Certificate of Need (CON)


The Department of Social Services is responsible for the Certificate of Need (CON) process for nursing homes, residential care homes and intermediate care facilities for individuals with intellectual disabilities. The Offices of Health Care Access is responsible for the CON process as it relates to hospitals.

 Certificate of Need approval is required prior to undertaking any of the following activities:

  • Capital expenditure exceeding $2 million.
  • Capital expenditure exceeding $1 million, which increases facility square footage by five thousand square feet or five percent of existing square footage.
  • Introduction of any new or additional function or service.
  • Termination of a health service including facility closure or a substantial decrease in total bed capacity by a facility or institution.
  • New nursing facilities associated with a continuing care facility provided such beds do not participate in the Medicaid program.
  • Medicaid certified beds to be relocated from one licensed nursing facility to another licensed nursing facility to meet a priority need identified in the strategic plan developed pursuant to subsection (c) of section 17b-369 of the Connecticut General Statutes.
  • Medicaid beds to be relocated from a licensed facility to a new licensed facility, provided at least one currently licensed facility is closed in the transaction, and the new facility bed total is not less than 10% lower than the total number of beds relocated.
  • Requests to license a new residential care facility or intermediate care facility for the intellectually disabled.

Architectural plans are required for CON requests related to capital improvements and new facilities. These plans must comply with current State and Federal laws and regulations. 

 The CON process begins with an applicant's submission of a letter of intent. The Department issues an application within 10 business days and the Applicant has up to 180 days to submit the CON application. The Department will issue a written decision generally within 120 days after receiving the application. CON decisions may be reviewed by the public during normal business hours. Please email to schedule a time to review CON decisions.