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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>59090</law_id><section_number>32.1-102.6</section_number><catch_line>Administrative procedures</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-102.2</reference><reference>32.1-102.3</reference><reference>32.1-102.9</reference><reference>32.1-122.05</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="1" identifier="4">Health Care Planning</unit><unit label="article" level="3" order_by="1" identifier="1.1">Medical Care Facilities Certificate of Public Need</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> To obtain a <span class="dictionary">certificate</span> for a <span class="dictionary">project</span>, the applicant shall file a completed <span class="dictionary">application</span> for a <span class="dictionary">certificate</span> with the <span class="dictionary">Department</span> and the appropriate <span class="dictionary">regional health planning agency</span> if a <span class="dictionary">regional health planning agency</span> has been designated for that region. Such <span class="dictionary">application</span> shall be filed in accordance with procedures established by the <span class="dictionary">Department</span>. An <span class="dictionary">application</span> submitted for review shall be considered complete when all relevant sections of the <span class="dictionary">application</span> form have responses. The applicant shall provide sufficient information to prove public need for the requested <span class="dictionary">project</span> exists without the addition of supplemental or supporting <span class="dictionary">material</span> at a later date. The <span class="dictionary">Department</span> shall ensure that only data necessary for review of an <span class="dictionary">application</span> is required to be submitted and that the <span class="dictionary">application</span> reflects statutory requirements. Nothing in this section shall prevent the <span class="dictionary">Department</span> from seeking, at its discretion, additional information from the applicant or other sources.
			Within 10 calendar days of the date on which the document is received, the <span class="dictionary">Department</span> and the appropriate <span class="dictionary">regional health planning agency</span>, if a <span class="dictionary">regional health planning agency</span> has been designated, shall determine whether the <span class="dictionary">application</span> is complete or not and the <span class="dictionary">Department</span> shall notify the applicant, if the <span class="dictionary">application</span> is not complete, of the information needed to complete the <span class="dictionary">application</span>. If no <span class="dictionary">regional health planning agency</span> is designated for the <span class="dictionary">health planning region</span> in which the <span class="dictionary">project</span> will be located, no filing with a <span class="dictionary">regional health planning agency</span> is required and the <span class="dictionary">Department</span> shall determine if the <span class="dictionary">application</span> is complete and notify the applicant, if the <span class="dictionary">application</span> is not complete, of the information needed to complete the <span class="dictionary">application</span>.
			At least 30 calendar days before any <span class="dictionary">person</span> is contractually obligated to acquire an existing <span class="dictionary">medical care facility</span>, the cost of which is $600,000 or more, that <span class="dictionary">person</span> shall notify the <span class="dictionary">Commissioner</span> and the appropriate <span class="dictionary">regional health planning agency</span>, if a <span class="dictionary">regional health planning agency</span> has been designated, of the <span class="dictionary">intent</span>, the services to be offered in the facility, the bed capacity in the facility and the projected impact that the cost of the acquisition will have upon the charges for services to be provided. If clinical services or beds are proposed to be added as a result of the acquisition, the <span class="dictionary">Commissioner</span> may require the proposed new owner to obtain a <span class="dictionary">certificate</span> prior to the acquisition. If no <span class="dictionary">regional health planning agency</span> is designated for the <span class="dictionary">health planning region</span> in which the acquisition will take place, no notification to a <span class="dictionary">regional health planning agency</span> shall be required. <a id="paragraph-216674" class="section-permalink" href="https://vacode.org/32.1-102.6/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> For <span class="dictionary">projects</span> proposed in <span class="dictionary">health planning regions</span> with regional planning agencies, the appropriate <span class="dictionary">regional health planning agency</span> shall (i) review each completed <span class="dictionary">application</span> for a <span class="dictionary">certificate</span> within 60 calendar days of the day that begins the appropriate batch review cycle as established by the <span class="dictionary">Board</span> by regulation pursuant to subdivision A 1 of &#xA7; <a class="law" title="Regulations" href="/32.1-102.2/">32.1-102.2</a>, such cycle not to exceed 190 days in duration; (ii) within 10 calendar days following the start of the review cycle, solicit public comment on such <span class="dictionary">application</span> by posting notice of such <span class="dictionary">application</span> and a summary of the proposed <span class="dictionary">project</span> on a website maintained by the <span class="dictionary">Department</span>; such notice shall include information about how comments may be submitted to the <span class="dictionary">regional health planning agency</span> and the date on which the public comment period shall expire, which shall be no later than 45 calendar days following the date of the public notice; and (iii) in the case of competing <span class="dictionary">applications</span> or in response to a written request by an elected local government representative, a member of the General Assembly, the <span class="dictionary">Commissioner</span>, the applicant, or a member of the public, hold one public <span class="dictionary">hearing</span> on each <span class="dictionary">application</span> in a location in the county or city in which the <span class="dictionary">project</span> is proposed or a contiguous county or city. Prior to any required public <span class="dictionary">hearing</span>, the <span class="dictionary">regional health planning agency</span> shall notify the local governing bodies in the planning district. At least nine days prior to the public <span class="dictionary">hearing</span>, the <span class="dictionary">regional health planning agency</span> shall cause