CON Review Types as Determined by Facility Type

I. Article 28 Providers (hospitals, nursing homes, and diagnostic and treatment centers)

Full Review

Proposals requiring a full review, including a recommendation or decision of the Public Health and Health Planning Council, are those that involve:

  • Addition of beds (regardless of cost) ;
  • Hospital bed conversion to a bed category not already existing in the facility;
  • Addition of, or changes in method of delivery of, the following services
    • Therapeutic radiology
    • Cardiac surgery
    • Certain transplants
    • Burn care
    • AIDS centers
    • Epilepsy services
  • Construction/renovation projects or acquisition of major medical equipment with a cost in excess of $30 million for general hospitals and in excess of $15 million for all other facilities, including proposals where costs exceed 10% of annual operating budgets or $100 Million for general hospitals; and 10% of annual operating budgets or $25 million for all other facilities.;
  • Changes in ownership, consolidations, creations of active parent entities;
  • Establishment of new facilities, home care agencies or hospice programs;
  • Relocation of cardiac catheterization services within a hospital network
  • Addition of Percutaneous Cardiac Intervention (PCI) services to a hospital without existing cardiac surgery
  • A project eligible for administrative review that receives a recommendation of disapproval by Department staff.

In general, any proposal with a cost in excess of $30 million for general hospitals and in excess of $15 million for all other facilities is subject to full review. This includes proposals where costs exceed 10% of annual operating budgets or $100 Million for general hospitals; and 10% of annual operating budgets or $25 million for all other facilities. This rule is explained in 10 NYCRR Section 710.1(c).

The Public Health and Health Planning Council (PHPPC)

The PHHPC reviews all proposals subject to full review. It has final decision-making authority over changes in ownership and over the establishment of new facilities, home care agencies and hospice programs. It makes recommendations to the Commissioner of Health concerning major construction, renovation, major medical equipment acquisition, and the addition of beds and specialized services. Learn more about the Public Health and Health Planning Council.

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Administrative Review

For Hospitals: Proposals with total project costs greater than $15 Million and less than or equal to $30 Million for general hospitals are eligible for an administrative review and do not require a recommendation for the Public Health and Health Planning Council. However, the upper threshold is a sliding threshold and includes proposals where costs do not exceed 10% of the facility's annual operating budget or $100 Million for general hospitals as defined in 10NYCRR Section 710.1(c)(3).

For Nursing Homes and Diagnostic & Treatment Centers: Proposals with total project costs greater than $6 Million and less than or equal to $15 Million are eligible for an administrative review and do not require a recommendation for the Public Health and Health Planning Council. However, the upper threshold is a sliding threshold and includes proposals where costs do not exceed 10% of the facility's annual operating budget or $25 Million as defined in 10NYCRR Section 710.1(c)(3).

Examples of proposals eligible for an administrative review are:

  • Change in licensed services other than those requiring full review ;
  • Certification of or assuming operation of extension clinics or addition of primary care sites;
  • Addition of dialysis stations by a facility approved to operate dialysis stations; and
  • Nursing home conversion of Residential Health Care Facility (RHCF) beds to Ventilator Dependent Beds
  • Addition of Adult Day Health Care Program or slots
  • Relocation of main site of diagnostic and treatment center
  • Relocation of extension clinics that include addition of services
  • Emergency room replacements, renovations or modernizations unless the total project costs requires a full review application
  • Addition of PCI services to a hospital with a diagnostic cardiac catheterization service
  • Addition of Electrophysiology (EP) to a hospital with PCI services
  • Addition of hospital operating rooms unless the total project costs requires a full review application

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Limited Review

Proposals eligible for a limited review do not require a recommendation from the Public Health and Health Planning Council. These include proposals with a total project cost less than or equal $15 Million for general hospitals and less than or equal to $6 Million for all other facilities requesting to:

  • Perform minor construction (proposals not related to clinical space are subject to a construction notice rather than a limited review);
  • Acquire, relocate, install or modify certain medical equipment;
  • Decertify facility beds and/or services;
  • Add certain services;
  • Convert beds within approved categories;
  • Add electrophysiology (EP) services to an appropriately certified facility;
  • Add, upgrade or replace cardiac catheterization laboratory or equipment by an appropriately certified facility;
  • Relocate an extension clinic without addition of services within the same service area;
  • Operation, change in category of services offered, change in hours of operation or re-location of a part-time clinic site

Learn more about Limited Review

Search NYCRR Title 10, Section 710.1(c)(5)-(7)

II. PHL Article 36 Providers (home care agencies)

Full Review

Establishment Applications

Proposals requiring a decision by the Public Health and Health Planning Council (PHHPC) are those that relate to:

  • Establishment of a new certified home health agency (CHHA) or licensed home care services agency (LHCSA);
  • Transfer of ownership of a CHHA or LHCSA, including mergers, consolidations, and creation, or changes in ownership of, a parent entity.

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Construction/Service Applications

Proposals requiring a recommendation of the Public Health and Health Planning Council (PHHPC) are those that relate to:

  • Initiation of a long term home health care program (LTHHCP).
  • Change in the geographic service area of a CHHA or LTHHCP.
  • Change in the method of providing a service when costs exceed $400,000.
  • Acquisition, construction or renovation of a building when costs exceed $400,000.
  • Purchase, repair, maintenance or alteration of equipment when costs exceed $400,000.
  • Increase in LTHHCP capacity requiring a competitive review.

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Administrative Review

Proposals requiring an administrative review, without recommendation of the PHHPC are those that relate to:

  • Addition or deletion of a service on a CHHA operating certificate.
  • Increase in LTHHCP capacity not requiring a competitive review.
  • Construction/renovation projects when costs do not exceed $400,000.
  • Purchase of equipment when costs do not exceed $400,000.
  • Addition of an AIDS Home Care Program.

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III. Article 40 Providers (hospice)

Full Review

Establishment Applications

Proposals requiring a decision by the Public Health and Health Planning Council (PHHPC) are those that relate to:

  • Establishment of a new hospice.
  • Transfer of ownership of a hospice, including mergers, consolidations, and creation of, or changes in ownership of, a parent entity.

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Construction/Service Applications

Proposals requiring a recommendation of the PHHPC, are those that relate to:

  • Change in geographic service area.
  • Change in the method of, or arrangement for, hospice inpatient or residence care and services ;
  • Addition of certified hospice inpatient or residence beds;
  • Purchase, repair, maintenance or alteration of equipment when costs exceed $1 million;
  • Construction, relocation, repair or alteration of an administrative office site when costs exceed $1 million;
  • Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $1 million;
  • Acquisition or construction of a hospice inpatient unit or residence when costs exceed $250,000;
  • Approval of any dually certified hospice residence beds, regardless of cost.

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Administrative Review

Proposals requiring an administrative review, without recommendation of the PHHPC, are those that relate to:

  • Purchase, repair, maintenance or alteration of equipment when costs exceed $500,000, but not $1 million.
  • Construction, relocation, repair or alteration of an administrative office site when costs exceed $500,000, but not $1 million.
  • Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $250,000, but not $1 million.
  • Acquisition or construction of a hospice inpatient unit or residence when costs do not exceed $250,000.

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