of new health facilities at a cost over $2 million in
counties in Nevada where the population is less than 100,000
requires a letter of approval from the Nevada's Director of
the Department of Health and Human Services. This process is
commonly referred to as the Certificate of Need (CON) review
Need is a process whereby proposed new construction projects
which require CON review must submit an application which
justifies 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. The Bureau of Health
Planning and Statistics of the State Health Division
conducts the CON review process and makes 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 purpose of
the CON is the containment of health care costs. The goals
of the CON are to ensure there is a demonstrated need for a
proposed project, the project will not add unnecessary costs
to the consumers or payers, and the project will be
appropriate to the area and the population served.
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.
The first step
in the CON review process is a Letter of Intent
(NAC439A.305). Any person who intends to initiate a project
that may be subject to CON review should contact the Health
Planning and Primary Care Office located at
4150 Technology Way, Suite 104 in Carson City, NV 89706. The
phone number is (775) 684-4041.
If it appears
that a CON review process may be required, staff will
send the prospective applicant information regarding the
Certificate of Need process including a Letter of Intent
form. 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, which may be by telephone, will
letter of intent/determination
original and three copies of a completed application
together with a cashiers 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.
application 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
for Certificate of Need
will be reviewed in accordance with the following four sets
of criteria detailed in sections NAC439A.605 through
need for the proposed project exists in the community;
proposed project is financially feasible;
of the proposed project on the cost of health care; and
appropriateness of the proposed project in the
phase of analysis of an application will
involve a review of the application resulting in a list of
questions and requests for clarification and additional
information from the applicant. 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 for the Director.
The Director of the Department of Health and Human Services
has responsibility for rendering a decision regarding
approval or disapproval of an application.
Within 30 days
after the public hearing, the Director will issue a letter
of approval or disapproval.
This process is
totally separate from the licensure and certification
required by the Health Division's Bureau of Health Care
Quality and Compliance.