notice of the public <span class="dictionary">hearing</span> to be published in a newspaper of general circulation in the county or city where the <span class="dictionary">project</span> is proposed to be located. The <span class="dictionary">regional health planning agency</span> shall consider the comments of the local governing bodies in the planning district and all other public comments in making its decision. Such comments shall be part of the record. In no case shall a <span class="dictionary">regional health planning agency</span> hold more than two meetings on any <span class="dictionary">application</span>, one of which shall be the public <span class="dictionary">hearing</span> required pursuant to clause (iii), if any, conducted by the <span class="dictionary">board</span> of the <span class="dictionary">regional health planning agency</span> or a subcommittee of the <span class="dictionary">board</span>. The applicant shall be given the opportunity, prior to the vote by the <span class="dictionary">board</span> of the <span class="dictionary">regional health planning agency</span> or a committee of the agency, if acting for the <span class="dictionary">board</span>, on its recommendation, to respond to any comments made about the <span class="dictionary">project</span> by the <span class="dictionary">regional health planning agency</span> staff, any information in a <span class="dictionary">regional health planning agency</span> staff report, or comments by those voting members of the <span class="dictionary">regional health planning agency</span> <span class="dictionary">board</span>; however, such opportunity shall not increase the 60-calendar-day period designated herein for the <span class="dictionary">regional health planning agency</span>&#x2019;s review unless the applicant or applicants request a specific extension of the <span class="dictionary">regional health planning agency</span>&#x2019;s review period.
			The <span class="dictionary">regional health planning agency</span> shall submit its recommendations on each <span class="dictionary">application</span> and its reasons therefor to the <span class="dictionary">Department</span> within 10 calendar days after the completion of its 60-calendar-day review or such other period in accordance with the applicant&#x2019;s request for extension.
			If the <span class="dictionary">regional health planning agency</span> has not completed its review within the specified 60 calendar days or such other period in accordance with the applicant&#x2019;s request for extension and submitted its recommendations on the <span class="dictionary">application</span> and the reasons therefor within 10 calendar days after the completion of its review, the <span class="dictionary">Department</span> shall, on the eleventh calendar day after the expiration of the <span class="dictionary">regional health planning agency</span>&#x2019;s review period, proceed as though the <span class="dictionary">regional health planning agency</span> has recommended <span class="dictionary">project</span> approval without conditions or revision.
			If no <span class="dictionary">regional health planning agency</span> has been designated for a region, the <span class="dictionary">Department</span> shall (a) within 10 calendar days following the start of the review cycle, solicit public comment on such <span class="dictionary">application</span> by posting notice of such <span class="dictionary">application</span> and a summary of the proposed <span class="dictionary">project</span> on a website maintained by the <span class="dictionary">Department</span>; such notice shall include such information about how comments may be submitted to the <span class="dictionary">Department</span> and the date on which the public comment period shall expire, which shall be no later than 45 calendar days following the date of the public notice, and (b) in the case of competing <span class="dictionary">applications</span> or in response to a written request by an elected local government representative, a member of the General Assembly, the <span class="dictionary">Commissioner</span>, the applicant, or a member of the public, hold one <span class="dictionary">hearing</span> on each <span class="dictionary">application</span> in a location in the county or city in which the <span class="dictionary">project</span> is proposed or a contiguous county or city. Prior to any required <span class="dictionary">hearing</span>, the <span class="dictionary">Department</span> shall notify the local governing bodies in the planning district in which the <span class="dictionary">project</span> is proposed. At least nine days prior to the public <span class="dictionary">hearing</span>, the <span class="dictionary">Department</span> shall cause notice of the public <span class="dictionary">hearing</span> to be published in a newspaper of general circulation in the county or city where the <span class="dictionary">project</span> is proposed to be located. The <span class="dictionary">Department</span> shall consider the comments of the local governing bodies in the planning district and all other public comments in making its decision. Such comments shall be part of the record. <a id="paragraph-216675" class="section-permalink" href="https://vacode.org/32.1-102.6/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> After commencement of any public <span class="dictionary">hearing</span> and before a decision is made there shall be no <span class="dictionary">ex parte</span> contacts concerning the subject <span class="dictionary">certificate</span> or its <span class="dictionary">application</span> between (i) any <span class="dictionary">person</span> acting on behalf of the applicant or holder of a <span class="dictionary">certificate</span> or any <span class="dictionary">person</span> opposed to the issuance or in favor of <span class="dictionary">revocation</span> of a <span class="dictionary">certificate</span> of public need and (ii) any <span class="dictionary">person</span> in the <span class="dictionary">Department</span> who has authority to make a determination respecting the issuance or <span class="dictionary">revocation</span> of a <span class="dictionary">certificate</span> of public need, unless the <span class="dictionary">Department</span> has provided advance notice to all parties referred to in clause (i) of the time and place of such proposed contact. <a id="paragraph-216676" class="section-permalink" href="https://vacode.org/32.1-102.6/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> The <span class="dictionary">Department</span> shall commence the review of each completed <span class="dictionary">application</span> upon the day which begins the appropriate batch review cycle and simultaneously with the review conducted by the <span class="dictionary">regional health planning agency</span>, if a <span class="dictionary">regional health planning agency</span> has been designated.
