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Division of Health Planning
Jeff Ockerman, Director

Certificate of Need Standards and Criteria

A 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 improve access, quality, and cost savings through orderly growth management of the state's health care system. The Division of Health Planning is updating the standards and criteria for granting a CON. The current CON standards and criteria are contained in the Guidelines for Growth, 2000 Edition. The new standards and criteria will appear in the State Health Plan.

The agency that uses the standards and criteria to decide whether to grant a CON is the Health Services and Development Agency (HSDA). Members of the public considering applying for a CON or with questions regarding CON applicability to a possible project should contact the HSDA directly at http://www.tn.gov/hsda/.

The Division of Health Planning is updating CON services and facilities standards and criteria in phases, starting with Positron Emission Tomography Services, Cardiac Catheterization Services, and Open Heart Surgery Services. Refer to this page for updates on the CON standards and criteria revision process, or sign up for news from our electronic mailing list.

The Division of Health Planning consults with experts throughout the state on the revision to each area of CON. Please go to our Get Involved page if you would like to comment or provide your expert opinion on the updates to the CON standards and criteria, or you can directly contact Eric Harkness, Planning and Research Coordinator for the Division of Health Planning, at Eric.Harkness@tn.gov.

A CON is required to establish any of the following specific services and facilities: nursing home, swing bed, acute care bed, inpatient rehabilitation, air ambulance, neonatal nursery, burn units, obstetrical services, long term care beds, modification of health care institutions, psychiatric inpatient, ICF/MR, mental health residential treatment, alcohol and drug abuse residential treatment, non-residential methadone treatment, lithotripsy, PET, MRI, megavoltage radiation therapy, home health services, residential hospice, hospice, open heart surgery, cardiac catheterization, ASTC, outpatient diagnostic center, and birthing center.

In addition, a CON is required for hospitals making facility expansions that exceed $5 million and non-hospitals making facility expansions that exceed $2 million. Also, the acquisition of any piece of medical equipment that exceeds $2 million requires a CON. Finally, there are several cases where the transfer of beds and/or location of an existing service require a CON.