Center for Policy, Planning and Epidemiology Certificate of Need Program State Health Planning and Development Agency Who Needs a Certificate of Need? A Certificate of Need (CON) is required by any person, partnership, or corporation proposing to: Construct, develop, or otherwise establish a new health care facility, health care service, or home health agency. Make a capital expenditure of $2.5 million or more in connection with a health service or health facility. Make a capital expenditure of $1.5 million or more by a health care facility or by or on behalf of any private group practice of diagnostic radiology or radiation therapy to acquire major medical equipment.. A single piece of diagnostic or therapeutic equipment which is acquired by lease, purchase, donation, or other comparable arrangement by or on behalf of a physician or group of physicians, or an independent owner or operator of the equipment, and for which the cost or value is in excess of $250,000. Relocate beds from one facility to another. Redistribute the beds of a health care facility by 10 beds or 10 percent, whichever is less, in any two-year period. Offer any health service, which was not offered on a regular basis by the health care facility within the previous 12-month period. Increase the number of renal dialysis stations in a facility, or move stations from one facility to another. Acquire an existing health care facility or major medical equipment by purchase, lease, or other arrangement. Health Maintenance Organizations (HMOs) are exempt from these requirements in many circumstances. Major medical equipment used in certain medical laboratories is also exempt. Details are available from the Project Review Branch. If you have any questions, please contact SHPDA at (202) 442-5875.