Certificate of need capital expenditure thresholds by US state
Capital expenditure dollar amounts that trigger certificate-of-need (CON) review in each US state with a CON program. Each record is one state, giving the expenditure threshold by facility type (hospital, long-term care, other), whether the threshold is inflation-adjusted, which facility types and services are covered, whether there is a moratorium on new facilities, and the statute citation. Answers 'how much can I spend on a healthcare facility project in [state] before I need a CON' and 'does [state] require a CON for [hospital beds / imaging equipment / ambulatory surgery centers]'.
Records51
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LicenceFacts extracted from state government health department pages and NCSL legislative overview; statutory thresholds are not copyrightable
The data
| State | Has CON program | Hospital threshold | Long-term care threshold | General threshold | Major equipment threshold | Covered services | Moratorium | Statute citation | Inflation-adjusted |
|---|---|---|---|---|---|---|---|---|---|
| Alabama | yes | $4,000,000 | $4,000,000 | $4,000,000 | $2,000,000 | general hospitals, specialized hospitals, nursing facilities, intermediate care facilities, rehabilitation centers, hospice service providers, home health agencies, HMOs, ambulatory surgery centers, kidney disease treatment centers | no | Ala. Code § 22-21-260 | |
| Alaska | yes | $1,000,000 | $1,000,000 | $1,000,000 | hospitals, psychiatric hospitals, independent diagnostic testing facilities, residential psychiatric treatment centers, skilled nursing facilities, kidney disease treatment centers, intermediate care facilities, ambulatory surgical facilities | no | Alaska Stat. § 18-07-31 et seq. | ||
| Arizona | no | no | |||||||
| Arkansas | yes | nursing home facilities, residential care facilities, assisted living facilities, post-acute head injury retraining facilities, home health care services agencies | Constructing a new residential care facility. Replacing a residential care facility with 16 beds or more. Adding new beds or expanding existing bed capacity for residential care facilities. | Ark. Stat. Ann. § 20-8-109 et seq. | |||||
| California | no | no | |||||||
| Colorado | no | no | |||||||
| Connecticut | yes | hospitals, specialty hospitals, free-standing emergency departments, outpatient surgical facilities, mental health facilities, substance abuse treatment facilities, nursing homes, rest homes, residential care homes | no | Conn. Gen. Stat. § 19a-638 (General Health Facilities) | Conn Gen. Stat. 17b-352 (Long Term Care Facilities) | |||||
| Delaware | yes | $5,800,000 | $5,800,000 | $5,800,000 | hospitals, nursing homes, free-standing birthing centers, free-standing surgical centers, free-standing acute inpatient rehabilitation hospitals, free-standing emergency centers, continual care community and other non-traditional long-term care facilities | Del. Code Ann. Tit. 16 § 9301 et seq. | yes | ||
| Florida | yes | skilled nursing facilities, hospices, intermediate care facilities for the developmentally disabled | Fla. Stat. § 408.031 et seq. | ||||||
| Georgia | yes | $10,000,000 | $10,000,000 | $10,000,000 | hospitals, destination cancer hospitals, skilled nursing facilities, intermediate care facilities, personal care homes, ambulatory surgical facilities, obstetrical facilities, free-standing emergency departments, HMOs, home health agencies, diagnostic, treatment and rehabilitation centers | Ga. Code § 31-6-40 et seq. | |||
| Hawaii | yes | hospitals, surgical centers, extended care and rehabilitation centers, nursing homes, skilled nursing facilities, intermediate care facilities, hospices, kidney disease treatment centers, outpatient clinics, ambulatory health care facilities, emergency care facilities, home health agencies, HMOs | no | Hawaii Rev. Stat. § 323D-42 et seq. | |||||
| Idaho | no | no | |||||||
| Illinois | yes | hospitals, long-term care facilities, dialysis centers, ambulatory surgery centers, alternative health care delivery models, free-standing emergency centers, birthing centers | no | Ill. Rev. Stat. ch. 20, § 3960/1 et. seq. | |||||
| Indiana | yes | comprehensive care facilities (nursing homes) | no | Ind. Code § 16-29-7 et seq. | |||||
| Iowa | yes | $1,500,000 | $1,500,000 | $1,500,000 | $1,500,000 | hospitals, residential care facilities, nursing facilities, intermediate care facilities, outpatient surgical facilities, community mental health facilities, birthing centers | no | Iowa Code § 135.61 et seq. | |
| Kansas | no | no | |||||||
| Kentucky | yes | hospitals, psychiatric hospitals, physical rehabilitation hospitals, chemical dependency programs, nursing facilities, nursing homes, personal care homes, intermediate care facilities, outpatient clinics, ambulatory care facilities, ambulatory surgical centers, emergency care centers, ambulance providers, hospices, community mental health centers, home health agencies, kidney disease treatment centers | no | Ky. Rev. Stat. § 216B.020 et seq. | |||||
