Indiana Certificate of Need Requirements: Facility Guide
Certificate of need (CON) programs are based on state-level regulations that require healthcare providers to demonstrate that a need exists before making significant changes to their facility or services. The Indiana certificate of need program was first enacted in the 1980s, but repealed in 1999. It was reinstated in 2019 with a focus on regulating comprehensive care facilities.
The general intent of CON regulations is to control healthcare costs, cut down on duplicate services, and promote health equity. If you’re an Indiana healthcare provider planning on building or expanding a facility, or offering new services to your community, you may need to obtain a CON before you begin. Let’s go over the essentials so that you know what the process will entail.
Indiana Certificate of Need Regulations at a Glance
Indiana’s CON program has gone through significant changes over the years. Before you begin the application process you may want to review the latest laws, determine if your project is covered by the regulations, and get an overview of the evaluation criteria. We gathered the key information, links, and resources so that you have everything you need in one place.
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| Legal Authorities | Indiana Code, Title 16, Article 29:
Indiana Administrative Code, Title 410, Article 40: |
| Covered Entities, Services, or Actions | The Indiana Department of Health (IDOH) outlines the facilities and activities that are covered by CON regulations.
The facilities regulated by CON laws are comprehensive care health facilities, as defined in IC 16-29-7-3, such as nursing homes. These laws also regulate comprehensive care beds which are defined in Section 16-29-2-1 as beds solely used for patients who are:
The activities that require a certificate of need include:
Certain types of facilities and activities are exempt from the regulations, and do not have to file for a CON. These include:
* More information about exceptions to CON regulations can be found in IC 16-29-7-1 and IC 16-29-7-16. |
| Establishment of Need | Applications are evaluated by the IDOH commissioner or a designee. To determine need the reviewer will consider the scope of the project and how it will impact the cost and quality of healthcare in the area. Criteria include:
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| Duration of Process | The Indiana certificate of need application process may take 9 to 10 months. |
| Enforcement Agency | The Indiana State Department of Health enforces CON regulations. |
| Fees | The fee for applying for a CON in Indiana is $5,000. |
| Application Forms | The application process takes place on an annual schedule and entails submission of a certificate of need application form, time for public comments, and a review/evaluation.
Questions about the application process can be emailed. |
| Penalties | Providers or facilities that fail to comply with the regulations could face misdemeanor charges, among other penalties. |
Indiana’s CON Laws: A Brief History
The first healthcare-related certificate of need program was initiated in New York State in 1964, and by 1970 an additional 25 states had similar regulatory mechanisms in place. In 1974 lawmakers passed the National Health Planning and Resources Development Act (NHPRDA), with threats to withhold federal funding from non-CON states. By the 1980s nearly all states, including Indiana, implemented CON programs.
Changes to reimbursement practices, emerging research, and new federal mandates contributed to a repeal movement, and many states eliminated their laws requiring a certificate of need. Indiana fully repealed its CON laws in 1999, as the last state to complete a repeal before the movement stalled out. In 2019, the program was reinstated in a new, scaled-back iteration, due in part to concerns about the lack of healthcare resources in rural areas.
Considerations for a Certificate of Need: Indiana’s Bed Need Analysis
In Indiana’s certificate of need program, the “bed need analysis” is a crucial part of the application and evaluation process. The analysis is conducted yearly based on population projections and demographic data, and is used to determine the need for additional comprehensive care/nursing home beds in each county. If your proposal relates to nursing homes, reviewers will evaluate need based on this analysis.
Additional Resources for the Application Process
As you gather information for your application, it might be helpful to look at posted certificate of need applications to review other projects and public comments. The annual review schedule includes two months for the public, including competitors, to provide input on proposals.
Be aware that the state will adopt provisional rules during times of emergency, such as when there is an imminent threat to public health. Understanding provisional rule procedures will help you determine whether a certain situation qualifies.
Get More Insights to Support Your Facility’s Growth
Getting a new healthcare project off the ground is both challenging and rewarding. Your Indiana certificate of need will be one step toward new and exciting opportunities for providing patient care. We’re here to support you with expert-written facility guides and resources that give you the information you need, when you need it.
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.