Conning the Competition

South Carolina requires CONs within five broad categories—hospital beds, beds outside hospitals, equipment, facilities and services. The Department of Health and Environmental Control administers the CON program through a comprehensive state health plan issued at least once every two years. S.C. Code § 44-7-180(C); S.C. Code Regs. 61-15 § 106. South Carolina requires facilities to obtain a CON when offering any new service, yet it also requires facilities to obtain a CON when expanding a service at the cost of $2 million or more.

COVID-19 Response

On March 19, 2020, Governor McMaster issued a robust executive order that broadly lifted requirements to allow healthcare facilities and providers to respond to the pandemic by, among other things: (1) converting non-traditional beds and spaces into areas for patient care without a CON and (2) purchasing equipment necessary to care for COVID-19 patients without at CON. Exec. Order 2020-11 (Mar. 19, 2020). The Department issued further guidance on the orders. S.C. Dep’t of Health and Envtl. Control, Exec. Order No. 2020-11, Section 4 Suspending Certain Aspects of Certificate of Need Review Frequently Asked Questions.

Application Process

In South Carolina, the application process takes 30 to 150 days after an application is complete and affected parties have been notified of the application. S.C. Code § 44-7-210(A). The entire process from submission to approval typically takes much longer. Applications can be submitted at any time and the fee for a CON application is $500. S.C. Code § 44-7-200(A); S.C. Code Regs. 61-15 § 301. Competitors can intervene in the application process and can offer evidence or argument as to why an application should be denied. S.C. Code § 44-7-210(A), (E).