, SNAP changes and new federal health policies.
Oklahoma soars past North Carolina in Game 3 to win MCWS
Oklahoma capitalized on North Carolina's uncharacteristic pitching struggles and got another clutch performance from LJ Mercurius out of the bullpen on its way to victory in the winner-take-all Game 3 of the Men's College World Series finals Monday night.
MCWS 2026: How UNC, Oklahoma are looking to remain undefeated in Omaha
In the end, the numbers were on North Carolina's and Oklahoma's side as they advanced to the MCWS championship.
Stein makes new Helene federal funding request, billions lower than last ask
North Carolina's governor is in Washington on Wednesday meeting with members of Congress to push for new federal money for Helene recovery.
Inside North Carolina’s Small Business Centers and their role as ‘economic development engines’
Located at North Carolina's 58 community colleges, Small Business Centers serve as economic development engines for their community.
'We'll never know if he could have been saved.' The gaps in Trump's rural health fund
Republicans promise that $50 billion in new health funding will help rural America. But it's not expected to aid the years-long effort in North Carolina's Martin County to reopen its only hospital.
Away fans give a boost to North Carolina's sports economy
Heidi Welchlin said she has traveled to several different cities to see the Carolina Hurricanes play.
Perspective | North Carolina child care is in crisis — and it's a business issue
Gene McLaurin describes how North Carolina's lack of affordable, high-quality child care negatively effects businesses statewide.
Business leaders use their voices to advocate for child care
North Carolina's business leaders are joining forces to advocate for a child care subsidy reimbursement floor.
UNITE HERE shakes up NC politics: A conversation with Maria Hernandez
This spring, UNITE HERE Local 23 played a key role in unseating conservative Democrats and replacing them with progressive candidates in North Carolina's primary elections. An active member of Local 23 in Charlotte spoke with Facing South about how they mobilized voters amid a climate of fear.
ECU Health’s plan to reopen hospital offers hope to Martin County
Martin County has been without a hospital since 2023. A $220M plan aims to make it home to North Carolina's first Rural Emergency Hospital.
North Carolina’s photo voter ID mandate can continue as a judge upholds the law
A federal judge has upheld North Carolina's photo voter ID law, rejecting claims by civil rights groups that discrimination against Black and Latino voters warrants striking it down.
Brad Stevens quickly removes himself from consideration in North Carolina's coaching search
Not even one of the three best jobs in college basketball is moving Stevens out of Boston
After North Carolina's split with Hubert Davis, here are 6 candidates to replace him
UNC is a primo job, so the school won't have trouble finding suitors. But the right fit will be tricky.
Health care cost illusions still underpin debates
North Carolina's 2026 session could reshape health care affordability statewide.
What to expect in North Carolina's midterm primaries
North Carolina voters will narrow down the field of candidates Tuesday in a competitive U.S. Senate race that could decide control of the closely divided chamber in November.
AP Decision Notes: What to expect in North Carolina's state primaries
North Carolina voters will narrow down the field of candidates Tuesday in a competitive U.S. Senate race that could decide control of the closely divided chamber in November
What to watch in the race for North Carolina's open Senate seat
North Carolina’s primary election is next week, and early voting is already underway. We discuss what to watch in the race for the state's open Senate seat and a competitive Democratic primary in the state's 4th congressional district.This episode: voting correspondent Miles Parks, political correspondent Ashley Lopez, and WUNC Capitol Bureau Chief Colin Campbell.This podcast was produced by Casey Morell and Bria Suggs, and edited by Rachel Baye.Our executive producer is Muthoni Muturi.Listen to every episode of the NPR Politics Podcast sponsor-free, unlock access to bonus episodes with more from the NPR Politics team, and support public media when you sign up for The NPR Politics Podcast+ at plus.npr.org/politics.
Democrats celebrate as 73,000 North Carolina voters without proper ID stay on rolls
North Carolina's election board reached a settlement allowing 73,000 voters to keep registration status after a GOP lawsuit challenged voter rolls.
North Carolina's tech industry shows staying power in 2026 report
The North Carolina Technology Association (NC TECH)'s newly released 2026 State of the Technology Industry Report (commonly known as NC STIR) highlights a sector that continues to expand its footprint, deepen its impact, and outperform much of the country across key economic metrics.
Tariffs sour Valentine’s for North Carolina's small business entrepreneurs
Many of the gifts that define Valentine’s, specifically flowers and chocolates, rely heavily on imports which have been affected by tariffs.
Gov. Stein to discuss rural health improvements at virtual town hall
Governor Josh Stein, along with other state officials, will host a virtual town hall on Friday, Jan. 16, to discuss North Carolina's Rural Health Transformation