Georgia Certificate of Need Requirements: Facility Guide
Many states require healthcare organizations looking to construct or expand operations to first obtain a certificate of need (CON) — essentially, a permit establishing a community justification for the offered service. Each state’s process for certification is unique, the Georgia certificate of need procedure being no exception. Its program differs from those of other states in many ways, including certain exemptions allowed for destination cancer hospitals — small hospitals that provide oncological services for a mostly out-of-state patient base.
If you’re thinking about setting up your own ambulatory surgical center in Savannah, or a new urgent care clinic in Athens, you’ll likely need a CON before investing in construction contracts. Familiarize yourself with the regulatory process with this general overview of the Georgia CON and its associated steps for application.
The Certificate of Need: Georgia Laws and Regulations at a Glance
Even after submitting your application for a certificate of need, Georgia’s Department of Community Health (DCH) can take as long as 120 days after the application is filed (longer, with an extension) to decide if the project merits approval. To help you streamline your understanding of the initial steps and save precious time, we’ve outlined some key provisions and provided helpful links to resources.
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| Legal Authorities | Code of Georgia, Title 31, Chapter 6:
Georgia Administrative Code, Subject 111-2-2
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| Requirements | Healthcare activities that can trigger CON review include:
Prior to the passage of House Bill 1339, the Georgia CON threshold for capital expenditures was $10 million. Now, capital expenditures of any amount no longer require CON review. HB 1339 also established or expanded exemptions for, among other things:
Other projects exempted from CON review include, but are not limited to:
*Unless otherwise specified within the applicable statutes and regulations, applicants seeking exemption status must receive approval via a letter of non reviewability. Georgia DCH does retain the right to audit for compliance with the terms of issuance and such investigations can be initiated at any time. |
| State Agencies | The Georgia Department of Community Health enforces CON policies via the Office of Health Planning. |
| Fees | Application fees are determined by the proposed expenditure.
Certain organizations and facilities are exempt from application fees, including state-owned institutions. Under appropriately justified financial circumstances, certain hospital facilities and public non-profit providers may request a fee waiver alongside their application. |
| Application Categories and Forms | There are two categories of Georgia CON applications:1. Non-batched Applications are accepted throughout the year.
2. Batched Applications are accepted at designated times, typically requiring certain facilities to apply during assigned seasons. Fall and Spring batched applications apply to:
Winter and Summer batched applications apply to:
Georgia DCH CON forms include:
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| Penalties | If an organization begins providing services prior to CON approval, the following penalties may apply:
After giving notice and a fair hearing, the DCH can also revoke prior CON approval if the project doesn’t maintain compliance with its original proposal or CON requirements. |
Georgia Certificate of Need Application: Additional Considerations
The DCH doesn’t accept CON applications by mail or in-person. Applicants must submit the required documentation for a Georgia certificate of need online through the department portal. The process for both non-batched and batched applications follows a similar sequence of steps, laid out within the application packet:
- Letter of Intent: This must be submitted 25 days prior to the official application date.
- Application: It may take 10 days for the application to be judged complete once it’s submitted.
- Review Cycle: Confirmation that an application is complete begins the review cycle.
- 60-Day Meeting: This meeting is only for the applicant and serves as a deadline for receipt of any opposition letters.
- 75th Day: Any additional required information must now be delivered.
- 90th Day: Opposition meetings are scheduled. Application may attend and the opposition must provide a written copy of their argument.
- 100th Day: This is the deadline for submitting any letters of support for the CON application.
- 110th Day: The applicant can now provide amended information and a response to opposition.
- 120th Day: This is the official deadline for the final approval or rejection decision.
- 150th Day: The department may extend a project to this point if appropriate and necessary.
In Georgia, certificate of need change of ownership processes may be required. If a provider acquires a facility or services — through a merger, for example — they’re obligated to notify the DCH within 45 days via written notice that includes the date of acquisition and the name and address of the new owner. DCH can fine the new owners $500 per day if that deadline is missed.
Access as a Priority in the Certificate of Need: Georgia Regulatory Provisions
While some states look to repeal their CON laws, Georgia is continuing to refine its programs — angling new provisions specifically toward improving access and creating new options for patients. One key aspect of the CON-reforming HB 1339 was the allowance for the historically Black Morehouse School of Medicine to open a new hospital, providing services once offered by Atlanta Medical Center, without prior CON approval. Improving access in that area of Fulton county was intended to counter its “healthcare desert.”
Examples of access improvement strategies beyond the Morehouse hospital exemption also include the allowance of non-owner providers to utilize outpatient surgical centers for care delivery (as long as they belong to the same specialty) and CON exemption status for reopening shuttered rural hospitals (provided there is no replacement in the same county). Provisions like these help improve the availability of services in areas that may have struggled to accommodate patients before HB 1339’s changes.
Want to Broaden Access Within Your Healthcare Programs?
Whether you need to better understand the Georgia certificate of need program before expanding or you’re looking to improve your patient relationship initiatives, IntelyCare has expert-vetted resources and facility guides to help promote access to your valuable services.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.