The construction of new health facilities at a cost of over $2 million in all rural communities in Nevada requires a letter of approval from the Nevada Director of the Department of Health and Human Services. This process is commonly referred to as the Certificate of Need (CON) review process. Eligibility criteria are defined under NRS 439A.100.
Certificate of Need is a process whereby certain proposed new construction projects must submit an application to document the needs for the project according to criteria specified in state CON law and regulations, NRS 439A.100 and NAC439A.010 through NAC439A.675. New construction is defined as a new health facility or construction which increases the square footage in an existing facility or the redesign or renovation of an existing building which is not currently being used as a health facility. Staff in the Health Planning and Primary Care Office conduct the CON review process and make a recommendation to the Director of the Department of Health and Human Services. The Director has the responsibility for granting or denying a Letter of Approval for each proposed project requiring CON review.
The CON process is consistent with NRS 439A.081 functions to control increases in the cost of health care, to provide adequate supply and distribution of resources, and to provide equal access to health care of good quality at a reasonable cost.
The CON review program was enacted by the Nevada State Legislature during the 1971 session and became effective in August 1972. The Nevada CON law has been amended substantially over the years. In 1991, Washoe County and Clark County were exempted from the CON process. In 1995, the law was again changed to cover only the construction of new health facilities involving capital expenditures over $2 million. In 2015, rural communities in Washoe and Clark counties were added back in.
Updated draft regulations are available under "General Information" in the right-hand column. Businesses with fewer than 150 employees are invited to complete the Small Business Impact Questionnaire, before March 11, 2016, online or you can download the form located in the right-hand column.
Letter of Intent/Determination
Complete and submit the letter of intent/determination form to initiate the staff review process for a proposed project. Within 15 days after receiving the completed Letter of Intent, staff will determine if a CON application and review process are required. A letter of response to the Letter of Intent will be sent to the prospective applicant. If staff determines a CON review is required a pre-application conference will be scheduled to review the process and requirements.
An original and three copies of a completed application together with a check for $9500 made out to the Department of Health and Human Services must be submitted by the date specified in the response to the Letter of Intent
The Application for Certificate of Need must be completed according to the form provided and must fully address every item. If an application is deemed insufficient, it will be denied. If accepted as complete, a public hearing will be scheduled within 45 days. Notice of the public hearing will include the identity of the applicant, place of the hearing, and the date by which written information from interested persons must be submitted.
The application will be reviewed in accordance with the following criteria detailed in NAC 439A.605 through 439A.637:
• Whether a need for the proposed project exists in the community;
• Whether the proposed project is financially feasible;
• The effect of the proposed project on the cost of health care; and
• The appropriateness of the proposed project in the community.
Any requests for clarification or additional information will be provided to the applicant, following initial review of the application. Testimony at the public hearing and written information received prior to the hearing will also be taken into consideration in preparation of Findings of Fact. The Director of the Department of Health and Human Services has responsibility for rendering a decision regarding approval or disapproval of an application.
Letter of Approval/Disapproval
Within 30 days after the public hearing, the Director will issue a letter of approval or disapproval.
Applicants for a Certificate of Need must also work with staff in the Bureau of Health Care Quality and Compliance, for licensure and certification, which is a totally separate process.