| Louisiana | yes | nursing facilities, intermediate care facilities for persons with developmental disabilities, home- and community-based service providers, hospice providers, pediatric day health care facilities, behavioral health services providers, opioid treatment programs | Intermediate care facilities for the developmentally disabled. Nursing facilities (until July 1, 2027). | La. Rev. Stat. Ann. § 2116 | |||||
| Maine | yes | $10,000,000 | $10,000,000 | $10,000,000 | hospitals, psychiatric hospitals, nursing facilities, kidney disease treatment centers, rehabilitation facilities, ambulatory surgical facilities, independent radiological service centers, independent cardiac catheterization centers, cancer treatment centers | no | Me. Rev. Stat. Ann. Tit. 22, Chapter 103-A et seq. | ||
| Maryland | yes | lesser of 25% of the hospital's gross regulated charges for the preceding year or $50 million | hospitals, limited-service hospitals, related institutions providing domiciliary, personal or nursing care, ambulatory surgical facilities, rehabilitation facilities, home health agencies, hospices | no | Md. Health Code Ann. § 19-120 et seq. | ||||
| Massachusetts | yes | $250,000 | hospitals or clinics, long-term care facilities, clinical laboratories, public medical institutions | no | Mass. Gen. Laws Ann. ch. 111 §25C et seq. | ||||
| Michigan | yes | hospitals, psychiatric hospitals or psychiatric units, nursing homes or hospital long-term care units, free-standing surgical outpatient facilities, HMOs | no | Mich. Comp. Laws § 333.22201 et seq. | |||||
| Minnesota | no | Hospitals and hospital beds (Minn. Stat. § 144.551). Nursing home beds (Minn. Stat. § 144A.071). Intermediate care facilities for persons with developmental disabilities (Minn. Stat. § 252.291). Radiation therapy facilities in certain counties (Minn. Stat. § 144.5509). | |||||||
| Mississippi | yes | hospitals, psychiatric hospitals, chemical dependency hospitals, skilled nursing facilities, end-stage renal disease facilities, intermediate care facilities, ambulatory surgical facilities, home health agencies, psychiatric residential treatment facilities, pediatric skilled nursing facilities, long-term care hospitals, comprehensive medical rehabilitation facilities | Skilled nursing facilities. Intermediate care facilities. Converting hospitals beds to skilled or intermediate nursing home care. Medicaid-certified child/adolescent psychiatric or chemical dependency beds. Intermediate care facilities for the intellectually disabled. | Miss. Code Ann. § 41-7-171 et seq. | |||||
| Missouri | yes | hospitals, residential care facilities, assisted living facilities, intermediate care facilities, skilled nursing facilities, long-term care beds in a hospital, long-term care hospitals | no | Mo. Rev. Stat. § 197.300 et seq. | |||||
| Montana | yes | $1,500,000 | $1,500,000 | long-term care facilities | no | Mont. Code Ann. § 50-5-301 et seq. | |||
| Nebraska | yes | skilled nursing facilities, intermediate care facilities, nursing facilities, long-term care hospitals | Long-term care beds. | Neb. Rev. Stat. § 71-5829 et seq. | |||||
| Nevada | yes | $2,000,000 | health facilities broadly defined as a facility in or through which health services are provided | no | Nev. Rev. Stat. § 439A.100 et seq. | ||||
| New Hampshire | no | no | |||||||
| New Jersey | yes | $2,000,000 | $2,000,000 | $2,000,000 | $2,000,000 | general hospitals, special hospitals, mental hospitals, public health centers, diagnostic centers, treatment centers, rehabilitation centers, extended care facilities, skilled nursing homes, intermediate care facilities, assisted living residences, comprehensive personal care facilities, outpatient clinics, home health care agencies, residential health care facilities, bioanalytical laboratories | no | N.J. Rev. Stat. §26-2H-7 et seq. | |
| New Mexico | no | no | |||||||
| New York | yes | hospitals, nursing homes, diagnostic and treatment centers, ambulatory surgery centers, certified home health agencies, long term home health care programs, hospices, adult care facilities, adult day health care programs | no | N.Y. Public Health Law § 2802 et seq. | |||||
| North Carolina | yes | hospitals, long-term care hospitals, psychiatric facilities, rehabilitation facilities, nursing home facilities, adult care homes, kidney disease treatment centers, intermediate care facilities, home health agency offices, chemical dependency treatment facilities, diagnostic centers, hospice offices, hospice inpatient facilities, ambulatory surgical facilities | no | N.C. Gen. Stat. § 131E-175 et seq. | |||||
| North Dakota | no | no | |||||||
| Ohio | yes | $4,000,000 | long-term care facilities | Long-term care beds. | Ohio Rev. Code Ann. § 3701-12-01 et seq. | ||||
| Oklahoma | yes | $1,000,000 | $1,000,000 | long-term care facilities, specialized facilities for developmentally disabled clients, hospital-based skilled nursing units | no | Okla. Stat. Tit. 63 § 1-850 et seq. | |||