			A determination whether a public need exists for a <span class="dictionary">project</span> shall be made by the <span class="dictionary">Commissioner</span> within 190 calendar days of the day which begins the appropriate batch cycle.
			The 190-calendar-day review period shall begin on the date upon which the <span class="dictionary">application</span> is determined to be complete within the batching process specified in subdivision A 1 of &#xA7; <a class="law" title="Regulations" href="/32.1-102.2/">32.1-102.2</a>.
			If the <span class="dictionary">application</span> is not determined to be complete within 40 calendar days from submission, the <span class="dictionary">application</span> shall be refiled in the next batch for like <span class="dictionary">projects</span>.
			The <span class="dictionary">Commissioner</span> shall make determinations in accordance with the provisions of the Administrative Process Act (&#xA7; <a class="law" title="Short title; purpose" href="/2.2-4000/">2.2-4000</a> et seq.) except for those parts of the determination process for which timelines and specifications are delineated in subsection E. Further, if an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference is determined to be necessary by the <span class="dictionary">Department</span> or is requested by a <span class="dictionary">person</span> seeking <span class="dictionary">good cause</span> standing, the parties to the case shall include only the applicant, any <span class="dictionary">person</span> showing <span class="dictionary">good cause</span>, any third-<span class="dictionary">party</span> payor providing health care insurance or prepaid coverage to five percent or more of the patients in the applicant&#x2019;s service area, and the relevant health planning agency. <a id="paragraph-216677" class="section-permalink" href="https://vacode.org/32.1-102.6/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> Upon entry of each completed <span class="dictionary">application</span> or <span class="dictionary">applications</span> into the appropriate batch review cycle: <a id="paragraph-216678" class="section-permalink" href="https://vacode.org/32.1-102.6/#E"><i class="fa fa-link"/></a></p></section>
						<section id="E1" class="indent-1"><p><span class="prefix-number">1.</span> The <span class="dictionary">Department</span> shall establish, for every <span class="dictionary">application</span>, a date between the eightieth and ninetieth calendar days within the 190-calendar-day review period for holding an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference, if such conference is necessary. <a id="paragraph-216679" class="section-permalink" href="https://vacode.org/32.1-102.6/#E1"><i class="fa fa-link"/></a></p></section>
						<section id="E2" class="indent-1"><p><span class="prefix-number">2.</span> The <span class="dictionary">Department</span> shall review every <span class="dictionary">application</span> at or before the seventy-fifth calendar day within the 190-calendar-day review period to determine whether an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference is necessary. <a id="paragraph-216680" class="section-permalink" href="https://vacode.org/32.1-102.6/#E2"><i class="fa fa-link"/></a></p></section>
						<section id="E3" class="indent-1"><p><span class="prefix-number">3.</span> Any <span class="dictionary">person</span> seeking to be made a <span class="dictionary">party</span> to the case for <span class="dictionary">good cause</span>, no later than four days after the <span class="dictionary">Department</span> has completed its review and submitted its recommendation on an <span class="dictionary">application</span> and has transmitted the same to the applicants and to <span class="dictionary">persons</span> who have, prior to the issuance of the report, requested a copy in writing, shall notify the <span class="dictionary">Commissioner</span>, all applicants, and the <span class="dictionary">regional health planning agency</span>, in writing and under <span class="dictionary">oath</span>, stating the grounds for <span class="dictionary">good cause</span> and providing the factual basis therefor. <a id="paragraph-216681" class="section-permalink" href="https://vacode.org/32.1-102.6/#E3"><i class="fa fa-link"/></a></p></section>
						<section id="E4" class="indent-1"><p><span class="prefix-number">4.</span> In any case in which an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference is held, a date shall be established for the closing of the record which shall not be more than 30 calendar days after the date for holding the informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference. <a id="paragraph-216682" class="section-permalink" href="https://vacode.org/32.1-102.6/#E4"><i class="fa fa-link"/></a></p></section>
