Certificate of Need (CON) Overview
Like many other states, Nevada has an extensive CON process in place for healthcare services and facilities. Winning approval for a CON application is often a time consuming and difficult undertaking. Working with RPC provides clients with a team of expert consultants with experience working with CON projects.
When working on a CON project, RPC can prepare the entire CON application or sections of the application as the client prefers. When the client is defining the project and deciding whether to file an application, RPC can help assess the market and regulatory situation to determine the relative likelihood of success for a project. RPC not only works to create a thorough market, need and financial analysis, but also works seamlessly with the client’s staff, architects, engineers and other outside consultants to create a solid CON application.
RPC is led by Ron Luke, JD, PhD, who has prepared CON applications and presented testimony in CON hearings since 1981 in more than 20 states. RPC’s work on CON projects includes the opening of new acute care hospitals, hospices, physical rehabilitation and psychiatric specialty hospitals, ambulatory surgery centers, nursing homes, the relocation and addition of beds, and the acquisition of major medical equipment. Working with RPC during the CON process gives the applicant the advantage of a skilled expert team that can provide expert advice and produce an effective CON application.
State Agencies
Certificate of Need Program Staff
The CON reviews are conducted by the Division of Public and Behavioral Health’s Primary Care Office, and final determinations are made by the Director, NV Department of Health and Human Services. The Certificate of Need (CON) program staff, as an agent of the Nevada Health Facilities Review Committee, reviews letters of intent and CON applications, and conducts subsequent compliance follow-up.
Nevada Department of Health and Human Services
Division of Public and Behavioral Health, Primary Care Office
4150 Technology Way, Suite 300
Carson City, NV 89706
(775) 684-2204
Services that Require CON
The Nevada Certificate of Need (CON) program started in the early 1970s and functions to control increases in the cost of health care, to provide adequate supply and distribution of resources, and to provide equal access to health care of good quality at a reasonable cost.
Any person undertaking any expenditure for new construction on behalf of a health facility costing in excess of $2,000,000 must obtain a letter of approval from the Director of the Department of Health and Human Services (CON Statute NRS 439A.100). New construction includes the redesign or renovation of an existing building not currently in use as a healthcare facility. Projects in Clark County (Las Vegas) and Washoe County (Reno) are exempt from the CON Review. Capital expenditures for land acquisition, parking, facility maintenance and renovation to comply with safety standards or energy conservation measures are exempt from CON review. Construction of a hospital in an unincorporated town is exempt from review if:
- The population of the town is more than 24,000
- No other hospital exists in the town
- The town is at least a 45-minute drive from the nearest trauma center
- No other hospital has been approved for construction
Certificate of Need Process Milestones
- File Letter of Intent
Applicants must submit a letter of intent (LOI) to the Primary Care Office at DHHS before submitting an application. Within fifteen days, staff determines if a CON is required. The Department responds to the LOI with a determination letter that informs the applicant whether the project meets criteria for a full CON review. A pre-application conference will be scheduled if a CON review is required. - Submit Application
The applicant submits an original and three copies of the completed application, along with the $9,500 application fee, to the Primary Care Office by the due date specified in the LOI response letter. The review period officially begins on the day the application is received. - Review and Public Hearing
An application must be complete and fully address every item. If an application is deemed insufficient, it will be denied. If an application is accepted as complete, a public hearing will be scheduled within 45 days. Notice of the hearing will include the applicant’s identity, the place of the hearing and the date by which written information from interested parties must be submitted. - Final Decision
Within 30 to 45 days after the public hearing, the Director issues a Letter of Approval or a Letter of Disapproval with written findings. - Reconsideration
Any applicant may submit a written request for reconsideration of the Director’s decision within 30 days of the notice of the decision. If the Director determines there is good cause for reconsideration, the Department will hold a public hearing (unless waived by the applicant). The Director will render a decision within 30 days after the close of the public hearing, or the date the hearing was waived. - Progress Reports
The holder of a letter of approval shall provide the Department with quarterly progress reports, beginning with the first calendar quarter following issuance of the letter of approval. Each report is due no later than 30 days after the end of each quarter. Each progress report must include information on the project start date, compliance with the approved timetable, project cost updates, material changes in the project, and the estimated completion date.
What Criteria are Used to Review a CON?
The Director compares applications for similar services in the same service area and bases his decision on established criteria, including the following, which are detailed in NAC 439A:
- Projected demand by the population in the area to be served
- The financial feasibility of the project
- The effect of the project on the cost of health care for users and payors
- Whether the project is appropriate for the area to be served, including access and compatibility with existing health services
- Benefit to enrolled members of Health Maintenance Organizations, if applicable
Certificate of Need Application Filing Fee
The application fee is a standard $9,500.
Additional Sources
(links good as of January 2022)
Nevada Certificate of Need Program
https://dpbh.nv.gov/Programs/Certificate_of_Need/Certificate_of_Need_-_Home/
CON Statute and Regulations
https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Programs/Certificate_of_Need/1.%20R022-20%20Adopted%20by%20DHHS(1).pdf
CON Application Forms:
– CON Letter of Intent
- Nevada CON Letter of Approval Application
https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Programs/Certificate_of_Need/Application(1).pdf
Contact RPC Consulting
Should you or your client need an expert team to help you with the Nevada Certificate of Need Process (CON) please contact Dr. Ron Luke at 512-371-8166.
Disclaimer: The information on this page has been compiled by RPC in June 2010 and updated in January 2022 based on sources believed to be reliable. Where possible we have had the material reviewed by state CON officials or others knowledgeable of the state’s CON program. The information is not offered as legal advice. A state may change its rules, forms and procedures at any time and RPC offers no assurance that the information will be correct on the date it is viewed. Therefore the reader is urged to use this information only as a starting point for any CON application and to speak with state officials or seek legal or consulting advice early in the process.