Most common types of certificates of need

The District of Columbia and many states in the U.S. require Certificates of Need (CONs) for the approval of healthcare capital expenditures and projects. These programs aim to control healthcare costs by ensuring new expenses fit community and healthcare system needs.

In the Definitive Healthcare HospitalView product, we collect CONs by monitoring the websites of the 36 states/federal jurisdictions with participating programs. Since 2018, more than 11,400 healthcare CONs have been recorded.

To provide insight into the types of capital projects that hospitals are undertaking, we ranked the most frequent categories for healthcare CONs between January 2018 and September 2022.

Top 10 most common hospital certificate of need categories

Rank CON category Number of CONs
1 Change in ownership/stock/management 2,234
2 Hospital/facility renovation 1,981
3 Certify new unit/service 1,834
4 Equipment new/replace 1,721
5 New hospital/unit 1,606
6 Change in beds status/number/classification 1,057
7 Certify/change service 474
8 Hospital/facility relocation 408
9 Transfer equipment 75
10 Hospital/facility closure 41

Fig. 1 Data is from the Definitive Healthcare HospitalView product. CONs and hospital purchasing data are from a variety of sources and updated daily. Data accessed October 2022.

What is the most common CON type?

Changes in ownership, stocks, or management CONs for healthcare organizations are the most common with more than 2,200 recorded between January 2018 and September 2022. These CONs cover network affiliation changes and funding news.

Hospital and facility renovations are the second most common CON type and track construction projects. The remaining top categories with more than 1,000 CONs between January 2018 and September 2022 include:

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