Illinois

Illinois

Illinois requires CONs within five broad categories—hospital beds, beds outside hospitals, equipment, facilities and services. Of the state’s 59 independent CON requirements, 33 apply to different types of services. Additionally, Illinois maintains 10 specific facility CON requirements and bolsters its robust program with three catch-all CON requirements for facilities. That is, if no specific CON applies, catch-all CONs are required if: (1) a hospital proposes a project that will cost more than $13,743,450; (2) a long-term care facility proposes any project that will cost more than $7,768,030; or (3) any other facility proposes any project that will cost more than $3,585,250. See 77 Ill. Admin. Code §1130.310(a)(1); 20 ILCS 3960/3.

COVID-19 Response

As of May 15, 2020, Governor Pritzker had not suspended CON requirements in response to COVID-19. The Health Facilities and Services Review Board (Board), however, indicated that an emergency rule allowing the temporary addition of beds was in effect during the COVID-19 pandemic. See Board, Frequently Asked Questions and Answers for Health Care Facilities (Apr. 20, 2020). Under the emergency rule, healthcare facilities can temporarily increase bed capacity to accommodate extraordinary needs due to pandemics or other disasters so long as they provide written notice to the Board within 30 days of the decision to increase capacity. See 77 Ill. Adm. Code § 1130.240(f)(4)(A).

Application Process

In Illinois, the CON application process takes up to 120 days. 20 ILCS 3960/6.2. Applications can be submitted at any time. The non-refundable fee for a CON application ranges from $2,500 up to $100,000 depending on the cost of the proposed project. 77 Ill. Admin. Code § 1130.230(h)(2)(C)-(D). Competitors can request public hearings, at which they can offer evidence and argument as to why an application should be denied. 20 ILCS 3960/6.2.

CON? Number of CONs Moratoria Temporary COVID-19 response:
Hospital Beds Yes 2 – Preexisting regulations
Beds Outside Hospitals Yes 13 – Preexisting regulations
Equipment Yes 1 – No action
Facilities/ Buildings Yes 10 – No action
Services Yes 33 – No action
Emergency Medical Transport No – – –

Note: these citations are accurate as of May 2020.

Illinois CONs in Detail

Category

Types of CONs

Citation

Hospital Beds

Increasing the total number of beds, distributing beds or relocating beds from one facility to another by more than 20 beds or 10% of the total bed capacity limit, whichever is less, over a two-year period.

20 ILCS 3960/5(c)

1.Hospital beds.

20 ILCS 3960/3(2)

2.Hospital beds in a state-operated facility.

20 ILCS 3960/3(4)

Beds Outside Hospitals

Increasing the total number of beds, distributing beds or relocating beds from one facility to another by more than 20 beds or 10% of the total bed capacity limit, whichever is less, over a two-year period.

20 ILCS 3960/5(c)

1.Beds used in ambulatory surgical treatment centers.

20 ILCS 3960/3(1)

2.Beds used in a state-operated ambulatory surgical treatment center.

20 ILCS 3960/3(4)

3.Beds used in long-term care nursing facilities.

20 ILCS 3960/3(3)

4.Beds used in a state-operated nursing facility.

20 ILCS 3960/3(4)

5.Beds used in facilities providing care for intellectual or developmental disabilities.

20 ILCS 3960/3(3.5)

6.Beds used in facilities providing mental health rehabilitation.

20 ILCS 3960/3(3.7)

7.Beds used in a kidney disease treatment center.

20 ILCS 3960/3(5)

8.Beds used in state-operated kidney disease treatment centers.

20 ILCS 3960/3(4)

9.Beds used in outpatient treatment centers that are owned or operated by an out-of-state facility.

20 ILCS 3960/3(6)

10.Beds in any facility or room used for cardiac catheterization.

20 ILCS 3960/3(7)

11.Beds in any facility or room used for open heart surgery.

20 ILCS 3960/3(7)

12.Beds in any facility or room used for pediatric care.

20 ILCS 3960/3(7);

see 77 Ill. Admin. Code § 1100.220

13.Beds used in any facility or room housing equipment which is used for diagnosis or treatment and exceeds the capital expenditure minimum.

20 ILCS 3960/3(8)

Category

Types of CONs

Citation

Equipment

1.The acquisition of major medical equipment, which is equipment costing more than $3,585,250, as updated annually.

77 Ill. Admin. Code § 1130.310(a)(7);

see Memo from Board, Revised CON Review Thresholds (July 1, 2019) 34

Facilities/Buildings

1.Any substantial change to the scope of functional operation of the facility.

77 Ill. Admin. Code §§ 1130.310(a)(2),

see also 1130.140

2.Hospital.

3.Ambulatory surgical treatment center.

4.Long-term care facility licensed under the Nursing Home Care Act.

5.End stage renal disease facility.

6.Birth center.

7.Freestanding emergency center.

8.Facility used for outpatient surgical procedures owned or operated by out-of-state facilities.

77 Ill. Admin. Code §§ 1130.310(a)(3),

see also 1130.210

9.A change of ownership of a health care facility, unless an exemption is issued.

77 Ill. Admin. Code § 1130.310(5)

10.The discontinuation of an entire health care facility, unless an exemption has been issued.

77 Ill. Admin. Code § 1130.310(6)

Services

1.Acute mental illness treatment services.

2.Ambulatory care.

3.Cardiac catheterization.

4.Cardiovascular surgery.

5.Chronic renal dialysis.

6.Community-based residential rehabilitation.

7.Comprehensive physical rehabilitation.

8.Emergent care.

9.Extracorporeal circulation.

10.Freestanding emergency center medical services.

11.General long-term care.

12.Hospital services that schedule surgical procedures on an inpatient basis.

13.In-center hemodialysis.

77 Ill. Admin. Code §§ 1130.215(i), see 1100.220 (enumerating various categories of services)

Category

Types of CONs

Citation

Services

14.Intensive care service.

15.Kidney transplants.

16.Maternity care.

17.Medical-surgical service.

18.Neonatal intensive care service.

19.Non-hospital (outpatient) ambulatory surgery.

20.Obstetrics/gynecological care.

21.Obstetrics service.

22.Open heart surgery.

23.Pediatric catheterization.

24.Pediatric service.

25.Postsurgical recovery care center alternative health care model.

26.Selected organ transplantation service.

27.Long-term care specializing in chronic mental illness.

28.Long-term care specializing in care for developmentally disabled adults.

29.Long-term care specializing in care for developmentally disabled children.

30.Subacute care.

31.Any project requiring a total capital expenditure in excess of $13,743,450, as updated annually, at a hospital.

32.Any project requiring a total capital expenditure in excess of $7,768,030, as updated annually, at a long term care facility.

33.Any project requiring a total capital expenditure in excess of $3,585,250, as updated annually, at any other facility.

77 Ill. Admin. Code §§ 1130.215(i),

see 1100.220 (enumerating various categories of services)

Emergency Medical Transport

No CONs in this category.

Illinois CON Exceptions

No CON Required For:

Citation

1.Change of ownership of an existing health care facility, not including nursing homes.

77 Ill. Adm. § 1130.410(a) 

2.Discontinuation of an existing health care facility or category of service, other than a health care facility maintained by the state or any nursing home maintained by a county.

77 Ill. Adm. § 1130.410(b)

3.A proposed project to establish or expand service or beds at a neonatal intensive care facility.

77 Ill. Adm. § 1130.410(c)

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