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Certificate of Need

Program Overview

The Certificate of Need program is a regulatory process that requires certain healthcare providers to get state approval before building certain types of facilities or offering new or expanded services.

Program staff members are available to provide technical assistance to you before submitting your application. Staff members are also available to help you determine if a Certificate of Need is necessary.

For example, a Certificate of Need is required if a hospital wants to add to the number of its licensed beds.

The Certificate of Need process is intended to help ensure that facilities and new services proposed by healthcare providers are needed for quality patient care within a particular region or community.

Certificate of Need review is required for:

  • Construction, development or establishment of the following healthcare facilities:
    • Hospitals
    • Nursing homes
    • Kidney dialysis centers
    • Medicare or Medicaid home health agencies
    • Medicare or Medicaid hospice agencies
    • Ambulatory surgical centers
    • Hospice care centers
  • Increases in the number of stations at a kidney dialysis center.       
  • Sale, purchase or lease of all or part of an existing hospital, regardless of profit/non-profit status.
    • Increases in the number of licensed beds at a hospital, nursing home or hospice care center.
    • Offering a new tertiary health service. These include:
    • Level I rehabilitation programs
    • Open heart surgery
    • Therapeutic cardiac catheterization
    • Organ transplantation specialty burn services
    • Intermediate care nursery and/or obstetric services
    • Level II neonatal intensive care nursery and/or obstetric services
    • Level III specialized inpatient pediatric services
  • A capital expenditure made by a nursing home exceeding $1 million dollars (adjusted for inflation). The 2012 minimum is set at $2,403,990.
  • Nursing home bed banking transactions.
  • Nursing home replacements. 

Review details are found in Chapter 246-310 WAC Certificate of Need. More information is available by contacting the Certificate of Need program at 360-236-2955.

Certificate of Need and Construction Review Services are distinct review and approval processes. Application requirements differ for each review process. Applicants are encouraged to contact the programs early to avoid unexpected delays. Contact Construction Review staff members for information about their services.


Join one of our Listservs to receive Certificate of Need information.