Certificate of Need Process

1. A CON application is commenced by the filing of the Letter of Intent (LOI) electronically through the e-application portal between the 1st through the 15th of any month. The information contained in the LOI must be published in a newspaper of general circulation (Click Here for information) in the county in which the project will be located during that same 15-day period.

In the case of an application for or by a home care organization, the Letter of Intent must be published in each county in which the agency will be licensed or in a regional newspaper which qualifies as a newspaper of general circulation in each county. In those cases where the Letter of Intent is published in more than one newspaper, the earliest date of publication shall be the date of publication for the purpose of determining competition deadlines and filing the application.

2. The CON application and filing fee are due by the first day of the following month, through the e-application potal.

3. The application will be reviewed by the commission staff for completeness during which time supplemental questions may be asked. Upon being deemed complete, the application will enter the next review cycle.

4. Applications are deemed complete by the close of business on the fourteenth day of the month.

5. A review cycle starts on the fifteenth day of each month, as specified in Commission Rules.

6. The review cycle is typically 30 days.

7. Application materials, including a staff review, will be forwarded to the 11 member board about 12 days prior to the meeting in which the application will be heard.

8. During the Commission meeting at which the application is being heard, the applicant will make a short presentation (10 minutes) highlighting how the application meets the criteria necessary for granting a Certificate of Need application.

9. Persons supporting and/or opposing the application will have an opportunity to provide testimony.

10. Commission members may ask questions of the applicant and any supporting and opposing party and then discuss the application in the public forum.

11. The Commission will then vote to approve or deny the application. In certain circumstances, an application may be deferred so additional information may be obtained.

12. Approval/Denial letters will be issued within a week of the Commission's decision. The actual certificate will be issued within 4 weeks of the decision.

13. Commission decisions may be appealed up to 15 days under certain conditions as noted in T.C.A. §68-11-1609(g)(1) & (2).  The appeal process is more fully described in T.C.A. §68-11-1610.

(Notice to Applicants filing CON applications for cardiac catheterization services:  The current criteria and standards for review of cardiac catheterization CON applications utilize diagnostic-equivalent procedure and weights for measuring laboratory capacity.  The resulting weighted procedures are used in evaluating applications with respect to minimum volume standards.  This data is available by request at the website of the Department of Health (TDH).  An applicant should request diagnostic equivalent cardiac catheterization data for the three most recent years available for all hospital cardiac catheterization providers within the declared service area at the following Department of Health/Health Statistics Site .  Applicants should plan on requesting and receiving this data from TDH at least 2 weeks prior to filing the CON application.)

How to Apply for a Certificate of Need

Applicants  in the process of filing an application with the Tennessee Health Facilities Commission may contact HFC staff for a pre-filing conference.  Conferences may be held in person or via telephone any business day, 8:00 am through 4:30 pm (Central Time).  Please contact Director of Certificate of Need Program, Phillip Earhart at phillip.m.earhart@tn.gov or call 615-741-2364 to set up an appointment.

Please visit HFC FORMS (in the website header) for all the necessary forms you will need to file an application.  The Letter of Intent (LOI) and Publication of Intent (POI) forms contain certain required information so please use the forms so your publication will be correct.