State of Nevada


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Last Updated: 06/13/13 07:12:41 AM

Certificate of Need
The construction 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 process.


Certificate of 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.

Letter of Intent/Determination

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 be scheduled.

download letter of intent/determination (word)


An 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.

The 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 submitted.

Application for Certificate of Need (word)

Review Criteria

The application will be reviewed in accordance with the following four sets of criteria detailed in sections NAC439A.605 through 439A.637: 

  • Whether a need for the proposed project exists in the community;

  • Whether the proposed project is financially feasible;

  • The effect of the proposed project on the cost of health care; and 

  • The appropriateness of the proposed project in the community. 

The initial 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.

Letter of Approval/Disapproval

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.



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