The Kentucky Certificate of Need process prevents the proliferation of health care facilities, health services and major medical equipment that increase the cost of quality health care in the commonwealth.
Forms and Applications
Application Forms
Pursuant to KRS 216B.061, unless otherwise provided in this chapter, no person shall do any of the following without first obtaining a certificate of need:
(a) Establish a health facility;
(b) Obligate a capital expenditure which exceeds the capital expenditure minimum;
(c) Make a substantial change in the bed capacity of a health facility;
(d) Make a substantial change in a health service;
(e) Make a substantial change in a project;
(f) Acquire major medical equipment;
(g) Alter a geographical area or alter a specific location which has been designated on a certificate of need or license;
(h) Transfer an approved certificate of need for the establishment of a new health facility or the replacement of a licensed facility.
Form2A: Certificate of Need Application
Word
PDF
Formal review applications must be filed by an applicant for facilities or services with review criteria in the State Health Plan. Nonsubstantive review applications do not have review criteria in the State Health Plan.
Please note that proposals from PACE applicants seeking to provide CON services directly to their members are considered as meeting the state readiness review requirement of 900 KAR 6:075, Section 2(3)(g)1. by submitting a copy of a preliminary approval letter from KY Medicaid with their CON application.
Form 2B: Certificate of Need Application for Ground Ambulance Services
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PDF
Ground ambulance applications must be filed by an applicant for a certificate of need for a ground ambulance service.
Form2C: Certificate of Need Application for Change of Location, Replacement, Cost Escalation, or Acquisition Word
PDF
Public Hearing Documents
Each of these documents must be submitted at least five calendar days prior to any scheduled nonsubstantive review hearing date and at least seven calendar days prior to date of all other scheduled hearings.
Miscellaneous Forms
Form 6: Cost Escalation Form
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PDF
Pursuant to 900 KAR 6:095, a person shall not obligate a capital expenditure in excess of the amount authorized by an existing certificate of need or a previously approved administrative escalation unless the person has received an administrative escalation or an additional certificate of need from the cabinet.
Form 7: Request for Advisory Opinion
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PDF
KRS 216B.040(3)(e) authorizes the Cabinet to establish a mechanism for issuing advisory opinions to prospective applicants for CON on whether a certificate is required.
Form 8: Certificate of Need Six Month Progress Report
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PDF
A holder of a certificate of need shall submit progress reports on this form at six month intervals. A notice specifying the date each progress report is due shall be sent to every holder of a certificate of need whose project is not fully implemented.
Form 9: Notice of Intent to Acquire a Health Facility or Health Service
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PDF
A health facility shall submit a completed form to notify the cabinet of the acquisition of a health facility or health service at least thirty (30) days prior to the acquisition.
Form 10A: Notice of Addition or Establishment of a Health Service or Equipment
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PDF
A health facility shall submit a completed form to notify the Cabinet within 10 days of adding equipment or adding to an existing health service for which there is review criteria in the State Health Plan, but for which a certificate of need is not required.
Form 10B: Notice of Termination or Reduction of a Health Service or Reduction of Bed Capacity
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PDF
A hospital shall submit a completed form to notify the Cabinet within 10 days of relocating acute care beds or redistributed beds by licensure category.
Form10C: Notice of Relocation of Acute Care Beds or Redistribution of Beds by Licensure Category
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PDF
A health facility shall submit a completed form to notify the cabinet of the reduction or termination of a health service, or reduction of bed capacity within 30 days prior to the reduction or termination.
Form 11: Application for a Certificate of Compliance for a Continuing Care Retirement Community (CCRC)
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PDF
In order to be certified as a continuing care retirement community, a certificate of compliance shall be obtained.