{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-102.1_3.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-102.1_3.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-102.1_3.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-102.1_3.html"}],"law_id":63394,"edition_id":1,"section_id":63394,"structure_id":14008,"section_number":"32.1-102.1:3","catch_line":"(Effective July 1, 2028) Medical care facilities and projects for which a certificate is required","history":"2020, c. 1271; 2025, cc. 114, 135, 325.","full_text":"A\n\nThe following medical care facilities shall be subject to the provisions of this article:1\n\nAny facility licensed as a hospital, as defined in § 32.1-123;2\n\nAny hospital licensed as a provider by the Department of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403 et seq.) of Chapter 4 of Title 37.2;3\n\nAny facility licensed as a nursing home, as defined in § 32.1-123;4\n\nAny intermediate care facility established primarily for the medical, psychiatric, or psychological treatment and rehabilitation of individuals with substance abuse licensed by the Department of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403 et seq.) of Chapter 4 of Title 37.2;5\n\nAny intermediate care facility for individuals with developmental disabilities other than an intermediate care facility established for individuals with intellectual disability (ICF\/IID) that has not more than 12 beds and is in an area identified as in need of residential services for individuals with intellectual disability in any plan of the Department of Behavioral Health and Developmental Services; and6\n\nAny specialized center or clinic or that portion of a physician’s office developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy.B\n\nThe following actions undertaken by or on behalf of a medical care facility described in subsection A shall constitute a project for which a certificate of public need is required pursuant to subsection A of \u00a7 32.1-102.1:2:1\n\nEstablishment of a medical care facility described in subsection A;2\n\nAn increase in the total number of beds or operating rooms in an existing medical care facility described in subsection A;3\n\nRelocation of beds from an existing medical care facility described in subsection A to another existing medical care facility described in subsection A;4\n\nAddition of any new nursing home service at an existing medical care facility described in subsection A;5\n\nIntroduction into an existing medical care facility described in subsection A of any cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), medical rehabilitation, neonatal special care, open heart surgery, positron emission tomographic (PET) scanning, psychiatric, organ or tissue transplant service, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, proton beam therapy, or substance abuse treatment when such medical care facility has not provided such service in the previous 12 months;6\n\nConversion of beds in an existing medical care facility described in subsection A to medical rehabilitation beds or psychiatric beds;7\n\nThe addition by an existing medical care facility described in subsection A of any new medical equipment for the provision of cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), open heart surgery, positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy, other than new medical equipment for the provision of such service added to replace existing medical equipment for the provision of such service;8\n\nAny capital expenditure of $15 million or more, not defined as reviewable in subdivisions 1 through 7, by or on behalf of a medical care facility described in subsection A other than a general hospital. The amounts specified in this subdivision shall be revised annually to reflect inflation using appropriate measures incorporating construction costs and medical inflation. Nothing in this subdivision shall be construed to modify or eliminate the reviewability of any project described in subdivisions 1 through 7 when undertaken by or on behalf of a general hospital; and9\n\nConversion in an existing medical care facility described in subsection A of psychiatric inpatient beds to nonpsychiatric inpatient beds.C\n\nNotwithstanding the provisions of subsection A, any nursing home affiliated with a facility that, on January 1, 1982, and thereafter, (i) is operated as a nonprofit institution, (ii) is licensed jointly by the Department as a nursing home and by the Department of Social Services as an assisted living facility, and (iii) restricts admissions such that (a) admissions to the facility are only allowed pursuant to the terms of a “life care contract” guaranteeing that the full complement of services offered by the facility is available to the resident as and when needed, (b) admissions to the assisted living facility unit of the facility are restricted to individuals defined as ambulatory by the Department of Social Services, and (c) admissions to the nursing home unit of the facility are restricted to those individuals who are residents of the assisted living facility unit of the facility shall not be subject to the requirements of this article.D\n\nNotwithstanding the provisions of subsection B, a certificate of public need shall not be required for the following actions undertaken by or on behalf of a medical care facility described in subsection A:1\n\nRelocation of up to 10 beds or 10 percent of the beds, whichever is