Kentucky Certificate of Need Requirements: Facility Guide
Thirty-five states and Washington, D.C., require a certificate of need (CON) prior to the construction or expansion of healthcare services. If you’re looking to open an urgent care facility in Lexington, you may be wondering, is Kentucky a certificate of need state? Short answer: yes. The Kentucky certificate of need is a regulatory measure meant to control healthcare costs by ensuring that new services are truly needed by the host community.
In this article, we’ll expand on that definition with the particular provisions of Kentucky’s CON and the process for application. Armed with information and our helpful links, you’ll be ready to move on from the planning stage of your healthcare project.
Certificate of Need: Kentucky Rules and Regulations
If you’re planning to open a new healthcare facility, you’ll need to be prepared for the CON process. Like other states, Kentucky’s can be time-consuming. Prepare for meeting its many requirements — Kentucky is said to have the 16th most restrictive CON in the U.S. — with this quick overview and helpful links.
| Legal Authorities | Kentucky Revised Statutes, Chapter 216B:
Kentucky Administrative Code, Title 900, Chapter 006: |
| Requirements | Healthcare actions that would require CON approval can include:
Healthcare facilities and services that are regulated by Kentucky CON laws typically offer services that treat more than minor illnesses and injuries. Examples of facilities and services subject to review include:
The minimum cost thresholds for triggering CON review are adjusted annually to account for any changes in the preceding 12-month cost index. Capital expenditure and major medical equipment threshold costs were set at $2,913,541 in 2013. These prices have been adjusted on an annual basis since 2015. Facilities that may be exempt from CON review include:
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| State Agency | Kentucky Cabinet for Health and Family Services (CHFS), Division of Certificate of Need and Licensing
Email: CON@ky.gov Phone: (502) 564-9592 Address: 275 E. Main St, 5E-A, Frankfort, KY 40621 |
| Fees | The fees for a Kentucky CON application follow a cost-based structure.
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| Application Forms | Kentucky certificate of need application forms must be delivered between 50 and 80 days prior to the Kentucky CHFS Division of Certificate of Need’s public notice. Notices are published in the CON newsletter, following a schedule set by service type. See the breakdown of publication timeframes below:
January, April, July, and October publication timetables apply to:
February, May, August, and November publication timetables apply to:
March, June, September, and December publication timetables apply to:
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| Penalties | Penalties for not complying with healthcare regulatory provisions can be steep. This includes the Kentucky certificate of need. Search for all the fees associated with KY healthcare and CON mandate violations within Section 216B.990.
Among other penalties, willful CON violations may incur a minimum fee of $500 and up to 1% of the proposed project cost in Kentucky. This includes offering new or expanded services, acquiring new medical equipment, or making a capital expenditure above the minimum threshold without prior CON approval (or after a CON has been revoked). |
The Certificate of Need: Kentucky’s Emergency Considerations
If there is an emergent need for healthcare services and the welfare of the community depends on immediate access to services, a provider may expand to meet that emergent need without prior CON approval. Some of the conditions for this temporary exemption include:
- Pre-licensure of the already existing facility.
- Notification to the Office of the Inspector General (OIG) Certificate of Need Division in writing within 5 days of the service beginning. This should include an affidavit and the required supporting documentation.
- Receipt of confirmation from the OIG of the emergency’s validity.
After acknowledgement of the emergency from the OIG, the provision of emergent services may then continue without a CON until:
- The emergency circumstances end or resolve.
- A final decision is made on a CON application for the same service.
Once the emergency ceases, the provider has 10 days to notify the OIG that the emergency services are no longer required. If the emergency circumstances go beyond 60 days, the provider must then submit a formal Kentucky certificate of need application.
Criteria for Establishing Need in Kentucky
A completed application must take into account many indicators to demonstrate community need. Here are several to be aware of as you compile your evidence.
Consistency With Plans
Proposed plans need to show that they’re consistent with the state health plan with consideration for the impact on local healthcare costs. If the specific type of proposal isn’t addressed in the state health plan, that alone can be grounds for CON denial.
Need and Accessibility
Evidence must clearly support a definitive need for the proposed services by the local area and ensure the accessibility of those services. Proposed regions shall not be limited by geographic boundaries. Instead, the location should be defined by the population it seeks to serve.
Interrelationships and Linkages
The proposed project should offer support and work in connection with the region’s already established healthcare facilities. Evidence should also support its contribution to the larger healthcare availability in Kentucky.
Costs, Economic Feasibility, and Resource Availability
All proposals need to be cost-effective and demonstrate a commitment to economic use of resources. Resources aren’t limited to capital and include operational manpower considerations and operational financing.
Quality of Services
The organization needs to ensure that it can deliver the proposed services in a manner consistent with current standards and requirements.
Ready to Improve Access to Your Vital Healthcare Services?
After meeting Kentucky certificate of need requirements, increasing the reach of your quality services in the Bluegrass State is a great next step. IntelyCare can help you to better serve your patients via expert-backed facility guides and resources to boost your local healthcare impacts.
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.