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  Certificate of Need

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The Certificate of Need (CON) program is a regulatory process that requires certain health care providers to obtain state approval before offering certain new or expanded services. For example, a certificate of need would be required if a hospital wishes to establish a comprehensive medical rehabilitation program.

The CON process is intended to help ensure that new services proposed by health care providers are needed for quality patient care within a particular region or community.

The program prevents unnecessary duplication of services by selecting the best proposal among competing applicants who wish to provide a particular health service. CON in Florida regulates hospice, skilled nursing, intermediate care for the developmentally disabled, the development of new hospitals and certain hospital services. It does not regulate outpatient services, home health services or the purchase of major medical equipment

When is a CON Notification or Review is Required?

Health providers requiring a certificate of need for certain types of projects include:

  • Hospitals
  • Nursing homes
  • Hospices
  • Intermediate Care Facilities for the Developmentally Disabled

CON review covers not only new facility construction but also initiation of specialized hospital services, certain bed conversions, increases in the number of inpatient beds at hospitals and nursing homes, transfers of CONs, and a variety of other projects.

Generally, nothing from the CON Office is required for:

  • The establishment of an Ambulatory Surgery Center
  • The establishment of outpatient adult diagnostic cardiac catheterization services
  • Renovations to existing health care facilities that do not involve the addition of beds or services
  • The replacement of a rural hospital under very specific conditions as outlined in 395.6025, Florida Statutes

    Note: In all cases listed above, the Division's Hospital and Outpatient Unit and Office of Plans and Construction should be contacted regarding licensure requirements.
     
  • The establishment of an Assisted Living Facility

    Note: The Division's Assisted Living Unit and Office of Plans and Construction should be contacted regarding licensure requirements.

Upon request, the CON Office will determine if a project must be submitted for review. Please contact James McLemore at 850-412-4401 or via e-mail at james.mclemore@ahca.myflorida.com for a determination.

Making Application

The CON application packet is available on-line and by contacting:

Kathy Biddle at 850-412-4401
email: kathy.biddle@ahca.myflorida.com

or write to:
Agency for Health Care Administration
Certificate Of Need
2727 Mahan Drive, MS 28
Tallahassee, Florida 32308
 
CON Application packets on-line: Application 2009 and General Hospital 2009 and Transfer 2009 applications. 

Fees are required for processing applications, based on a $10,000 minimum plus .015 for each dollar of proposed capital expenditure, with the total fee not to exceed $50,000. Fees must be submitted with each application.

Most projects are reviewed on a competitive basis, and a letter of intent must be filed with the Certificate of Need Office at least 30 days before an application is filed. A letter of intent is not required for projects that will be given a non-competitive, expedited review.

The fee for projects identified for review under Section 408.036(3), Florida Statutes which pertains to exemptions, is $250.00.

Any questions regarding whether a project is subject to CON review may be sent to james.mclemore@ahca.myflorida.com or calls made to James McLemore at 850-412-4401.

CON Review Process

Projects are reviewed in accordance with the provisions of Sections 408.031 through 408.045, Florida Statutes and Chapter 59C-1, Florida Administrative Code. There are two batching cycles each year for competitive reviews in each of two project categories:

  • Hospital Beds and Facilities
  • Other Beds and Programs

The agency publishes projections of future need for most of the services which are subject to competitive review every 6 months.

Provisions and criteria for an expedited review are set forth in Section 59C-1.010, F.A.C.

Public hearings may be held on a CON application if requested by the applicant or another affected party.

A decision on a CON application will be rendered within 60 days after an application is declared complete by the agency.

Notices of hearings, decisions and other actions as required by law are published in the Florida Administrative Weekly.

CON Monitoring Process

The CON Office monitors implementation of an approved project until it is licensed. CONs that were approved with conditions are monitored every year to assure that the required services are being provided.

CON Implementation and Monitoring Forms:

The "Project Completion Forecast", the "15-Month Monitoring Report," and "Procedures for applying for extended use of sheltered skilled nursing beds" are available for download in two formats: PDF and Microsoft Word on the CON Forms page.

CON Appeals Process

Applicants or other affected parties may appeal a decision of the agency according to the provisions of Section 59C-1.012, F.A.C. and Chapter 120, F.S. The Division of Administrative Hearings' (DOAH) website provides limited information about CON appeals and hearings. New general Hospital appeals are subject to the provisions contained in s. 408.039 (3), (5) and (6) F.S.

Upcoming CON Review Cycles Deadlines

Hospital Beds and Facilities:

  • New Hospital Facilities
  • Replacement Facilities
  • Neonatal Intensive Care Unit Level II and III
  • Rehabilitation Beds
  • Long Term Care Hospitals

1st Batching Cycle - 2012

Summary Need Projections Published
in Florida Administrative Weekly

1-20-2012

Letter of Intent Deadline

2-06-2012

Application Deadline

3-07-2012

Completeness Review Deadline

3-14-2012

Application Omissions Deadline

4-11-2012

Agency Initial Decision Deadline

6-08-2012

2nd Batching Cycle - 2012

Summary Need Projections Published
in Florida Administrative Weekly

7-20-2012

Letter of Intent Deadline

8-06-2012

Application Deadline

9-05-2012

Completeness Review Deadline

9-12-2012

Application Omissions Deadline

10-10-2012

Agency Initial Decision Deadline

12-07-2012

Other Beds and Programs:

  • Pediatric Open Heart Surgery
  • Pediatric Cardiac Catheterization
  • Specialty Burn Units
  • Organ Transplantation
  • Nursing Home Beds *  
  • Hospice Programs
  • Hospice Inpatient Facilities
  • Intermediate Care Facilities for the Developmentally Disabled (ICF/DDs)

    *In 2001, the Florida legislature placed a moratorium on the issuance of certificates of need for additional community nursing home beds until July 1, 2006. This action was taken because the legislature found that the continued growth in the Medicaid budget for nursing home care constrained the ability of the state to meet the needs of its elderly residents through the use of less restrictive and less institutional methods of long-term care.

 1st Batching Cycle - 2012

Summary Need Projections Published
in Florida Administrative Weekly

3-30-2012

Letter of Intent Deadline

4-16-2012

Application Deadline

5-16-2012

Completeness Review Deadline

5-23-2012

Application Omissions Deadline

6-20-2012

Agency Initial Decision Deadline

8-17-2012

2nd Batching Cycle - 2012

Summary Need Projections Published
in Florida Administrative Weekly

09-28-2012

Letter of Intent Deadline

10-15-2012

Application Deadline

11-14-2012

Completeness Review Deadline

11-21-2012

Application Omissions Deadline

12-19-2012

Agency Initial Decision Deadline

2-15-2013