less, (i) from one existing medical care facility described in subsection A to another existing medical care facility described in subsection A at the same site in any two-year period or (ii) in any three-year period, from one existing medical care facility described in subsection A licensed as a nursing home to any other existing medical care facility described in subsection A licensed as a nursing home that is owned or controlled by the same person and located either within the same planning district or within another planning district out of which, during or prior to that three-year period, at least 10 times that number of beds have been authorized by statute to be relocated from one or more medical care facilities described in subsection A located in that other planning district, and at least half of those beds have not been replaced; or2\n\nUse of up to 10 percent of beds as nursing home beds by a medical care facility described in subsection A licensed as a hospital, as provided in § 32.1-132E\n\nThe Department shall regularly review the types of medical care facilities subject to the provisions of this article and projects for which a certificate is required and provide to the Governor and the General Assembly, at least once every five years, a recommendation related to the continued appropriateness of requiring such types of medical care facilities to be subject to the provisions of this article and such types of projects to be subject to the requirement of a certificate. In developing such recommendations, the Department shall consider, for each type of medical care facility and project, the following criteria:1\n\nThe current and projected future availability of the specific type of medical care facility or project;2\n\nThe current and projected future demand for the specific type of medical care facility or project;3\n\nThe current and projected future rate of utilization of the specific type of medical care facility or project;4\n\nThe current and projected future capacity of existing medical care facilities or projects of that specific type;5\n\nThe anticipated impact of changes in population and demographics, reimbursement structures and rates, and technology on demand for and availability, utilization, and capacity of existing medical care facilities or projects of that specific type;6\n\nExisting quality, utilization, and other controls applicable to the specific type of medical care facility or project; and7\n\nAny risk to the health or well-being of the public resulting from inclusion of the specific type of medical care facility or project on such list.","order_by":null,"text":{"0":{"id":230986,"text":"The following medical care facilities shall be subject to the provisions of this article:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":230987,"text":"Any facility licensed as a hospital, as defined in § 32.1-123;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":230988,"text":"Any hospital licensed as a provider by the Department of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403 et seq.) of Chapter 4 of Title 37.2;","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":230989,"text":"Any facility licensed as a nursing home, as defined in § 32.1-123;","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":230990,"text":"Any intermediate care facility established primarily for the medical, psychiatric, or psychological treatment and rehabilitation of individuals with substance abuse licensed by the Department of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403 et seq.) of Chapter 4 of Title 37.2;","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":230991,"text":"Any intermediate care facility for individuals with developmental disabilities other than an intermediate care facility established for individuals with intellectual disability (ICF\/IID) that has not more than 12 beds and is in an area identified as in need of residential services for individuals with intellectual disability in any plan of the Department of Behavioral Health and Developmental Services; and","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"A6"},"6":{"id":230992,"text":"Any specialized center or clinic or that portion of a physician’s office developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy.","type":"section","prefixes":["A","6"],"prefix":"6","entire_prefix":"A6","prefix_anchor":"A6","level":2,"prior_prefix":"A5","next_prefix":"B"},"7":{"id":230993,"text":"The following actions undertaken by or on behalf of a medical care facility described in subsection A shall constitute a project for which a certificate of public need is required pursuant to subsection A of \u00a7 32.1-102.1:2:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A6","next_prefix":"B1"},"8":{"id":230994,"text":"Establishment of a medical care facility described in subsection A;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"9":{"id":230995,"text":"An increase in the total number of beds or operating rooms in an existing medical care facility described in subsection A;","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"B3"},"10":{"id":230996,"text":"Relocation of beds from an existing medical care facility described in subsection A to another existing medical care facility described in subsection A;","type":"section","prefixes":["B","3"],"prefix":"3","entire_prefix":"B3","prefix_anchor":"B3","level":2,"prior_prefix":"B2","next_prefix":"B4"},"11":{"id":230997,"text":"Addition