Last updated: November 2026. Sources read 2026-11-05.
A Virginia certificate of public need (COPN) is the Commissioner of Health's determination that a public need exists for a listed medical care facility project under Article 1.1 of Chapter 4 of Title 32.1 of the Code of Virginia, and a listed project cannot start without one unless an exemption applies. Integral Healthcare Solutions (IHS) drafts the application narrative, need and utilization worksheets, evidence map and review calendar for providers planning such a project. The applicant files and attends.
What does Virginia require for a certificate of public need?
Virginia bars a person from undertaking a listed project at a listed facility without first obtaining a certificate from the Commissioner (section 32.1-102.1:2(A)), and the Commissioner may not issue one unless a public need for the project has been demonstrated (section 32.1-102.3(A)). The governing text is Article 1.1 of the Code of Virginia (32.1-102.1:2, 32.1-102.1:3, 32.1-102.3, 32.1-102.4, 32.1-102.6) and the Certificate of Public Need Rules and Regulations, 12VAC5-220; the Virginia Department of Health COPN page and its FAQ add procedure. All were opened 2026-11-05.
- State Health Services Plan. Approval must follow the most recent applicable plan provisions. Under section 32.1-102.3(A), the Commissioner may depart on appropriate evidence of rural irrelevance, inaccuracy, obsolescence, inadequacy or other inapplicability, consistently with that finding, and must initiate amendments. If provisions were previously set aside and amendments are pending, the remaining applicable provisions and subsection B considerations govern.
- Eight considerations. They include access to care, community support from people, businesses and governmental leaders, reasonable alternatives that cost less or work better, financial accessibility including to indigent people, the effect on existing services, and feasibility (section 32.1-102.3(B)).
- Complete up front. An application is complete when every relevant section of the form has a response, and it must prove public need without later supplements, though the Department may still seek additional information (section 32.1-102.6(A)).
Standard review timing follows section 32.1-102.6; subsection J excludes qualifying expedited projects. Under subsection I, extensions require all applicants' consent, with the Commissioner and applicants agreeing on the remaining schedule.
| Step | Timing and conditions |
|---|---|
| Letter of intent | The later of 30 days before application submission or 10 days after the first LOI within the particular batch group for the same or similar services and facilities in the same planning district or medical service area (12VAC5-220-180(A)). |
| Application and fee | Application: at least 40 days before the cycle. Fee: received at least five days before the cycle under the VDH FAQ; payment is necessary for completeness (12VAC5-220-180(B), (C)). |
| Completeness | Section 32.1-102.6(A) sets a 10-calendar-day determination; 12VAC5-220-190 sets notification within 15 days. Counsel resolves their application. If not complete within 40 calendar days of submission, refile in the next batch for like projects (subsection D). |
| Regional review | Where designated, the regional agency reviews within 60 calendar days of cycle start. Public comment closes no later than 45 calendar days after notice (subsection B), subject to applicant-requested review extensions. |
| Conference | Necessity is assessed by day 75; any conference is scheduled between days 80 and 90, with the record closing no more than 30 calendar days afterward (subsection E). |
| Decision | Subsection D sets 190 calendar days from batch-cycle start and ties the review period to completeness within batching. Deemed approval follows the separate conditions in subsections E(6)-(8), including notice after 45 days, a further 25-day decision window and suspension during the specified injunctive proceeding. |
Projects are sorted into batch groups A through G by type (12VAC5-220-200), and the department publishes the batching schedule that sets each cycle.
Who needs a Virginia certificate of public need, and what triggers it?
A project needs a certificate when a listed action is taken by or for a listed facility. Section 32.1-102.1:3 holds both lists. It prints two versions, one headed "(Expires July 1, 2028)" and one headed "(Effective July 1, 2028)"; subsections A and B read the same, and only the exemptions in subsection D differ. Counsel confirms which governs your filing date.
Listed facilities (subsection A) include hospitals, nursing homes, certain intermediate care facilities, and a specialized center, clinic or part of a physician's office developed for outpatient or ambulatory surgery, cardiac catheterization, CT, MRI, PET, radiation therapy or proton beam therapy. Counsel reads the linear accelerator wording against the project.
Listed actions (subsection B) include:
- Establishing a listed facility; increasing its total beds or operating rooms; moving beds between listed facilities; converting beds to medical rehabilitation or psychiatric beds; or converting psychiatric inpatient beds to nonpsychiatric inpatient beds, subject to exemptions.
- Introducing a listed service, such as CT, MRI or radiation therapy, that the facility has not provided in the previous 12 months.
- Adding new equipment for a listed imaging, cardiac or radiation service, other than equipment added to replace existing equipment for that service.
- Capital expenditure by a listed non-general-hospital facility, not reviewable under items 1-7, at the annually adjusted threshold in subsection B(8). The statutory base is 15 million dollars, not a verified current threshold.
Separate filings include registration of replacement equipment for services specified in section 32.1-102.1:2(B), at least 30 calendar days before contractual obligation, and capital-expenditure registration under subsection C's annually adjusted thresholds. Acquisition notice under section 32.1-102.6(A) does not remove any certificate requirement for added services or beds. Exclusions and exemptions appear in section 32.1-102.1:3(C) and (D); section 32.1-102.2(A) provides expedited review for qualifying projects. Counsel assesses applicability.
How does IHS prepare a Virginia certificate of public need application?
IHS works with your planning and finance leaders and counsel.
- Gap assessment. IHS compares your project plan to the eight considerations in section 32.1-102.3(B) and lists the evidence you lack.
- Evidence mapping. IHS maps each consideration to its evidence: support letters, alternatives analysis, accessibility data and feasibility inputs.
