Washington requires CONs within four broad categories—hospital beds, beds outside hospitals, facilities and services. Washington maintains 27 specific CON requirements. Like nine other states, Washington excludes equipment from its CON program. Although most healthcare facilities in Washington only require a CON when they are first constructed, nursing homes must obtain a CON for any renovations or alterations that will cost more than $2,834,165, as updated annually. See Wash. Rev. Code § 70.38.105(4)(d).
On March 30, 2020, Governor Inslee suspended CON requirements for nursing homes and assisted living facilities to provide surge capacity for the state’s COVID-19 response. Wash. Proclamation 20-38 (Mar. 30, 2020); see also Wash. Procs. 20-38.2. (May 11, 2020), 20-38.3 (May 29, 2020) (extending CON suspension through June 17, 2020). After the expiration of the temporary suspension, healthcare facilities must stop operating at surge capacity or apply for a full CON to continue using additional beds.
In Washington, the CON application process takes between 15 and 90 days. Wash. Admin. Code §§ 246-310-140(1), -160(1). There are rolling applications for regular and expedited review. See General Timelines for Certificate of Need Application. The fee for a CON application depends on the project type, and can range from $770 to $46,253. Wash. Admin. Code § 246-310-990. Competitors can intervene in the application process and can offer “reasonable questioning” during a public hearing as to why an application should be denied. Wash. Admin. Code § 246-310-180(5).