of any new nursing home service at an existing medical care facility described in subsection A;","type":"section","prefixes":["B","4"],"prefix":"4","entire_prefix":"B4","prefix_anchor":"B4","level":2,"prior_prefix":"B3","next_prefix":"B5"},"12":{"id":230998,"text":"Introduction into an existing medical care facility described in subsection A of any cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), medical rehabilitation, neonatal special care, open heart surgery, positron emission tomographic (PET) scanning, psychiatric, organ or tissue transplant service, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, proton beam therapy, or substance abuse treatment when such medical care facility has not provided such service in the previous 12 months;","type":"section","prefixes":["B","5"],"prefix":"5","entire_prefix":"B5","prefix_anchor":"B5","level":2,"prior_prefix":"B4","next_prefix":"B6"},"13":{"id":230999,"text":"Conversion of beds in an existing medical care facility described in subsection A to medical rehabilitation beds or psychiatric beds;","type":"section","prefixes":["B","6"],"prefix":"6","entire_prefix":"B6","prefix_anchor":"B6","level":2,"prior_prefix":"B5","next_prefix":"B7"},"14":{"id":231000,"text":"The addition by an existing medical care facility described in subsection A of any new medical equipment for the provision of cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), open heart surgery, positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy, other than new medical equipment for the provision of such service added to replace existing medical equipment for the provision of such service;","type":"section","prefixes":["B","7"],"prefix":"7","entire_prefix":"B7","prefix_anchor":"B7","level":2,"prior_prefix":"B6","next_prefix":"B8"},"15":{"id":231001,"text":"Any capital expenditure of $15 million or more, not defined as reviewable in subdivisions 1 through 7, by or on behalf of a medical care facility described in subsection A other than a general hospital. The amounts specified in this subdivision shall be revised annually to reflect inflation using appropriate measures incorporating construction costs and medical inflation. Nothing in this subdivision shall be construed to modify or eliminate the reviewability of any project described in subdivisions 1 through 7 when undertaken by or on behalf of a general hospital; and","type":"section","prefixes":["B","8"],"prefix":"8","entire_prefix":"B8","prefix_anchor":"B8","level":2,"prior_prefix":"B7","next_prefix":"B9"},"16":{"id":231002,"text":"Conversion in an existing medical care facility described in subsection A of psychiatric inpatient beds to nonpsychiatric inpatient beds.","type":"section","prefixes":["B","9"],"prefix":"9","entire_prefix":"B9","prefix_anchor":"B9","level":2,"prior_prefix":"B8","next_prefix":"C"},"17":{"id":231003,"text":"Notwithstanding the provisions of subsection A, any nursing home affiliated with a facility that, on January 1, 1982, and thereafter, (i) is operated as a nonprofit institution, (ii) is licensed jointly by the Department as a nursing home and by the Department of Social Services as an assisted living facility, and (iii) restricts admissions such that (a) admissions to the facility are only allowed pursuant to the terms of a “life care contract” guaranteeing that the full complement of services offered by the facility is available to the resident as and when needed, (b) admissions to the assisted living facility unit of the facility are restricted to individuals defined as ambulatory by the Department of Social Services, and (c) admissions to the nursing home unit of the facility are restricted to those individuals who are residents of the assisted living facility unit of the facility shall not be subject to the requirements of this article.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B9","next_prefix":"D"},"18":{"id":231004,"text":"Notwithstanding the provisions of subsection B, a certificate of public need shall not be required for the following actions undertaken by or on behalf of a medical care facility described in subsection A:","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"D1"},"19":{"id":231005,"text":"Relocation of up to 10 beds or 10 percent of the beds, whichever is less, (i) from one existing medical care facility described in subsection A to another existing medical care facility described in subsection A at the same site in any two-year period or (ii) in any three-year period, from one existing medical care facility described in subsection A licensed as a nursing home to any other existing medical care facility described in subsection A licensed as a nursing home that is owned or controlled by the same person and located either within the same planning district or within another planning district out of which, during or prior to that three-year period, at least 10 times that number of beds have been authorized by statute to be relocated from one or more medical care facilities described in subsection A located in that other planning district, and at least half of those beds have not been replaced; or","type":"section","prefixes":["D","1"],"prefix":"1","entire_prefix":"D1","prefix_anchor":"D1","level":2,"prior_prefix":"D","next_prefix":"D2"},"20":{"id":231006,"text":"Use of up to 10 percent of beds as nursing home beds by a medical care facility described in subsection A licensed as a hospital, as provided in § 