Florida Certificate of Need Requirements: Facility Guide
Certificate of need (CON) programs are state-run regulatory processes that require certain healthcare providers to get approval before establishing new facilities or expanding their services. In Florida, certificate of need laws have a relatively narrow scope compared to other states that regulate healthcare in this way. For example, a CON is required for some aspects of healthcare, such as adding new beds to a nursing home, but no longer required for other endeavors, like building new hospitals.
Though the scope of Florida’s CON program is relatively narrow, the rules and regulations are detailed and the review process is complex. In this guide, we’ll provide the essential information and resources that you need for determining whether your healthcare project requires a certificate of need. We’ll also discuss the steps for applying, what to expect from the evaluation process, and more.
Certificate of Need: Florida‘s Key Laws and Program Overview
If you’re planning to expand or alter your healthcare services in Florida, you may need to obtain a CON. The following chart provides a summary of Florida’s CON program, including relevant laws and rules. If your project requires approval, take advantage of the convenient links to application forms and agency resources as you navigate the process.
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| Legal Authorities | Florida Statutes, Title XXIX, Chapter 408:
Florida Administrative Code, Division 59C: |
| Covered Entities, Services, or Actions | The Agency for Health Care Administration (AHCA) outlines the facilities and activities that require a certificate of need in Florida.
The facilities regulated by CON laws include:
The activities regulated by CON laws include:
Certain types of facilities and activities are not regulated, such as:
Note: Certain projects may qualify for an exemption. The certificate of need exception procedure specifies the process for qualifying. |
| Establishment of Need | Florida’s AHCA establishes need based on certain criteria such as:
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| Duration of Process | Once a Florida certificate of need application is declared complete, it will be reviewed within 45 days (expedited review procedures) or 60 days (comparative review procedures). |
| Enforcement Agency | Florida’s Agency for Health Care Administration enforces CON regulations. |
| Fees | The fee for applying for a certificate of need in Florida is $10,000 plus 1.5% of the proposed expenditure, with a maximum fee of $50,000. |
| Application Forms | Proposals are subject to comparative or expedited review (in accordance with Florida Code, Rule 59C-1.010).
The comparative review process involves filing a letter of intent (LOI) and application packet, potential public hearings, and a review/evaluation. Applications are batched into 4 annual cycles (2 cycles for hospice, 2 for SNFs and ICF/DD). The expedited review process involves submission of an application packet, potential public hearings, and a subsequent review/evaluation. No letter of intent or intent publication is required for this process and it must be initiated at least 90 days prior to implementation of the project. |
| Penalties | The penalties for failing to comply with the Florida certificate of need regulations are outlined in Florida Code, Rule 59C-1.021. Penalties may include:
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Certificate of Need in Florida: A Brief History
Florida’s certificate of need program can be traced back to the early 1970s, when efforts to ensure the quality of care, access to care, and cost containment of healthcare for residents gave rise to a CON program. When the federal government issued the National Health Planning and Resources Development Act of 1974, which linked federal funding to state CON programs, many other states implemented similar programs. At that time, Florida was 1 of 20 states with regulations already in place.
Federal laws shifted in 1986, causing many states to reconsider their CON statutes. Some states retired their programs, enabling care providers in all sectors of healthcare to establish new facilities or offer new services without applying for a certificate of need. Florida’s program underwent minor changes, but it wasn’t until 2019 that there was a significant restructuring of the CON program.
Florida’s Partial Repeal of Certificate of Need Laws
Florida’s restructuring of CON laws occurred in two phases. Phase one was initiated in 2019, with the elimination of the approval process for general hospitals and providers of tertiary-level clinical care (such as organ transplantation). Phase two took place in 2021, with the elimination of CON requirements for specialty hospitals. Though the CON program was significantly scaled back, the process remains rigorous for providers who need approval.
More Resources for Pursuing a Florida Certificate of Need
If you’re working toward obtaining a certificate of need in Florida, consider using the AHCA’s published need projection documents. These reports include data from several sources, processed according to established need methodologies. You can also access statewide health indicator data and statistics on Florida’s Community Health Assessment Resource Tool Set (CHARTS). These resources may be helpful for establishing a need for the particular new service or expansion you’re proposing.
Get More Insights to Support Your Facility’s Growth
Applying for your Florida certificate of need will be an exciting step as you bring your healthcare project to life. We offer a wealth of expert-backed healthcare guides and resources to support your facility’s growth — so you can focus on providing more of the patient care your community needs.
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.