- Drafting. IHS drafts the narrative, need and utilization worksheets, a calendar built backward from the cycle start, an attachment checklist and questions for your team to raise in preconsultation, which is advisory only (12VAC5-220-170). Your leaders and counsel approve each one.
- Mock review. IHS reads the draft as a reviewer would, checking that every section has a response and that public need is proved without later supplements.
- Readiness support. IHS drafts a post-approval tracker for certificate conditions and progress reports, and briefing notes if a conference is held.
What you supply: the project description, cost, location and service line; need and utilization data; financial projections; community support; counsel; and the filing, fee and attendance.
The real limit: the applicant files and attends. IHS does not file with the state or communicate with the Commissioner, the department or the regional agency for you. Section 32.1-102.6(C) restricts certificate-related contacts between the specified applicant, certificate-holder or opposing representatives and Department decision-makers after a public hearing starts and before a decision, unless the Department gives those parties advance notice of the contact's time and place. Counsel advises on this restriction. IHS gives no legal advice on reviewability, exemptions or appeals and does not guarantee approval.
IHS was founded in 2002 and is led by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC.
What should an applicant have ready for a Virginia certificate of public need?
IHS requests these preparation materials; the cited authorities were opened 2026-11-05.
- Counsel's project-category and exemption assessment under Code of Virginia 32.1-102.1:3, version expiring July 1, 2028.
- A filing calendar: application at least 40 days before the cycle under 12VAC5-220-180; fee received at least five days before it under the VDH FAQ, updated April 21, 2026.
- Support, alternatives, accessibility and feasibility evidence addressing Code of Virginia 32.1-102.3(B).
- Need worksheets and form responses supporting public need without later supplements under Code of Virginia 32.1-102.6(A), with plan analysis under 32.1-102.3(A).
- Acquisition notice materials and recipient calendar under Code of Virginia 32.1-102.6(A); see the acquisition FAQ below.
- A financial-assistance policy and annual certificate-condition documentation plan: both are required of certificate holders by Code of Virginia 32.1-102.4(B).
If most of these do not exist yet, the free introductory call is the place to sort what to build first.
How does an outside application build compare with the other routes?
The routes are not exclusive.
- Internal build: planning and finance staff write the narrative and worksheets.
- Counsel: advises on whether a certificate is needed, exemptions, hearings and appeals, which IHS does not.
- Outside drafting support (IHS): IHS drafts the narrative, worksheets and calendar for the applicant to approve; the applicant files and attends.
What does a Virginia certificate of public need application cost?
The Administrative Code text we read sets the application fee at 1.0 percent of the proposed expenditure, not less than 1,000 dollars and no more than 20,000 dollars (12VAC5-220-180(B), opened 2026-11-05). Verify current fees with the Virginia Department of Health.
IHS scopes each engagement after a free introductory call.
What this is not
This is not legal advice. IHS is a consulting firm, not a law firm. Whether a project needs a certificate and any appeal are questions for your counsel. It is not a filing service, because the applicant files and attends. It is not a guarantee of approval, and IHS does not communicate with the Commissioner or the department for you.
Frequently asked questions
What is a certificate of need in Virginia and which projects need one?
Virginia requires a certificate of public need before undertaking projects covered by section 32.1-102.1:3(B) or Board regulations at or for listed facilities (section 32.1-102.1:2(A)). Statutory exclusions and exemptions can apply; counsel assesses the project.
What must a Virginia certificate of need applicant show?
The application must establish public need without later supplements, addressing section 32.1-102.3(B)'s eight considerations. The Department may nevertheless seek additional information at its discretion (section 32.1-102.6(A)).
How long does the Virginia review take?
VDH says application and review can take six to seven months. Standard review has a 190-calendar-day decision period tied to completed applications within batching; qualifying expedited projects are excluded. Extensions require all applicants' consent and an agreed revised schedule (section 32.1-102.6(D), (I), (J)).
When are the letter of intent, the application and the fee due?
The LOI deadline is the later of 30 days before application submission or 10 days after the first LOI in the particular batch group for the same or similar services and facilities in the same planning district or medical service area (12VAC5-220-180(A)). Submit the application at least 40 days before the cycle; VDH's FAQ requires fee receipt at least five days before it for same-cycle completeness.
Is notice required before buying an existing facility?
For an existing medical care facility costing at least 600,000 dollars, notify the Commissioner and any designated regional health planning agency at least 30 calendar days before contractual obligation. Include acquisition intent, services, bed capacity and projected effects on charges. Added clinical services or beds may require a certificate before acquisition (section 32.1-102.6(A)).
What happens if a project starts without a certificate?
Starting without a required certificate or registration is grounds for license refusal (section 32.1-102.10). On petition of the Commissioner, Board or Attorney General, the circuit court where the project is located or proposed may enjoin the project, patient admissions or services (section 32.1-102.8).
What conditions and changes follow approval?
The Commissioner may revoke for failure to progress under the approved schedule or spending beyond the approved maximum (section 32.1-102.4(A)). Certificates last 12 months and are nontransferable; extensions depend on the Commissioner's approval under 12VAC5-220-440's progress, request and timing conditions. Progress documentation is required at 12 and 24 months after issuance and upon completion (12VAC5-220-450).
What does a Virginia certificate of need application cost?
The Administrative Code text we read sets the fee at 1.0 percent of the proposed expenditure, not less than 1,000 dollars and no more than 20,000 dollars (12VAC5-220-180(B)). Verify current fees with the Virginia Department of Health.
Related pages
Compliance Services overview | State licensing and certificate of need.