32.1-132","type":"section","prefixes":["D","2"],"prefix":"2","entire_prefix":"D2","prefix_anchor":"D2","level":2,"prior_prefix":"D1","next_prefix":"E"},"21":{"id":231007,"text":"The Department shall regularly review the types of medical care facilities subject to the provisions of this article and projects for which a certificate is required and provide to the Governor and the General Assembly, at least once every five years, a recommendation related to the continued appropriateness of requiring such types of medical care facilities to be subject to the provisions of this article and such types of projects to be subject to the requirement of a certificate. In developing such recommendations, the Department shall consider, for each type of medical care facility and project, the following criteria:","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D2","next_prefix":"E1"},"22":{"id":231008,"text":"The current and projected future availability of the specific type of medical care facility or project;","type":"section","prefixes":["E","1"],"prefix":"1","entire_prefix":"E1","prefix_anchor":"E1","level":2,"prior_prefix":"E","next_prefix":"E2"},"23":{"id":231009,"text":"The current and projected future demand for the specific type of medical care facility or project;","type":"section","prefixes":["E","2"],"prefix":"2","entire_prefix":"E2","prefix_anchor":"E2","level":2,"prior_prefix":"E1","next_prefix":"E3"},"24":{"id":231010,"text":"The current and projected future rate of utilization of the specific type of medical care facility or project;","type":"section","prefixes":["E","3"],"prefix":"3","entire_prefix":"E3","prefix_anchor":"E3","level":2,"prior_prefix":"E2","next_prefix":"E4"},"25":{"id":231011,"text":"The current and projected future capacity of existing medical care facilities or projects of that specific type;","type":"section","prefixes":["E","4"],"prefix":"4","entire_prefix":"E4","prefix_anchor":"E4","level":2,"prior_prefix":"E3","next_prefix":"E5"},"26":{"id":231012,"text":"The anticipated impact of changes in population and demographics, reimbursement structures and rates, and technology on demand for and availability, utilization, and capacity of existing medical care facilities or projects of that specific type;","type":"section","prefixes":["E","5"],"prefix":"5","entire_prefix":"E5","prefix_anchor":"E5","level":2,"prior_prefix":"E4","next_prefix":"E6"},"27":{"id":231013,"text":"Existing quality, utilization, and other controls applicable to the specific type of medical care facility or project; and","type":"section","prefixes":["E","6"],"prefix":"6","entire_prefix":"E6","prefix_anchor":"E6","level":2,"prior_prefix":"E5","next_prefix":"E7"},"28":{"id":231014,"text":"Any risk to the health or well-being of the public resulting from inclusion of the specific type of medical care facility or project on such list.","type":"section","prefixes":["E","7"],"prefix":"7","entire_prefix":"E7","prefix_anchor":"E7","level":2,"prior_prefix":"E6"}},"ancestry":[{"id":14008,"edition_id":1,"name":"Medical Care Facilities Certificate of Public Need","identifier":"1.1","label":"article","depth":3,"order_by":1,"parent_id":13670,"metadata":{},"date_created":"2026-06-26 03:46:36","date_modified":"2026-06-26 03:46:36","permalink":{"id":202397,"object_type":"structure","relational_id":14008,"identifier":"1.1","token":"32.1\/4\/1.1","url":"\/32.1\/4\/1.1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13670,"edition_id":1,"name":"Health Care Planning","identifier":"4","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:45:31","date_modified":"2026-06-26 03:45:31","permalink":{"id":202389,"object_type":"structure","relational_id":13670,"identifier":"4","token":"32.1\/4","url":"\/32.1\/4\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":77111,"structure_id":14008,"section_number":"32.1-102.1","catch_line":"Definitions","url":"\/32.1-102.1\/","token":"32.1\/4\/1.1\/32.1-102.1","metadata":false},{"id":75479,"structure_id":14008,"section_number":"32.1-102.10","catch_line":"Commencing project without certificate or registration grounds for refusing to issue license","url":"\/32.1-102.10\/","token":"32.1\/4\/1.1\/32.1-102.10","metadata":false},{"id":55098,"structure_id":14008,"section_number":"32.1-102.11","catch_line":"Application of article","url":"\/32.1-102.11\/","token":"32.1\/4\/1.1\/32.1-102.11","metadata":false},{"id":63051,"structure_id":14008,"section_number":"32.1-102.12","catch_line":"Repealed","url":"\/32.1-102.12\/","token":"32.1\/4\/1.1\/32.1-102.12","metadata":false},{"id":77991,"structure_id":14008,"section_number":"32.1-102.13","catch_line":"Repealed","url":"\/32.1-102.13\/","token":"32.1\/4\/1.1\/32.1-102.13","metadata":false},{"id":86983,"structure_id":14008,"section_number":"32.1-102.1:1","catch_line":"Equipment registration required","url":"\/32.1-102.1_1\/","token":"32.1\/4\/1.1\/32.1-102.1_1","metadata":false},{"id":69151,"structure_id":14008,"section_number":"32.1-102.1:2","catch_line":"Certificate of public need required; 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monitoring; revocation of certificates; civil penalties","url":"\/32.1-102.4\/","token":"32.1\/4\/1.1\/32.1-102.4","metadata":false},{"id":70069,"structure_id":14008,"section_number":"32.1-102.5","catch_line":"Certificate not transferable","url":"\/32.1-102.5\/","token":"32.1\/4\/1.1\/32.1-102.5","metadata":false},{"id":59090,"structure_id":14008,"section_number":"32.1-102.6","catch_line":"Administrative