Last revised date: May 24, 2023
The Certificate of Need (CN) program is a regulatory process that requires certain healthcare providers to obtain state approval before building certain types of facilities or offering new or expanded services. Program staff members are available to provide technical assistance to you before submitting your application. Staff members are also available to help you determine if a Certificate of Need is necessary.
Certificate of Need determines need according to factors that are variable in relation to the proposed services.
Standards are outlined in the links below
- Ambulatory surgery
- Adult elective percutaneous coronary interventions (PDF)
- End-stage renal disease (ESRD) – kidney treatment (effective until December 31, 2017)
- End-stage renal disease (ESRD)- kidney treatment (PDF) (effective January 1, 2018)
- Home health, State Health Plan, v. 2 (PDF)
- Hospice care centers
- Hospital (PDF)
- Kidney transplant
- Nursing homes
- Open heart surgery
- Pediatric cardiac surgery and interventional treatment
Adult elective percutaneous coronary interventions
- 2022-2023 Final percutaneous coronary interventions (PCI) need forecast (PDF)
- 2022-2023 percutaneous coronary interventions (PCI) need forecast (PDF) For comparison, two different runs of the methodology were produced. One using Clinical Outcomes Assessment Program (COAP) data. The other, using Comprehensive Hospital Abstract Reporting System (CHARS) data and department outpatient survey results. These data sources are identified in WAC 246-310-745(7).
- 2022-2023 Hospice Need Methodology (PDF) - Updated with October decisions
- 2022-2023 Hospice Need Methodology (PDF) - Initial posting for community review
- 2021-2022 Hospice Need Methodology (PDF) - Updated with October and November 2021 decisions
- 2020-2021 Hospice Need Methodology (PDF) - Updated with October 2020 decisions and corrections
- 2019-2020 Hospice Need Methodology (PDF) - Updated with November 2019 decisions
- 2018-2019 Hospice Need Methodology (PDF) - Updated for population October 2018
- 2017-2018 Hospice Need Methodology (PDF)
- Nursing home projects' current capital expenditure threshold is set at a minimum of $2,834,165. Updated December 2019 and established for calendar years 2019 and 2020, Washington Administration Code 246-310-900.
- 2019-2020 Nursing Home Capital Expenditure (PDF)
- 2018 Estimate of Nursing Home Comparable Home and Community-based Long Term Care Capacity. Table Only (PDF)
- Estimating Nursing Home Comparable Home and Community-based Long-Term Care Capacity – updated 2018 (PDF)
- 2022-2024 Nursing Home Bed Need Forecast – 70+ (PDF)
- Nursing Home Bed Supply (PDF)
- 2023-2025 70 Nursing Homes Bed Forecast – 70+ corrected (PDF)
End-stage renal disease (ESRD)
- Map of King County Sub Service Areas (PDF)
- Map of Pierce County Sub Service Areas (PDF)
- Map of Snohomish County Sub Service Areas (PDF)
- Map of Spokane County Sub Service Areas (PDF)
- Corresponding Zip Code Maps (PDF)
Operational Station Report and Timeline Modifications
- ESRD operational station report (PDF) updated April 2023 posted in accordance to Washington Administrative Code 246-310-803(6).
- Timeline modifications that have been approved are detailed on the above ESRD operational station report. These timeline modifications may impact whether the department can approve new in-center dialysis stations.
End-stage Renal Disease Service Area Methodologies
To access current ESRD superiority files contact the CN Program.
Contact and connect
- CN program contact and mailing information
- To receive Certificate of Need information, please select the "Subscribe" button at the bottom of the page.