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Certificate of Need

The Michigan Department of Community Health, Certificate of Need (CON) is a state regulatory program intended to balance the cost, quality, and access of Michigan's health care system.


Certificate of Need


Public Act 368 of 1978, as amended (Part 222 of the Public Health Code)




 1.  Applicability (activities that require the Certificate of Need)

An entity (health facility, physician, group practice, etc.) proposing any of the following types of projects must obtain a CON to add licensed beds or relocate licensed beds from one site to another; acquire an existing health facility (hospital, psychiatric hospital or unit, nursing home, freestanding surgical outpatient facility/ambulatory surgical center); begin operation of a new health facility; initiate, replace or expand a covered clinical service (air ambulance; cardiac catheterization; computed tomography (CT); magnetic resonance imaging (MRI); megavoltage radiation therapy (MRT); neonatal intensive care unit (NICU); open heart surgery; positron emission tomography (PET); surgical services; bone marrow, heart, lung, liver, and pancreas transplantations, urinary lithotripsy); or initiate a short-term nursing care program (swing beds). In addition, capital expenditure projects (construction, renovation, etc.) that involve a health facility require a CON if the expenditure exceeds $2,932,500 for clinical service areas.

 2.  Pre-Application Requirements

An applicant must file a Letter of Intent (LOI) first with the Department and regional review agency, if any. Based on LOI information, the Department notifies the applicant of required application forms for the proposed project.

 3.  Application Submission Requirements

An applicant must file an application within one (1) of the LOI as instructed in the Department's notification letter on the appropriate filing date, with the required forms, and applicable application fee.

 4.  Procedures and Time-Frame for Obtaining Permit or Approval

Within 15 days of receipt of an application, the Department reviews it for completeness and requests any necessary additional information. The applicant has 15 days to submit the requested information to the Department. The Department deems the application complete and a proposed decision is issued within the deadlines for each review type: Nonsubstantive - 45 days, Substantive - 120 days, and Comparative - 150 days.

 5.  Operational Requirements


 6.  Fees

CON application fees are based on total project costs. Fee for projects less than or equal to $500,000 is $1,500; between $500,000 and $4,000,000 is $5,500; and equal to or more than $4,000,000 is $8,500.

 7.  Appeal Process

An applicant may within 15 days after receipt by the applicant of the Bureau's proposed decision to request a hearing. A request for a hearing stays the final decision of the Department until the appeal phase is complete.

 8.  Public Input Opportunities

Any public input received regarding a particular application will be made part of that application and may be used by the Department in its decision.

E. Contact Information:

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Creation/Revision Date:

September 8, 2010