Certificate of Need

Program Overview

The Certificate of Need (CN) Program is a regulatory process that requires certain healthcare providers to obtain state approval before building specific types of facilities or offering new or expanded services. The CN process ensures that proposed facilities or services are necessary to maintain quality patient care within a particular region or community. Review details are found in chapter 246-310 WAC: Certificate of Need.

Program staff offer technical assistance (TA) to support applicants during the CN process. While TA is not required, it is highly recommended. Use our online form to request a TA meeting.

When Certificate of Need Review is Required

Construction, development or establishment of the following healthcare facilities
  • Hospitals
  • Nursing homes
  • Kidney dialysis centers
  • Medicare or Medicaid home health agencies
  • Medicare or Medicaid hospice agencies
  • Ambulatory surgical centers
  • Hospice care centers 
Offering a new tertiary health service
  • Level I rehabilitation programs
  • Open heart surgery
  • Therapeutic cardiac catheterization
  • Organ transplantation specialty burn services
  • Intermediate care nursery and/or obstetric services
  • Level II neonatal intensive care nursery and/or obstetric services
  • Level III specialized inpatient pediatric services
Other instances where a CN is required
  • Increases in the number of stations at a kidney dialysis center
  • Sale, purchase or lease of all or part of an existing hospital, regardless of profit/non-profit status.
  • Increases in the number of licensed beds at a hospital, nursing home or hospice care center.

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