Ohio

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). Additionally, the state maintains two moratoria applicable only to long-term care facilities. One prohibits new long-term care facilities from opening under specific circumstances, and the other prohibits an existing long-term care facility from increasing its beds under specific circumstances. Ohio Rev. Code § 3702.59.

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 takes between 60 and 90 days. Ohio Rev. Code §§ 3702.52(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 July. 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. 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 Admin. Code 3702-12-08, 3702-12-11.

CON? Number of CONs Moratoria Temporary COVID-19 response:
Hospital Beds Yes 3 – No action
Beds Outside Hospitals Yes 3 1 No action
Equipment No – – –
Facilities/ Buildings Yes 10 1 No action
Services No – – –
Emergency Medical Transport No – – –

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

Ohio CONs in Detail

Category 

Moratoria/Types of CONs

Ohio Rev. Code 

Hospital Beds 

1.Increase in long-term care bed capacity. 

§ 3702.511(A)(4) 

2.Relocation of long-term care bed from one site to another. 

§ 3702.511(A)(5) 

3.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 

1.Moratorium on adding long-term care beds to long-term care facilities in enumerated circumstances.  

§ 3702.59 

1.Increase in long-term care bed capacity. 

§ 3702.511(A)(4) 

2.Relocation of long-term care bed from one site to another. 

§ 3702.511(A)(5) 

3.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 

1.Moratorium on developing new long-term care facilities in enumerated circumstances.

§ 3702.59 

Establishment, development, or construction of a new long-term care facility, which includes: 

1.Nursing homes 

2.Portion of any facility that is certified as a skilled nursing facility 

3.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: 

4.Nursing homes 

5.Portion of any facility that is certified as a skilled nursing facility 

6.Portion of any hospital that contains skilled nursing or long-term care beds 

§§ 3702.511(A)(2),

3702.51(N) 

Category 

Moratoria/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: 

7.Nursing homes

8.Portion of any facility that is certified as a skilled nursing facility

9.Portion of any hospital that contains skilled nursing or long-term care beds

§§ 3702.511(A)(3), 3702.51(N) 

10.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 

1.Acquisition of computer hardware or software. 

§ 3702.511(B)(1) 

2.Acquisition of a telephone system. 

§ 3702.511(B)(2) 

3.Construction or acquisition of parking facilities.

§ 3702.511(B)(3) 

4.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) 

5.Acquisition of an existing long-term care facility that does not involve a change in the number of beds.

§ 3702.511(B)(5) 

6.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) 

7.Construction, repair, or renovation of bathroom facilities. 

§ 3702.511(B)(7) 

8.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) 

9.Removal of asbestos from a healthcare facility. 

§ 3702.511(B)(9) 

10.Any part of a long-term facility’s campus that is certified as an intermediate care facility for individuals with intellectual disabilities. 

§ 3702.62 

11.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) 

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