						<section id="E5" class="indent-1"><p><span class="prefix-number">5.</span> In any case in which an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference is not held, the record shall be closed on the earlier of (i) the date established for holding the informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference or (ii) the date that the <span class="dictionary">Department</span> determines an informal <span class="dictionary">fact</span>-<span class="dictionary">finding</span> conference is not necessary. <a id="paragraph-216683" class="section-permalink" href="https://vacode.org/32.1-102.6/#E5"><i class="fa fa-link"/></a></p></section>
						<section id="E6" class="indent-1"><p><span class="prefix-number">6.</span> The provisions of subsection C of &#xA7; <a class="law" title="Timetable for decision; exemptions" href="/2.2-4021/">2.2-4021</a> notwithstanding, if a determination whether a public need exists for a <span class="dictionary">project</span> is not made by the <span class="dictionary">Commissioner</span> within 45 calendar days of the closing of the record, the <span class="dictionary">Commissioner</span> shall notify the applicant or applicants and any <span class="dictionary">persons</span> seeking to show <span class="dictionary">good cause</span>, in writing, that the <span class="dictionary">application</span> or the <span class="dictionary">application</span> of each shall be deemed approved 25 calendar days after expiration of such 45-calendar-day period, unless the receipt of recommendations from the <span class="dictionary">person</span> performing the <span class="dictionary">hearing</span> officer functions permits the <span class="dictionary">Commissioner</span> to <span class="dictionary">issue</span> his case decision within that 25-calendar-day period. The validity or timeliness of the aforementioned notice shall not, in any event, prevent, delay or otherwise impact the effectiveness of this section. <a id="paragraph-216684" class="section-permalink" href="https://vacode.org/32.1-102.6/#E6"><i class="fa fa-link"/></a></p></section>
						<section id="E7" class="indent-1"><p><span class="prefix-number">7.</span> In any case when a determination whether a public need exists for a <span class="dictionary">project</span> is not made by the <span class="dictionary">Commissioner</span> within 70 calendar days after the closing of the record, the <span class="dictionary">application</span> shall be deemed to be approved and the <span class="dictionary">certificate</span> shall be granted. <a id="paragraph-216685" class="section-permalink" href="https://vacode.org/32.1-102.6/#E7"><i class="fa fa-link"/></a></p></section>
						<section id="E8" class="indent-1"><p><span class="prefix-number">8.</span> If a determination whether a public need exists for a <span class="dictionary">project</span> is not made by the <span class="dictionary">Commissioner</span> within 45 calendar days of the closing of the record, any applicant who is competing in the relevant batch or who has filed an <span class="dictionary">application</span> in response to the relevant Request For <span class="dictionary">Applications</span> issued pursuant to &#xA7; <a class="law" title="Certificates of public need; applications to be filed in response to Requests for Applications (RFAs)" href="/32.1-102.3_2/">32.1-102.3:2</a> may, prior to the <span class="dictionary">application</span> being deemed approved, <span class="dictionary">petition</span> for immediate injunctive relief pursuant to &#xA7; <a class="law" title="Recovery of costs and attorney fees from agency" href="/2.2-4030/">2.2-4030</a>, naming as respondents the <span class="dictionary">Commissioner</span> and all parties to the case. During the pendency of the proceeding, no <span class="dictionary">applications</span> shall be deemed to be approved. In such a proceeding, the provisions of &#xA7; <a class="law" title="Recovery of costs and attorney fees from agency" href="/2.2-4030/">2.2-4030</a> shall apply. <a id="paragraph-216686" class="section-permalink" href="https://vacode.org/32.1-102.6/#E8"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> Deemed approvals shall be construed as the <span class="dictionary">Commissioner</span>&#x2019;s case decision on the <span class="dictionary">application</span> pursuant to the Administrative Process Act (&#xA7; <a class="law" title="Short title; purpose" href="/2.2-4000/">2.2-4000</a> et seq.) and shall be subject to judicial review on <span class="dictionary">appeal</span> as the <span class="dictionary">Commissioner</span>&#x2019;s case decision in accordance with such act.
