Rhode Island Certificate of Need Requirements: Facility Guide
Certificate of need programs are based on state-level healthcare regulations that require providers to get approval before making significant changes regarding the services they offer. In Rhode Island, certificate of need (CON) laws regulate certain aspects of care, from opening a new hospital to adding a cardiac catheterization lab to an existing facility.
Rhode Island’s CON program was the second one to take effect in the nation, and has been a significant factor in their public health strategy ever since. The evaluation process reflects statewide priorities and health reform objectives, such as access to quality care for all Rhode Islanders, including at-risk populations.
Rhode Island Certificate of Need Laws at a Glance
If you’re considering changing or expanding your healthcare practice in Rhode Island, you’ll need to prove that your proposal aligns with statewide health goals by getting approved for a certificate of need.
Rhode Island’s state regulations are detailed and extensive, so we gathered the essential information into one easy-to-reference chart. Below you’ll find an overview of key references to help you understand the program, the guidelines that will be used to evaluate your proposal, and links to the forms you’ll need to submit.
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| Legal Authorities | Rhode Island General Laws, Title 23, Chapter 15:
Rhode Island Administrative Code, Title 216, Chapter 40:
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| Covered Entities, Services, or Actions | The Rhode Island Office of Health Systems Development (OHSD) follows specific regulations to determine when a CON is required. In general, types of facilities that fall under state regulations include:
Activities that fall under state regulations include:
Entities and services that are exempt from Rhode Island certificate of need regulations include:
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| Establishment of Need | CON application reviewers consider whether the proposed project is needed by the community. Reviewers use six guiding principles when evaluating proposals. Here’s a look at those principles and some of the questions they address:
1. Need of the population: Will the proposed project improve the health of Rhode Islanders? 2. Health reform goals: Does the project align with the state’s goals for better health outcomes, improved patient experiences, and lower per-capita healthcare costs? 3. Quality: Will the applicant be able to provide high-quality care? 4. Affordability: Will the project affect the cost of health insurance premiums or state spending through Medicaid? 5. Accessibility: Will the project prioritize social justice, improve health equity, or eliminate health disparities? 6. Innovation: Does the proposed project support clinical research, professional training, or academic activities? |
| Duration of Process | The Rhode Island certificate of need application process can take up to 6 months. |
| Enforcement Agency | Rhode Island Office of Health Systems Development |
| Fees | The application fee is calculated by adding 0.25% of the capital cost of a project to a base fee.
The base fees are as follows:
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| Application Forms | The Rhode Island certificate of need application and review process involves the emailed submission of a letter of intent (LOI), followed by a completed application.
In addition, a paper copy of the completed application should be mailed to: Center for Health Systems Policy and Planning, Rhode Island Department of Health, 3 Capitol Hill, Room 410, Providence, Rhode Island 02908 Proposals are evaluated according to a biannual review schedule. |
| Penalties | Providers or facilities that fail to comply with the regulations could face sanctions that can include:
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A Brief History of Rhode Island’s CON Regulations
Rhode Island was one of the first certificate of need states, joining in the nationwide trend toward increased regulation of healthcare facilities and services. The first iteration of laws, implemented in 1969, focused on regulating the rising cost of hospital services, but expansion in 1974 led to the coverage of nursing homes and the health-maintenance sector.
Over the decades more categories were added under the program’s oversight, as well as projects with expenditures over a set limit. Several public health initiatives have influenced the CON program, such as a Statewide Health Inventory and the State Healthcare Innovation Plan, both created in 2015.
Competition Is Part of the Process
There are multiple layers of input built into the CON review process, including opportunities for the public and competing stakeholders to give input on your proposal. Because of this, be aware that competing facilities or providers may file challenges or comments to your application. In addition, because of the cyclical nature of the review process, your application may be grouped with other, similar projects and weighed against them.
Applying for a Certificate of Need: Rhode Island Resources
If you’re in the process of applying for a CON in Rhode Island, take advantage of the program’s high level of transparency. The OHSD shares valuable data in their Annual Report of Reviews including past/pending applications, lengths of the various parts of the process, review council findings, and links o meeting audio.
Get the Essential Insights You Need for Growth
While filing for a Rhode Island certificate of need can be challenging, it also represents a significant milestone in bringing your potential healthcare project to life. Whether you’re opening a new facility or providing a needed service to your patients, growth is exciting. We’re here to support you with a wealth of expert-written guides and resources.
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.