| Oregon | yes | hospitals, skilled nursing facilities, intermediate care facilities, long-term care facilities, health facilities established by a health maintenance organization | no | Or. Rev. Stat. § 442-015 et seq. | |||||
| Pennsylvania | no | no | |||||||
| Rhode Island | yes | hospitals, nursing facilities, home nursing-care providers, home care providers, hospice providers, inpatient rehabilitation centers, free-standing emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, facilities providing inpatient hospice care | New nursing facilities, nursing facility licensed beds, and increases in capacity of licensed nursing facilities (until July 1, 2022). | R.I. Gen. Laws § 23-15-2 et seq. | |||||
| South Carolina | yes | $5,000,000 | $5,000,000 | $5,000,000 | $1,500,000 | hospitals (except hospital care at home programs), nursing homes | no | S.C. Code Ann. § 44-7-110 et seq. | |
| South Dakota | no | no | |||||||
| Tennessee | yes | nursing homes, recuperation centers, hospitals, ambulatory surgical treatment centers (to be exempted effective December 2027), mental health hospitals, intellectual disability institutional habilitation facilities (to be exempted effective December 2025), home care organizations, outpatient diagnostic centers, rehabilitation facilities, residential hospices, nonresidential substitution-based treatment center for opiate addiction, long-term care hospitals (to be exempted effective December 2027) | no | Tenn. Code Ann. § 68-11-1602 et seq. | |||||
| Texas | no | no | |||||||
| Utah | no | no | |||||||
| Vermont | yes | $1,000,000 | general hospitals, mental hospitals, chronic disease facilities, birthing centers, maternity hospitals, psychiatric facilities, nursing homes, HMOs, home health agencies, outpatient diagnostic or therapy programs, kidney disease treatment centers, mental health agencies or centers, diagnostic imaging facilities, independent diagnostic laboratories, cardiac catheterizations laboratories, radiation therapy facilities, ambulatory surgical, diagnostic or treatment centers | No certificate of need can be granted for the offering of home health services, which includes hospices or new home health agencies, through Jan. 1, 2025, or until the General Assembly lifts the moratorium. | Vt. Stat. Ann. Tit. 18 V.S.A., § 9432 et seq. | ||||
| Virginia | yes | $5,000,000 | $15,000,000 | $15,000,000 | general hospitals, sanitariums, nursing homes, intermediate care facilities, extended care facilities, mental hospitals, facilities for individuals with developmental disabilities, psychiatric hospitals, rehabilitation hospitals, ambulatory surgery centers, cardiac catheterization centers, CT scanning centers, MRI centers, PET scanning centers, radiation therapy centers | None, but Certificates of Public Need for an increase in nursing beds are subject to the department issuing a request for applications for an increase in beds. | Va. Code §32.1-102.1 et seq. | ||
| Washington | yes | $2,830,000 | hospices, hospice care centers, hospitals, psychiatric hospitals, nursing homes, ambulatory surgical facilities, home health agencies | no | Wash. Rev. Code §70-38-025 et seq. | ||||
| Washington, D.C. | yes | $6,000,000 | $3,500,000 | $3,500,000 | $3,500,000 (hospital) / $2,000,000 (other facility) / $350,000 (physician or independent owner/operator) | private general hospitals, psychiatric hospitals, other specialty hospitals, rehabilitation facilities, skilled nursing facilities, intermediate care facilities, ambulatory care centers or clinics, ambulatory surgical facilities, kidney disease treatment centers, free-standing hemodialysis facilities, diagnostic health care facilities, home health agencies, hospices | D.C. Code Ann. § 44-401 et seq. | ||
| West Virginia | yes | public or private facility, agency or entity that offers or provides health services, whether a for-profit or nonprofit entity | New intermediate care or skilled nursing beds. New skilled nursing facilities. New intermediate care beds for persons with intellectual disabilities. Opioid treatment programs (unless it is part of an approved clinical trial and registered with the Board of Pharmacy). In-home personal care services. | W. Va. Code §16-2D-2 et seq. | |||||
| Wisconsin | no | Nursing homes are subject to a statewide bed limit. Hospital beds. | |||||||
| Wyoming | no | no |
Where this came from
Every record above links the page it was taken from and quotes the sentence that states it. These are the 2 sources this dataset was assembled from.
- ncsl.orghttps://www.ncsl.org/health/certificate-of-need-state-laws
- rpcconsulting.comhttps://rpcconsulting.com/potential-certificate-of-need-change-legislation/
Machine-readable
- data.jsonThe whole dataset — every record with its source URL and source quote.
- Open Knowledge Format bundleOne JSON object per line — every record's frontmatter and quoted span exactly as it is held here, in one fetch.
- How this is made and checkedWhat "verified against source" does and does not mean.