James (Jim) C. Wrenn, Jr.

Jim Wrenn is a business attorney who serves as trusted outside general counsel and strategic advisor to healthcare providers, governmental entities, businesses, and nonprofit organizations throughout North Carolina. With nearly 25 years of experience, he has helped organizations navigate complex legal, operational, and strategic issues at the intersection of law, business, and public policy, focusing particularly on healthcare, real estate, and governmental matters.

Jim advises clients on a broad range of matters, including corporate governance, healthcare regulatory compliance, strategic transactions, economic development, public-private partnerships, real estate development, land use and zoning, employment matters, internal investigations, environmental compliance, public contracting, and government relations. He frequently serves as the primary legal advisor to boards of directors, boards of trustees, governing bodies, executive leadership teams, and elected officials on high-stakes matters. Clients frequently look to Jim to advise on governance challenges, executive leadership issues, internal investigations, regulatory scrutiny, organizational change, and other matters requiring practical business judgment. 

Jim currently serves as an appointed county attorney and town attorney. He also serves as outside general counsel to two of North Carolina's leading long-term care trade associations and as general counsel to a health system, a water and sewer authority, a regional economic development corporation, and numerous private healthcare organizations. In addition, he is a registered lobbyist representing governmental, healthcare, and nonprofit organizations before the North Carolina General Assembly and executive agencies. Together, these leadership roles provide Jim with a unique perspective on the legal, regulatory, and public policy issues facing organizations across the state and inform the multidisciplinary approach he brings to clients across the corporate, healthcare, governmental, real estate, and economic development sectors. 

• Health Care: As Co-Leader of Smith Anderson's Health Care Practice, Jim devotes a substantial portion of his practice to serving the healthcare industry. He serves as general counsel to a hospital, long-term care providers, healthcare associations, and other healthcare organizations. He regularly advises clients on governance, regulatory compliance, affiliations, acquisitions and dispositions, physician and provider relationships, reimbursement matters, operational issues, licensure and certification requirements, investigations, and healthcare transactions. Jim has extensive experience representing skilled nursing facilities, assisted living facilities, independent living communities, and home- and community-based providers, giving him a comprehensive understanding of the continuum of care and the operational challenges facing healthcare organizations. 
• Government & Public Policy: Jim maintains a significant governmental practice and regularly advises counties, municipalities, utilities, regional authorities, and economic development organizations on governance, economic development initiatives, procurement, infrastructure projects, public-private partnerships, legislative matters, public records and open meetings laws, and complex public-sector transactions. He is particularly valued for helping public bodies navigate matters that require balancing legal compliance, policy objectives, political considerations, and practical operational concerns. 
• Real Estate & Economic Development: Jim is also an experienced real estate and economic development attorney. He assists clients with all phases of commercial, industrial, and mixed-use development projects, including acquisitions and dispositions, development agreements, incentives, utility matters, land use approvals, public-private partnerships, and related transactional work. 

Prior to joining Smith Anderson, Jim practiced with a boutique firm in Oxford, North Carolina, where he spent nearly twenty years advising businesses, healthcare providers, governmental entities, and nonprofit organizations throughout the region.

A lifelong resident of Oxford, Jim lives with his wife, Martha, their sons, Jack and Jake, and their jagdterrier, Ralph. Outside the office, he enjoys hunting, fishing, farming, timber and wildlife management, and the occasional—though admittedly poorly played—round of golf. He also enjoys traveling, particularly when it involves an opportunity to hunt or fish, and reading history and business books.

