Illinois Certificate of Need Requirements: Facility Guide

• Sections 20 ILCS 3690/1 to 20 ILCS 3960/19.6

Illinois Administrative Code, Title 77, Chapter II:

• Section 1130.110 to Section 1130.790

• Hospitals
• Long term care (LTC) facilities (skilled and intermediate)
• Ambulatory surgical centers
• Specialized Mental Health Rehabilitation Facilities
• Kidney disease treatment centers (including free-standing hemodialysis units)
• State-run hospitals, nursing homes, and other agencies that provide clinical care
• Birthing centers

Unless an exemption applies, CON-regulated activities may include:

• Establishing, constructing, or modifying a health care facility.
• Acquiring major medical equipment.
• Substantially changing the scope or functional operation of a facility.
• Changing the bed capacity by either increasing available beds, redistributing them between services, or relocating beds from one physical healthcare setting to another by more than 20 beds or 10% of total bed capacity (whichever is less) over a 2-year period.
• Changing ownership without a certificate of exemption (COE).
• Discontinuing an entire category of service or closing a health care facility.
• Accruing capital expenditures in excess of capital expenditure minimum.

The monetary thresholds for capital expenditures that trigger CON review include:

• $17,787,538 for hospitals.
• $10,053,816 for LTC facilities.
• $4,640,230 for all other facilities.

Note: These minimum thresholds are adjusted annually to reflect inflation.

Proposals that are exempt from CON review as long as they procure a COE include:

• Changing ownership for existing healthcare facilities (excluding facilities licensed by the Nursing Home Care Act).
• Discontinuing an existing health care facility or service provision (excluding healthcare facilities maintained by the state or nursing homes maintained by the county).
• Establishing or expanding neonatal intensive care services or beds.

Applicants seeking exemption status from certificate of need review must first apply for a COE. The associated fees are assessed in this manner:

• All exemption applications (excepting change of ownership applications) will incur a $5,000 application fee.
• All change of ownership applications shall incur a fee that is the greater of $5,000 or .22% of the transaction’s price. If the change of ownership is between relatives, the fee is set at $5,000.
• All COE application fees are capped at $150,000.

For CON applications, an initial deposit of $5,000 must be made to the HFSRB. Once an application is deemed complete, the remainder of the fee is due. Fees are based on the estimated project cost.

• For projects estimated to cost less than $2.25 million, the application fee shall be $5,000.
• If the total cost estimate of a project is greater than or more than $2.25 million, the application fee shall be .22% of the project costs.
• The maximum CON application fee is capped at $150,000.

*If the remainder of the application fee is not submitted to the HRSB within 30 days of application receipt notice, the application will be declared null and void.

• Illinois CON Application Form
• LTC CON Application Form
• Change of Ownership COE Application Form
• Discontinuation COE Application
• Neonatal ICU COE Application

• The HFSRB may revoke or deny a CON or COE, if the terms of issuance are not adhered to.
• Providers who operate without prior CON approval may also be prevented from attaining other necessary operational licenses.
• Violating the terms of the Illinois Health Facilities Planning Act is considered a business offense and may result in a $25,000 fine.
• Failing to comply with the terms of the CON may result in fines up to 1% of the project’s total proposed costs, plus an additional 1% of those costs for each 30-day period that the violation continues.
• If the scope or cost of a proposed project changes without HFSRB approval, the offending party may be fined the lesser of $25,000 or 2% of the project’s total proposed cost.