procedures","url":"\/32.1-102.6\/","token":"32.1\/4\/1.1\/32.1-102.6","metadata":false},{"id":73958,"structure_id":14008,"section_number":"32.1-102.6:1","catch_line":"Revocation of a certificate","url":"\/32.1-102.6_1\/","token":"32.1\/4\/1.1\/32.1-102.6_1","metadata":false},{"id":62746,"structure_id":14008,"section_number":"32.1-102.7","catch_line":"Repealed","url":"\/32.1-102.7\/","token":"32.1\/4\/1.1\/32.1-102.7","metadata":false},{"id":64703,"structure_id":14008,"section_number":"32.1-102.8","catch_line":"Enjoining project undertaken without certificate or registration","url":"\/32.1-102.8\/","token":"32.1\/4\/1.1\/32.1-102.8","metadata":false},{"id":64968,"structure_id":14008,"section_number":"32.1-102.9","catch_line":"Designation of judge","url":"\/32.1-102.9\/","token":"32.1\/4\/1.1\/32.1-102.9","metadata":false}],"previous_section":{"id":69151,"structure_id":14008,"section_number":"32.1-102.1:2","catch_line":"Certificate of public need required; registration of certain equipment and capital projects required","url":"\/32.1-102.1_2\/","token":"32.1\/4\/1.1\/32.1-102.1_2","metadata":false},"next_section":{"id":85729,"structure_id":14008,"section_number":"32.1-102.2","catch_line":"Regulations","url":"\/32.1-102.2\/","token":"32.1\/4\/1.1\/32.1-102.2","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-102.1:3\/","history_text":"

This law was first created in 2020. The record of its establishment is cataloged in chapter 1271<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 2025, chapters 114<\/a>, 135<\/a>, and 325<\/a>.<\/p>","references":[{"id":77111,"section_number":"32.1-102.1","catch_line":"Definitions","order_by":null,"url":"\/32.1-102.1\/"},{"id":55098,"section_number":"32.1-102.11","catch_line":"Application of article","order_by":null,"url":"\/32.1-102.11\/"},{"id":69151,"section_number":"32.1-102.1:2","catch_line":"Certificate of public need required; registration of certain equipment and capital projects required","order_by":null,"url":"\/32.1-102.1_2\/"},{"id":85729,"section_number":"32.1-102.2","catch_line":"Regulations","order_by":null,"url":"\/32.1-102.2\/"},{"id":84648,"section_number":"32.1-102.4","catch_line":"Conditions of certificates; monitoring; revocation of certificates; civil penalties","order_by":null,"url":"\/32.1-102.4\/"},{"id":77454,"section_number":"32.1-3","catch_line":"Definitions","order_by":null,"url":"\/32.1-3\/"},{"id":76508,"section_number":"59.1-444.4","catch_line":"Reporting of medical debt prohibited; civil penalty","order_by":null,"url":"\/59.1-444.4\/"}],"refers_to":[{"id":80727,"section_number":"32.1-123","catch_line":"(Effective January 1, 2026) Definitions","order_by":null,"url":"\/32.1-123\/"},{"id":60864,"section_number":"37.2-403","catch_line":"Definitions","order_by":null,"url":"\/37.2-403\/"}],"permalink":{"id":202427,"object_type":"law","relational_id":63394,"identifier":"32.1-102.1:3","token":"32.1\/4\/1.1\/32.1-102.1_3","url":"\/32.1-102.1_3\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-102.1_3\/","token":"32.1\/4\/1.1\/32.1-102.1_3","dublin_core":{"Title":"(Effective July 1, 2028) Medical care facilities and projects for which a certificate is required","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-102.1:3","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The following medical care facilities shall be subject to the provisions of this article: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Any facility licensed as a hospital, as defined in § 32.1-123<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Any hospital licensed as a provider by the Department<\/span> of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403<\/a> et seq.) of Chapter 4 of Title 37.2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Any facility licensed as a nursing home, as defined in § 32.1-123<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Any intermediate care facility established primarily for the medical, psychiatric, or psychological treatment and rehabilitation of individuals with substance abuse licensed by the Department<\/span> of Behavioral Health and Developmental Services in accordance with Article 2 (§ 37.2-403<\/a> et seq.) of Chapter 4 of Title 37.2; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Any intermediate care facility for individuals with developmental disabilities other than an intermediate care facility established for individuals with intellectual disability (ICF\/IID) that has not more than 12 beds and is in an area identified as in need of residential services for individuals with intellectual disability in any plan of the Department<\/span> of Behavioral Health and Developmental Services; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Any specialized center or clinic or that portion of a physician’s office developed for the provision of outpatient or ambulatory surgery, cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The following actions undertaken by or on behalf of a medical care facility<\/span> described in subsection A shall constitute a project<\/span> for which a certificate<\/span> of public need is required pursuant to subsection A of \u00a7 32.1-102.1:2<\/a>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Establishment of a medical care facility<\/span> described in subsection A; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> An increase in the total number of beds or operating rooms in an existing medical care facility<\/span> described in subsection A; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Relocation of beds from an existing medical care facility<\/span> described in subsection A to another existing medical care facility<\/span> described in subsection A; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Addition of any new nursing home service at an existing medical care facility<\/span> described in subsection A; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Introduction into an existing medical care facility<\/span> described in subsection A of any cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), medical rehabilitation, neonatal special care, open heart surgery, positron emission tomographic (PET) scanning, psychiatric, organ or tissue transplant service, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, proton beam therapy, or substance abuse treatment<\/span> when such medical care facility<\/span> has not provided such service in the previous 12 months; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Conversion of beds in an existing medical care facility<\/span> described in subsection A to medical rehabilitation beds or psychiatric beds; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> The addition by an existing medical care facility<\/span> described in subsection A of any new medical equipment for the provision of cardiac catheterization, computed tomographic (CT) scanning, magnetic resonance imaging (MRI), open heart surgery, positron emission tomographic (PET) scanning, radiation therapy, stereotactic radiotherapy other than radiotherapy performed using a linear accelerator or other medical equipment that uses concentrated doses of high-energy X-rays to perform external beam radiation therapy, or proton beam therapy, other than new medical equipment for the provision of such service added to replace existing medical equipment for the provision of such service; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> Any capital expenditure of $15 million or more, not defined as reviewable in subdivisions 1 through 7, by or on behalf of a medical care facility<\/span> described in subsection A other than a general hospital. The amounts specified in this subdivision shall be revised annually to reflect inflation using appropriate measures incorporating construction costs and medical inflation. Nothing in this subdivision shall be construed to modify or eliminate the reviewability of any project<\/span> described in subdivisions 1 through 7 when undertaken by or on behalf of a general hospital; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

9.<\/span> Conversion in an existing medical care facility<\/span> described in subsection A of psychiatric inpatient beds to nonpsychiatric inpatient beds. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> Notwithstanding the provisions of subsection A, any nursing home affiliated with a facility that, on January 1, 1982, and thereafter, (i) is operated as a nonprofit institution, (ii) is licensed jointly by the Department<\/span> as a nursing home and by the Department<\/span> of Social Services as an assisted living facility, and (iii) restricts admissions such that (a) admissions to the facility are only allowed pursuant to the terms of a “life care contract<\/span>” guaranteeing that the full complement of services offered by the facility is available to the resident as and when needed, (b) admissions to the assisted living facility unit of the facility are restricted to individuals defined as ambulatory by the Department<\/span> of Social Services, and (c) admissions to the nursing home unit of the facility are restricted to those individuals who are residents of the assisted living facility unit of the facility shall not be subject to the requirements of this article. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Notwithstanding the provisions of subsection B, a certificate<\/span> of public need shall not be required for the following actions undertaken by or on behalf of a medical care facility<\/span> described in subsection A: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Relocation of up to 10 beds or 10 percent of the beds, whichever is less, (i) from one existing medical care facility<\/span> described in subsection A to another existing medical care facility<\/span> described in subsection A at the same site in any two-year period or (ii) in any three-year period, from one existing medical care facility<\/span> described in subsection A licensed as a nursing home to any other existing medical care facility<\/span> described in subsection A licensed as a nursing home that is owned or controlled by the same person<\/span> and located either within the same planning district or within another planning district out of which, during or prior to that three-year period, at least 10 times that number of beds have been authorized by statute<\/span> to be relocated from one or more medical care facilities described in subsection A located in that other planning district, and at least half of those beds have not been replaced; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Use of up to 10 percent of beds as nursing home beds by a medical care facility<\/span> described in subsection A licensed as a hospital, as provided in § 32.1-132<\/a> <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> The Department<\/span> shall regularly review the types of medical care facilities subject to the provisions of this article and