Recognition

• Chambers USA, Healthcare (2024-2026)
• The Best Lawyers in America®, Health Care Law (2024-2026)
• North Carolina Lawyers Weekly, Power List 2023, Healthcare

Clerkships

• The Honorable Karen Johnson Williams of the Fourth Circuit Court of Appeals (2000-2001)

Education

• Harvard Law School, J.D., 2000
• Virginia Military Institute, B.A., International Studies, 1997

Bar & Court Admissions

• North Carolina Association of County Attorneys
• North Carolina Bar Association
  • Health Law Section

Health Care

• Serves as general counsel for a hospital and related nursing home and physician practices, advising on health care compliance, physician contracts, medical staff matters, construction contracts, strategic planning, HIPAA, employment matters, purchasing, and other operational issues.
• Serves as outside general counsel for assisted living and skilled nursing trade associations, advising on regulatory, reimbursement, funding policy, legislative strategy, and other issues affecting the associations and their members.
• Represented buyers and sellers in the acquisition, financing, licensure, and sale of numerous adult care homes and nursing homes.
• Served as counsel of record in dozens of contested case hearings challenging penalties and regulatory actions taken by the North Carolina Department of Health and Human Services, Division of Health Service Regulation.
• Represented a long-term care trade association and member facilities in administrative litigation against the North Carolina Department of Health and Human Services involving implementation of federally mandated Medicaid exclusions for Institutions for Mental Disease.
• Assisted long-term care trade associations with procurement of personal protective equipment, COVID-19 testing supplies, and technology supporting remote visitation through legislative appropriations totaling approximately $30 million.
• Counsels healthcare providers on the planning, development, construction, and operation of licensed healthcare facilities, including hospitals, ambulatory surgery centers, skilled nursing facilities, and other long-term care facilities.
• Advises healthcare providers in certificate of need proceedings, including the preparation and defense of CON applications, contested case hearings, and appeals involving major healthcare facility and service expansions.

Government & Public Policy

• Serves as appointed county attorney and town attorney, advising elected officials, governing boards, and executive leadership on governance, public policy, regulatory compliance, procurement, employment, and strategic initiatives.
• Represented a town in transitioning from a state-run municipality to an incorporated municipality, providing all legal services related to incorporation and coordinating legislative advocacy efforts.
• Provided all legal services related to transitioning state employees to local government employment in connection with municipal incorporation and the creation of a public safety authority.
• Represented a town in connection with Community Development Block Grant funding and Design-Build Bridging contracts for the design and construction of a veterans facility.
• Incorporated a regional water and sewer authority and represented the authority in acquiring utility assets from the State of North Carolina, counties, and municipalities.
• Represented governmental entities in forming a multi-jurisdictional stormwater utility to comply with Falls Lake water quality regulations.
• Led internal investigations for local governments, health care providers, and private businesses involving personnel matters, regulatory compliance, financial misconduct, and embezzlement.
• Led an internal investigation involving a sheriff's office that resulted in criminal prosecutions.
• Assisted local governments with strategies to maximize regional water and sewer capacity.

Real Estate & Economic Development

• Represented buyers and sellers in numerous commercial real estate transactions involving warehouses, shopping centers, industrial facilities, governmental properties, farmland, and timberland.
• Represented local ABC boards in the acquisition and disposition of real property and construction of new facilities.
• Represented a water and sewer authority in connection with multiple capital improvement projects, including a $30 million wastewater treatment plant upgrade and a $15 million water treatment plant expansion.
• Represented a water and sewer authority in an approximately $80 million wastewater infrastructure project involving easement acquisition, pump station site acquisition, construction contracts, grant funding, and USDA financing.
• Represented a technology company in securing utility easements needed to complete construction of an advanced manufacturing facility within an accelerated timeline.
• Represented a county in the financing, contracting, and construction of an approximately $30 million law enforcement center.
• Represented a county in assembling a 527-acre industrial park and later acquiring the park through bankruptcy proceedings.
• Represented a regional economic development corporation in securing federal and state grants and legislative appropriations to fund road, water, sewer, and other infrastructure improvements.
• Represented local governments and nonprofit economic development organizations in negotiating economic development incentive packages and obtaining state incentives and federal and state grant funding.
• Represented a building industry company in its $30 million sale to a private equity-backed buyer.