Connecticut Certificate of Need Requirements: Facility Guide
A certificate of need (CON) is an official statement of approval that may be required of healthcare providers before they can do things like open new facilities, add or take away services, or implement certain types of treatments and technology. Connecticut Certificate of Need requirements cover many different types of entities and services, with oversight divided between the state’s Office of Health Strategy (OHS) and Department of Social Services (DSS).
If you’re planning on making certain facility changes in Connecticut, whether it’s expanding a hospital or purchasing an MRI machine, you may need to obtain a CON. Navigating a program can be daunting, so we put together this guide to help. Let’s go over the scenarios when a CON is mandatory, how to apply, and the resources that will help you with the process.
Connecticut Certificate of Need: Application Process, Guidance, and Resources
The Connecticut CON process is complex. Below you’ll find key takeaways in one easy-to-reference chart covering key statutes, steps for establishing need, and links to the forms you can use to apply.
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| Legal Authorities | Connecticut General Statutes:
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| Covered Entities, Services, or Actions | When is it mandatory to obtain a certificate of need? Connecticut’s CON laws apply when providers wish to make significant changes to the state’s healthcare landscape, such as:
Some entities and activities do not require a certificate of need, such as:
*For a full list of entities and services that require a CON, and more information on exemptions, reference the CT CON Guidebook and the DSS CON program overview. |
| Establishment of Need | To be approved for a Connecticut certificate of need, organizations must show that there is a clear public demand for the change or new facility. For example, would a proposed project or new facility:
If so, including ample supporting data can help, as well as information demonstrating that the project will not have a negative impact, such as duplicating care that’s already available or adversely affecting the availability, diversity, or cost-effectiveness in care in the area. |
| Duration | The application process can take 60 days to 1 year, and in some cases longer. |
| Enforcement Agency | There are 2 agencies within the state that manage the CON program, each with a distinct area of enforcement:
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| Fees | The fee for filing an application varies depending on the cost of the proposed project, and can be anywhere from $1,000 (projects less than $50,000) to $10,000 (projects estimated to cost $10 million or more). |
| Application Forms | While the Connecticut certificate of need application process will vary by agency (OHS or DSS), generally applicants will need to provide notice of their intent, submit application forms, and proceed through a review process.
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| Penalties | Providers or facilities that negligently or willfully fail to go through the required process or miss required deadlines could face civil penalties of up to $1,000 per day. |
A Brief History of Connecticut’s CON Laws
The Connecticut certificate of need program was initiated in 1973 under the state’s Commission on Hospitals and Health Care. In 1993, the newly created Department of Social Services (DSS) took over the approval process for nursing homes and some types of residential and intermediate-term care facilities. Further evolutions shifted the oversight of all general applications to the Office of Health Strategy in 2010.
Also in 2010, the program underwent significant reform in keeping with the federal Patient Protection and Affordable Care Act. The changes and updates focused on:
- Simplifying the application process.
- Regulating safety-net services (aimed at providing care for vulnerable populations) and areas of potential overuse of services.
- Addressing financial aspects of the delivery of care.
- Improving the quality of care.
Pursuing a CON in Connecticut: Considerations
Despite attempts to simplify the application process, critics highlight long wait times. In 2024 it took Yale New Haven Health 16 months to get approval for the potential purchase of three struggling hospitals. If you’re pursuing a Connecticut certificate of need, plan ahead and give the process plenty of time. Submit ample information about your proposal with your application to avoid requests for more supporting data.
Applying for a Certificate of Need: Connecticut-Specific Resources
Another way to prepare for your CON application is to research applications that have been approved in the past. Access the public portal to find past/pending applications, read the relevant correspondences, and check out timelines. This will give you a better understanding of what the process will be like for your facility. You may also want to:
- View open certificate of need applications.
- Virtually attend an upcoming CON public hearing.
- Examine data and metrics (like mean/median processing time and annual reports).
Get More Resources to Help Your Facility Grow and Thrive
Growth is exciting, challenges and all. The Connecticut certificate of need process is one of the hurdles that you’ll have to overcome before providing crucial patient care in your area. Get more healthcare resources, insights, and guides to help your facility thrive.
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.