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You are Here: Home Page > Intro to CON process > Major Elements of a CON Review  

Major Elements of a CON Review

I.) Article 28 Providers:

Full Review (see NYCRR Title 10, Section 710.1(c)(2)): Proposals requiring a full review, including a recommendation of the State Hospital Review and Planning Council and/or the Public Health Council, are those that relate to:

• Addition of beds.
• Conversions to a different level of care.
• Changes in method of delivery of services.
• Construction/renovation projects over $10m.
• Purchases of major medical equipment.
• Changes in ownership.
• Establishment of new facilities or programs.
• Addition of highly specialized services (e.g., cardiac surgery, organ transplant).

Depending on the nature of the proposal, the application may be reviewed by the either or both councils:

• The Public Health Council reviews all proposals related to changes in ownership and/or the establishment of new facilities.
• The State Hospital Review and Planning Council reviews all proposals related to construction or renovation over $10M. Exceptions to this rule are explained in 10 NYCRR Section 710.1(c)(3).
• Both councils review applications that involve both establishment and construction.

Administrative Review (see 10 NYCRR Section 710.1(c)(3)): Proposals that have total project costs under $10M, or do not exceed $25M or 10% thresholds as defined in 10 NRCRR Section 710.1(c)(3) are eligible for an administrative review and do not require a recommendation from the State Hospital Review and Planning Council. Examples of proposals eligible for an administrative review are:

• Change in licensed services or number of beds within the same level of care;
• Operation or relocation of extension clinics, and addition of primary sites;
• Minor facility upgrades and/or purchases of certain types of equipment.

Limited Architectural Review (see NYCRR Title 10, Section 710.1(c)(5)): Proposals eligible for a limited architectural review have total project costs under $3M and do not require a recommendation from the State Hospital Review and Planning Council. These projects relate to the acquisition, relocation, installation or modification of certain medical equipment, inpatient and surgical areas, and facility support systems (e.g., HVAC, water, sewer, fire protection, etc.).

Limited Program Review (see NYCRR Title 10, Section 710.1(c)(6)): Proposals eligible for a limited program review do not require a recommendation from the State Hospital Review and Planning Council. These are proposals requesting to:

• decertify a facility's beds and/or services;
• add services which involves a total project cost under $3M;
• convert beds within approved categories;
• change services offered by, or relocate, a part-time clinic site.

II.) Article 36 Providers (Home Care)

Full Review (see NYCRR Title 10, Part 760): Proposals requiring a full review, including a recommendation of both the State Hospital Review and Planning Council, and the Public Health Council, are those that relate to:

• Establishment of a new certified home health agency (CHHA).
• Transfer of ownership of a CHHA.

Proposals requiring a full review (see NYCRR Title 10, Part 762), including a recommendation of only the State Hospital Review and Planning Council, are those that relate to:

• Initiation of a long term home health care program (LTHHCP).
• Expansion of the geographic service area of a CHHA or LTHHCP.
• Change in the method of providing a service when costs exceed $400,000.
• Construction/renovation projects when costs exceed $400,000.
• Purchase, repair, maintenance or alteration of equipment when costs exceed $400,000.
• Transfer of ownership of a LTHHCP.
• Increase in LTHHCP capacity requiring a competitive review.

Administrative Review (see NYCRR Title 10, Part 762): Proposals requiring an administrative review, without recommendation of either council, are those that relate to:

• Addition of a service to a CHHA operating certificate.
• Increase in LTHHCP capacity not requiring a competitive review.
• Construction/renovation projects when costs do not exceed $400,000.
• Purchase of equipment when costs do not exceed $400,000.
• Addition of an AIDS Home Care Program.

III.) Article 40 Providers (Hospice)

Full Review (see NYCRR Title 10, Part 790): Proposals requiring a full review, including a recommendation of both the State Hospital Review and Planning Council, and the Public Health Council, are those that relate to:

• Establishment of a new hospice.
• Transfer of ownership of a hospice.

Proposals requiring a full review (see NYCRR Title 10, Part 791), including a recommendation of only the State Hospital Review and Planning Council, are those that relate to:

• Change in the method of, or arrangement for, hospice inpatient or residence beds.
• Addition of certified hospice inpatient or residence beds.
• Purchase, repair, maintenance or alteration of equipment when costs exceed $1 million.
• Construction, relocation, repair or alteration of an administrative office site when costs exceed $1 million.
• Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $1 million.
• Acquisition or construction of a hospice inpatient unit or residence when costs exceed $250,000.

Administrative Review (see NYCRR Title 10, Part 791): Proposals requiring an administrative review, without recommendation of either council, are those that relate to:

• Expansion of geographic service area.
• Purchase, repair, maintenance or alteration of equipment when costs exceed $500,000, but not $1 million.
• Construction, relocation, repair or alteration of an administrative office site when costs exceed $500,000, but not $1 million.
• Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $250,000, but not $1 million.
• Acquisition or construction of a hospice inpatient unit or residence when costs do not exceed $250,000.

IV.) Public Comment: During the review process, the Department of Health accepts written comments on Certificate of Need proposals from interested parties. Further opportunity is given for comment on specific CONs at public meetings of the Statewide Hospital Review and Planning Council, and/or the Public Health Council.