projects<\/span> for which a certificate<\/span> is required and provide to the Governor and the General Assembly, at least once every five years, a recommendation related to the continued appropriateness of requiring such types of medical care facilities to be subject to the provisions of this article and such types of projects<\/span> to be subject to the requirement of a certificate<\/span>. In developing such recommendations, the Department<\/span> shall consider, for each type of medical care facility<\/span> and project<\/span>, the following criteria: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The current and projected future availability of the specific type of medical care facility<\/span> or project<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The current and projected future demand for the specific type of medical care facility<\/span> or project<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The current and projected future rate of utilization of the specific type of medical care facility<\/span> or project<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> The current and projected future capacity of existing medical care facilities or projects<\/span> of that specific type; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> The anticipated impact of changes in population and demographics, reimbursement structures and rates, and technology on demand for and availability, utilization, and capacity of existing medical care facilities or projects<\/span> of that specific type; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Existing quality, utilization, and other controls applicable to the specific type of medical care facility<\/span> or project<\/span>; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Any risk to the health or well-being of the public resulting from inclusion of the specific type of medical care facility<\/span> or project<\/span> on such list. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\n(EFFECTIVE JULY 1, 2028) MEDICAL CARE FACILITIES AND PROJECTS FOR WHICH A\nCERTIFICATE IS REQUIRED (\u00a7 32.1-102.1:3)\n\nA. The following medical care facilities shall be subject to the provisions of\nthis article:\n\n 1. Any facility licensed as a hospital, as defined in § 32.1-123;\n\n 2. Any hospital licensed as a provider by the Department of Behavioral Health\n and Developmental Services in accordance with Article 2 (§ 37.2-403 et\n seq.) of Chapter 4 of Title 37.2;\n\n 3. Any facility licensed as a nursing home, as defined in § 32.1-123;\n\n 4. Any intermediate care facility established primarily for the medical,\n psychiatric, or psychological treatment and rehabilitation of individuals with\n substance abuse licensed by the Department of Behavioral Health and\n Developmental Services in accordance with Article 2 (§ 37.2-403 et seq.)\n of Chapter 4 of Title 37.2;\n\n 5. Any intermediate care facility for individuals with developmental\n disabilities other than an intermediate care facility established for\n individuals with intellectual disability (ICF\/IID) that has not more than 12\n beds and is in an area identified as in need of residential services for\n individuals with intellectual disability in any plan of the Department of\n Behavioral Health and Developmental Services; and\n\n 6. Any specialized center or clinic or that portion of a physician’s\n office developed for the provision of outpatient or ambulatory surgery,\n cardiac catheterization, computed tomographic (CT) scanning, magnetic\n resonance imaging (MRI), positron emission tomographic (PET) scanning,\n radiation therapy, stereotactic radiotherapy other than radiotherapy performed\n using a linear accelerator or other medical equipment that uses concentrated\n doses of high-energy X-rays to perform external beam radiation therapy, or\n proton beam therapy.\n\nB. The following actions undertaken by or on behalf of a medical care facility\ndescribed in subsection A shall constitute a project for which a certificate of\npublic need is required pursuant to subsection A of \u00a7 32.1-102.1:2:\n\n 1. Establishment of a medical care facility described in subsection A;\n\n 2. An increase in the total number of beds or operating rooms in an existing\n medical care facility described in subsection A;\n\n 3. Relocation of beds from an existing medical care facility described in\n subsection A to another existing medical care facility described in subsection\n A;\n\n 4. Addition of any new nursing home service at an existing medical care\n facility described in subsection A;\n\n 5. Introduction into an existing medical care facility described in subsection\n A of any cardiac catheterization, computed tomographic (CT) scanning, magnetic\n resonance imaging (MRI), medical rehabilitation, neonatal special care, open\n heart surgery, positron emission tomographic (PET) scanning, psychiatric,\n organ or tissue transplant service, radiation therapy, stereotactic\n radiotherapy other than radiotherapy performed using a linear accelerator or\n other medical equipment that uses concentrated doses of high-energy X-rays to\n perform external beam radiation therapy, proton beam therapy, or substance\n abuse treatment when such medical care facility has not provided such service\n in the previous 12 months;\n\n 6. Conversion of beds in an existing medical care facility described in\n subsection A to medical rehabilitation beds or psychiatric beds;\n\n 7. The addition by an