Certificate of Need (CON)
Help with Certificate of Need (CON) Issues
Many states have Certificate of Need (also called Certificate of Necessity (CON) or Determination of Need (DON)) laws. CON laws are designed to control the growth and associated costs of health care facilities and services, coordinate the planning of healthcare facilities, and to avoid duplication. Although an incredibly large degree of variation between jurisdictions exists, all CON laws require that certain health care providers receive approval before commencing major projects, e.g., building expansions. Some states also allow for a Certificate of Exemption (COE) in lieu of a full CON. CON approval, however, is most commonly required for acute care hospital beds, ambulatory surgery centers, nursing homes, open heart surgery, and major medical equipment (MRI/PET/etc.).
Federal law once required states to have an approval process for healthcare projects involving major capital outlays. However, despite the repeal of that law, 35 states and Washington D.C. still have some form of CON program and CON Laws. Navigating the CON process requires a dedicated and experienced team who understand the Certificate of Need process for planning, development, and approval.
A number of factors combine to make the CON and COE process difficult. From a procedural as well as a substantive standpoint, the rules tend to be extremely complex. Applications commonly require not only regulatory expertise, but healthcare planning, financial, and clinical knowledge as well. The skill set required to complete CON applications and to argue their merits before the various regulatory bodies align perfectly with Advis’ particular strengths in regulatory, financial, and medical knowledge.
Through decades of multi-jurisdictional experience and a multitude of projects, Advis’ Certificate of Need consultants have successfully navigated the process for hospitals, surgery centers, hospices, and others in need of state CON approvals.
Certificate of Need (CON) Services
For providers interested in obtaining CON approvals, we offer a number of services including:
- General regulatory guidance
- Consultation as to the applicability of CON rules to a particular project
- Discussions regarding the applicability and feasibility of a COE
- Strategic analyses evaluating likelihood of approval
- Interface with state CON authorities
- Drafting and submission of applications
- Identification and development of a project’s unique value proposition
- Preparation for and participation in hearings before state governing bodies
- Providing expert testimony
- Post-approval implementation of projects
