Hospital Permission Slips
Freedom#52 of 109 · Added August 27, 2026States requiring a certificate of need to add health care capacity
Thirty-eight states make you prove a hospital bed is needed before anyone is allowed to build one. New Hampshire threw out the permission slip.
Certificate-of-need requirements for health care facilities (state CON program status)
View the data (50 states)
| # | State | Value |
|---|---|---|
| 1 | Alabama | CON program |
| 2 | Alaska | CON program |
| 3 | Arkansas | CON program |
| 4 | Connecticut | CON program |
| 5 | Delaware | CON program |
| 6 | Florida | CON program |
| 7 | Georgia | CON program |
| 8 | Hawaii | CON program |
| 9 | Illinois | CON program |
| 10 | Indiana | CON program |
| 11 | Iowa | CON program |
| 12 | Kentucky | CON program |
| 13 | Maine | CON program |
| 14 | Maryland | CON program |
| 15 | Massachusetts | CON program |
| 16 | Michigan | CON program |
| 17 | Mississippi | CON program |
| 18 | Missouri | CON program |
| 19 | Montana | CON program |
| 20 | Nebraska | CON program |
| 21 | Nevada | CON program |
| 22 | New Jersey | CON program |
| 23 | New York | CON program |
| 24 | North Carolina | CON program |
| 25 | Ohio | CON program |
| 26 | Oklahoma | CON program |
| 27 | Oregon | CON program |
| 28 | Rhode Island | CON program |
| 29 | South Carolina | CON program |
| 30 | Tennessee | CON program |
| 31 | Vermont | CON program |
| 32 | Virginia | CON program |
| 33 | Washington | CON program |
| 34 | West Virginia | CON program |
| 35 | California | No CON program |
| 36 | Colorado | No CON program |
| 37 | Idaho | No CON program |
| 38 | Kansas | No CON program |
| 39 | New Hampshire | No CON program |
| 40 | New Mexico | No CON program |
| 41 | North Dakota | No CON program |
| 42 | Pennsylvania | No CON program |
| 43 | South Dakota | No CON program |
| 44 | Texas | No CON program |
| 45 | Utah | No CON program |
| 46 | Wyoming | No CON program |
| 47 | Arizona | Limited review only |
| 48 | Louisiana | Limited review only |
| 49 | Minnesota | Limited review only |
| 50 | Wisconsin | Limited review only |