Overview of Certificate of Need

Health Service Facilities Regulated by the CON law [G.S.131E-175 (Article 9)]

  1. Acute Care Hospitals. [G.S. 131E-176(13)]
  2. Inpatient Psychiatric Hospitals. [G.S. 131E-176(21)]
  3. Inpatient Rehabilitation Hospitals. [G.S. 131E-176(22)]
  4. Nursing Homes. [G.S. 131E-176(17b)]
  5. Kidney Disease Treatment Centers (i.e., Certified End-Stage Renal Disease Facilities) [G.S. 131E-176(14e)]
  6. Intermediate Care Facilities for the Mentally Retarded [G.S. 131E-176(14a)]
  7. Certified Home Health Agency Offices [G.S. 131E-176(12)]
  8. Chemical Dependency Treatment Facilities (inpatient & residential) [G.S. 131E176(5a)]
  9. Diagnostic Centers. [G.S. 131E-176(7a)]
  10. Hospice Programs. [G.S. 131E-176(13a)]
  11. Hospice Inpatient Facilities. [G.S. 131E-176(13b)]
  12. Hospice Residential Care Facilities. [G.S. 131E-176(13c)]
  13. Ambulatory Surgical Facilities. [G.S. 131E-176(1b)]
  14. Adult Care Homes [G.S. 131E-176(1)]
  15. Long-Term Care Hospitals [G.S. 131E-176(14k)]

Activities Requiring Certificate of Need Review [G.S. §131E-175 (Article 9)]

  1. Establishment of a new health service facility (See 1 through 15 above). [G.S. 131E-176(16)a]
  2. Capital expenditure by any person for health service in excess of $2 million dollars. [G.S. 131E-176(16)b]
  3. Change in bed capacity. [G.S. 131E 176(16)c, 176(5) and 176(9c)]
    1. Relocation of health service facility beds or dialysis stations. [G.S. 131E-176(16)(5)(i)]
    2. Change of health service facility beds from one category to another. [G.S. 131E-176(5)(ii)]
    3. Increase in dialysis stations or health service facility beds. [G.S. 131E 176(5)(iii)]
    4. Health service facility beds are defined in G.S. 131E-176(9c) to include:
    1. acute care beds;
    2. inpatient psychiatric beds;
    3. inpatient rehabilitation beds;
    4. nursing home beds;
    5. intermediate care beds for the mentally retarded;
    6. chemical dependency treatment beds, including inpatient and residential;
    7. hospice inpatient facility beds;
    8. hospice residential care facility beds;
    9. adult care home beds; and
    10. long-term care hospital beds.
  4. Establishment of new dialysis services or home health services. [G.S. 131E-176(16)d]
  5. Change in project that includes cost overrun of 15% of the capital expenditure amount of an approved CON project or addition of a health service to an approved project. [G.S. 131E-176(16)e]
  6. The offering of any of the following services [G.S. 131E-176(16)f]:
    1. Bone marrow transplantation;
    2. Burn intensive care services;
    3. Neonatal intensive care services (NICU);
    4. Open-heart surgery services;
    5. Solid organ transplantation services; and
    6. Cardiac catheterization services.
  7. The acquisition of any of the following equipment [G.S. 131E-176(16)fl]:
    1. Air ambulance;
    2. Cardiac catheterization equipment;
    3. Gamma knife equipment;
    4. Heart-lung bypass machine;
    5. Linear Accelerator;
    6. Lithotriptor;
    7. Magnetic Resonance Imaging scanner;
    8. Positron Emission Tomography (PET) scanner; and
    9. Simulator.
  8. The acquisition of a health service facility from a health maintenance organization. [G.S. 131E-176(16)l]
  9. Conversion of non-health care beds to health care beds. [G.S. 131E-176(16)m]
  10. Construction, development or establishment of a hospice, hospice inpatient facility, or hospice residential care facility. [G.S. 131E-176(16)n]
  11. Opening of an additional office by an existing home health agency or hospice. [G.S. 131E-176(16)o]
  12. Acquisition of major medical equipment ($750,000 including costs of studies, design, construction, renovation and installation). [G.S. 131E-176(14o)]
  13. Relocation of a health service facility from one service area to another. [G.S. 131E 176(16)q and 176(24a)]
  14. Conversion of specialty ambulatory surgical program to a multispecialty ambulatory surgical program or the addition of a specialty to a specialty ambulatory surgical program. [G.S. 131E-176(16)r, 176(15a) and 176(24c)]
  15. Furnishing mobile medical equipment to any person in North Carolina if not in use in North Carolina prior to March 18, 1993. [G.S. 131E-176(16)s]
  16. The construction, development, establishment, increase in the number, or relocation of an operating room or gastrointestinal endoscopy room in a licensed health service facility, other than relocation within the same building or on the same grounds or to grounds not separated by more than a public right of way from existing location [G.S. 131E 176(16)u]
  17. The change in designation, in a licensed health service facility, of an operating room to a gastrointestinal endoscopy room or change in designation of a gastrointestinal endoscopy room to an operating room that results in a different number of each type of room than is reflected on the health service facility’s license in effect as of January 1, 2005. [G.S. 131E 176(16)v]