existing medical care facility described in subsection A\n of any new medical equipment for the provision of cardiac catheterization,\n computed tomographic (CT) scanning, magnetic resonance imaging (MRI), open\n heart surgery, positron emission tomographic (PET) scanning, radiation\n therapy, stereotactic radiotherapy other than radiotherapy performed using a\n linear accelerator or other medical equipment that uses concentrated doses of\n high-energy X-rays to perform external beam radiation therapy, or proton beam\n therapy, other than new medical equipment for the provision of such service\n added to replace existing medical equipment for the provision of such service;\n\n 8. Any capital expenditure of $15 million or more, not defined as reviewable\n in subdivisions 1 through 7, by or on behalf of a medical care facility\n described in subsection A other than a general hospital. The amounts specified\n in this subdivision shall be revised annually to reflect inflation using\n appropriate measures incorporating construction costs and medical inflation.\n Nothing in this subdivision shall be construed to modify or eliminate the\n reviewability of any project described in subdivisions 1 through 7 when\n undertaken by or on behalf of a general hospital; and\n\n 9. Conversion in an existing medical care facility described in subsection A\n of psychiatric inpatient beds to nonpsychiatric inpatient beds.\n\nC. Notwithstanding the provisions of subsection A, any nursing home affiliated\nwith a facility that, on January 1, 1982, and thereafter, (i) is operated as a\nnonprofit institution, (ii) is licensed jointly by the Department as a nursing\nhome and by the Department of Social Services as an assisted living facility,\nand (iii) restricts admissions such that (a) admissions to the facility are only\nallowed pursuant to the terms of a “life care contract” guaranteeing\nthat the full complement of services offered by the facility is available to the\nresident as and when needed, (b) admissions to the assisted living facility unit\nof the facility are restricted to individuals defined as ambulatory by the\nDepartment of Social Services, and (c) admissions to the nursing home unit of\nthe facility are restricted to those individuals who are residents of the\nassisted living facility unit of the facility shall not be subject to the\nrequirements of this article.\n\nD. Notwithstanding the provisions of subsection B, a certificate of public need\nshall not be required for the following actions undertaken by or on behalf of a\nmedical care facility described in subsection A:\n\n 1. Relocation of up to 10 beds or 10 percent of the beds, whichever is less,\n (i) from one existing medical care facility described in subsection A to\n another existing medical care facility described in subsection A at the same\n site in any two-year period or (ii) in any three-year period, from one\n existing medical care facility described in subsection A licensed as a nursing\n home to any other existing medical care facility described in subsection A\n licensed as a nursing home that is owned or controlled by the same person and\n located either within the same planning district or within another planning\n district out of which, during or prior to that three-year period, at least 10\n times that number of beds have been authorized by statute to be relocated from\n one or more medical care facilities described in subsection A located in that\n other planning district, and at least half of those beds have not been\n replaced; or\n\n 2. Use of up to 10 percent of beds as nursing home beds by a medical care\n facility described in subsection A licensed as a hospital, as provided in\n § 32.1-132\n\nE. The Department shall regularly review the types of medical care facilities\nsubject to the provisions of this article and projects for which a certificate\nis required and provide to the Governor and the General Assembly, at least once\nevery five years, a recommendation related to the continued appropriateness of\nrequiring such types of medical care facilities to be subject to the provisions\nof this article and such types of projects to be subject to the requirement of a\ncertificate. In developing such recommendations, the Department shall consider,\nfor each type of medical care facility and project, the following criteria:\n\n 1. The current and projected future availability of the specific type of\n medical care facility or project;\n\n 2. The current and projected future demand for the specific type of medical\n care facility or project;\n\n 3. The current and projected future rate of utilization of the specific type\n of medical care facility or project;\n\n 4. The current and projected future capacity of existing medical care\n facilities or projects of that specific type;\n\n 5. The anticipated impact of changes in population and demographics,\n reimbursement structures and rates, and technology on demand for and\n availability, utilization, and capacity of existing medical care facilities or\n projects of that specific type;\n\n 6. Existing quality, utilization, and other controls applicable to the\n specific type of medical care facility or project; and\n\n 7. Any risk to the health or well-being of the public resulting from inclusion\n of the specific type of medical care facility or project on such list.\n\nHISTORY: 2020, c. 1271; 2025, cc. 114, 135, 325.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}