			Any <span class="dictionary">person</span> who has sought to participate in the <span class="dictionary">Department</span>&#x2019;s review of such deemed-to-be-approved <span class="dictionary">application</span> as a <span class="dictionary">person</span> showing <span class="dictionary">good cause</span> who has not received a final determination from the <span class="dictionary">Commissioner</span> concerning such attempt to show <span class="dictionary">good cause</span> shall be deemed to be a <span class="dictionary">person</span> showing <span class="dictionary">good cause</span> for purposes of <span class="dictionary">appeal</span> of the deemed approval of the <span class="dictionary">certificate</span>.
			In any <span class="dictionary">appeal</span> of the <span class="dictionary">Commissioner</span>&#x2019;s case decision granting a <span class="dictionary">certificate</span> of public need pursuant to a Request for <span class="dictionary">Applications</span> issued pursuant to &#xA7; <a class="law" title="Certificates of public need; applications to be filed in response to Requests for Applications (RFAs)" href="/32.1-102.3_2/">32.1-102.3:2</a>, the <span class="dictionary">court</span> may require the <span class="dictionary">appellant</span> to file a <span class="dictionary">bond</span> pursuant to &#xA7; <a class="law" title="Security for appeal" href="/8.01-676.1/">8.01-676.1</a>, in such sum as shall be fixed by the <span class="dictionary">court</span> for protection of all parties interested in the case decision, conditioned on the payment of all <span class="dictionary">damages</span> and costs incurred in consequence of such <span class="dictionary">appeal</span>. <a id="paragraph-216687" class="section-permalink" href="https://vacode.org/32.1-102.6/#F"><i class="fa fa-link"/></a></p></section>
						<section id="G"><p><span class="prefix-number">G.</span> For purposes of this section, &#x201C;<span class="dictionary">good cause</span>&#x201D; means that (i) there is significant relevant information not previously presented at and not available at the time of the public <span class="dictionary">hearing</span>, (ii) there have been significant changes in factors or circumstances relating to the <span class="dictionary">application</span> subsequent to the public <span class="dictionary">hearing</span>, or (iii) there is a substantial <span class="dictionary">material</span> mistake of <span class="dictionary">fact</span> or <span class="dictionary">law</span> in the <span class="dictionary">Department</span> staff&#x2019;s report on the <span class="dictionary">application</span> or in the report submitted by the health planning agency. <a id="paragraph-216688" class="section-permalink" href="https://vacode.org/32.1-102.6/#G"><i class="fa fa-link"/></a></p></section>
						<section id="H"><p><span class="prefix-number">H.</span> The <span class="dictionary">project</span> review procedures shall provide for separation of the <span class="dictionary">project</span> review manager functions from the <span class="dictionary">hearing</span> officer functions. No <span class="dictionary">person</span> serving in the role of <span class="dictionary">project</span> review manager shall serve as a <span class="dictionary">hearing</span> officer. <a id="paragraph-216689" class="section-permalink" href="https://vacode.org/32.1-102.6/#H"><i class="fa fa-link"/></a></p></section>
						<section id="I"><p><span class="prefix-number">I.</span> The applicants, and only the applicants, shall have the authority to extend any of the time periods specified in this section. If all applicants consent to extending any time period in this section, the <span class="dictionary">Commissioner</span>, with the concurrence of the applicants, shall establish a new schedule for the remaining time periods. <a id="paragraph-216690" class="section-permalink" href="https://vacode.org/32.1-102.6/#I"><i class="fa fa-link"/></a></p></section>
						<section id="J"><p><span class="prefix-number">J.</span> This section shall not apply to <span class="dictionary">applications</span> for <span class="dictionary">certificates</span> for <span class="dictionary">projects</span> that meet the criteria for the expedited <span class="dictionary">application</span> and review process established in subdivision A 5 of &#xA7; <a class="law" title="Regulations" href="/32.1-102.2/">32.1-102.2</a>. Such <span class="dictionary">projects</span> shall be subject to an expedited <span class="dictionary">application</span> and review process developed by the <span class="dictionary">Board</span> in regulation pursuant to subdivisions A 2 and 5 of &#xA7; <a class="law" title="Regulations" href="/32.1-102.2/">32.1-102.2</a>. <a id="paragraph-216691" class="section-permalink" href="https://vacode.org/32.1-102.6/#J"><i class="fa fa-link"/></a></p></section></text><history>1982, c. 388; 1984, c. 740; 1991, c. 561; 1999, cc. 899, 922; 2000, c. 931; 2004, cc. 71, 95; 2005, c. 404; 2009, c. 175; 2010, c. 646; 2020, c. 1271; 2025, c. 325.</history><metadata></metadata></law>
