Ohio

Ohio requires CONs within three broad categories—hospital beds, beds outside hospitals and facilities. Ohio’s CON program applies only to long-term care facilities, which it defines as nursing homes, skilled nursing facilities or portions of hospitals that contain skilled nursing beds or long-term care beds. Ohio Rev. Code § 3702.51(N).   

Ohio’s COVID-19 Response  

As of May 15, 2020, Ohio had not suspended any CON requirements in response to COVID-19. 

Application Process  

In Ohio, the CON application process typically takes between 60 and 90 days. Ohio Rev. Code §§ 3702.52(B)(3), (C)(4)–(6). Most applications can be submitted at any time, but applications for the relocation of long-term care beds to a county with fewer long-term care beds than needed may only be submitted every four years in the month of January. Ohio Rev. Code § 3702.593(A), (D); Ohio Admin. Code 3701-12-09. For projects not involving a capital expenditure, the fee for a CON application is $5,000. For projects involving a capital expenditure, the fee is $5,000 or 1.5% of the proposed capital expenditure, whichever is greater, up to a maximum of $20,000. Ohio Admin. Code 3701-12-08(E). Competitors can intervene in the application process and can offer evidence or argument as to why an application should be denied. Ohio Rev. Code § 3702.60; Ohio Admin. Code 3702-12-08, 3702-12-11.  

Types of CONs in Ohio  

  CON?  CON applies with expenditure of:  Temporary  COVID-19 response:  
Hospital Beds  Yes Any amount  – 
Beds Outside Hospitals  Yes Any amount  – 
Equipment  No – – 
Facilities/Buildings  Yes $0 – $2 million+  – 
Services  No -  – 
Emergency Medical Transport  No – – 

Certain CON applications may only be submitted  every four years in the month of January.  

Ohio CONs in Detail 

Category  Types of CONs Ohio Rev. Code  
Hospital Beds  Increase in long-term care bed capacity.  § 3702.511(A)(4)  
Relocation of long-term care bed from one site to another.  § 3702.511(A)(5)  
Expenditure of more than 110% of the maximum expenditure specified in a CON concerning long-term care beds.   § 3702.511(A)(6)  
Beds Outside Hospitals Increase in long-term care bed capacity.  § 3702.511(A)(4)  
Relocation of long-term care bed from one site to another.  § 3702.511(A)(5)  
Expenditure of more than 110% of the maximum expenditure specified in a CON concerning long-term care beds.  § 3702.511(A)(6)  
Equipment   No CONs in this category.   
Facilities/Buildings Establishment, development, or construction of a new long-term care facility, which includes:  Nursing homes.  Portion of any facility that is certified as a skilled nursing facility.  Portion of any hospital that contains skilled nursing or long-term care beds.  §§ 3702.511(A)(1),  3702.51(N)  
Replacement of an existing long-term care facility, which includes:  Nursing homes. Portion of any facility that is certified as a skilled nursing facility.  Portion of any hospital that contains skilled nursing or long-term care beds.  §§ 3702.511(A)(2),  3702.51(N)  
Category  Types of CONs Ohio Rev. Code  
Facilities/Buildings Renovation or addition that involves a capital expenditure of $2 million or more (not including expenditures for equipment, staffing, or operational costs) to a long-term care facility, which includes:  Nursing homes. Portion of any facility that is certified as a skilled nursing facility. Portion of any hospital that contains skilled nursing or long-term care beds. §§ 3702.511(A)(3), 3702.51(N)  
Failure to act in substantial accordance with an approved CON application, including a change in site, within 5 years after implementing the activity for which the CON was granted.  § 3702.511(A)(7)  
Services   No CONs in this category.   
Emergency Medical Transport   No CONs in this category.   

Ohio CON Exceptions 

No CON Required For:   Ohio Rev. Code  
Acquisition of computer hardware or software.  § 3702.511(B)(1)  
Acquisition of a telephone system.  § 3702.511(B)(2)  
Construction or acquisition of parking facilities. § 3702.511(B)(3)  
Correction of cited deficiencies that constitute an imminent threat to public health or safety and are in violation of federal, state, or local fire, building, or safety statutes, ordinances, rules, or regulations.   § 3702.511(B)(4)  
Acquisition of an existing long-term care facility that does not involve a change in the number of beds. § 3702.511(B)(5)  
Mergers, consolidations, or other corporate reorganization of long-term facilities that do not involve a change in the number of beds.  § 3702.511(B)(6)  
Construction, repair, or renovation of bathroom facilities.  § 3702.511(B)(7)  
Construction of laundry facilities, waste disposal facilities, dietary department projects, heating and air conditioning projects, administrative offices, and portions of medical office buildings used exclusively for physician services.  § 3702.511(B)(8)  
Removal of asbestos from a healthcare facility.  § 3702.511(B)(9)  
Any part of a long-term facility’s campus that is certified as an intermediate care facility for individuals with intellectual disabilities.  § 3702.62  
One-time addition of 20 or fewer long-term beds to a nursing home if (1) the nursing home is licensed, (2) it does not participate in Medicare or Medicaid, and (3) all of the long-term care beds added are to be used solely for palliative care.  § 3702.512(A), (C)