Certificate of Need

Certificate of need (CON) is a permit for the establishment or modification of a health care institution, facility, or service at a designated location. Tennessee’s CON program seeks to deliver improvement in access, quality and cost savings through orderly growth management of the state’s health care system.  The Division of Health Planning is charged with setting the standards and criteria for granting a CON in the State Health Plan. The Health Services Development Agency (HSDA) decides whether to grant or deny a CON using the standards and criteria.

Public Chapter 1043 became effective July 1, 2016. This law made sweeping changes to the state’s Certificate of Need Program including additions and deletions to services overseen by the program, a new emphasis on the quality of health care provided by the applicant, increasing the oversight of granted CONs by the HSDA, and changes in the funding structure of the agency. The following list outlines the facilities, equipment, and services regulated by the CON program as of July 1, 2016.

Revision of CON Standards and Criteria

Since the first State Health Plan was published in 2009, the Division of Health Planning has revised specific standards and criteria. These revised standards replace the standards included in the Guidelines for Growth 2000 Edition, which the HSDA continues to reference for categories not yet revised under updated versions of the State Health Plan.

It takes considerable work to update CON standards and criteria, and the Division of Health Planning is committed to a transparent, inclusive, and well-informed process to ensure that the appropriate criteria are considered by the HSDA when granting a CON. In drafting revised standards, the division consults with experts and interested stakeholders through a variety of methods including interviews, public meetings, questionnaires, and public comment periods. To participate in the division’s CON standards review process, please visit the Get Involved page.

Once an updated State Health Plan is approved and adopted by the governor, any CON application deemed complete by the HSDA on or after the date of adoption is considered under the revised standards, if applicable. Below is a list of CON categories with revised standards and criteria previously adopted. 

Revised CON Standards and Criteria