CON Review Process: How It Works

When a health care provider applies for a Certificate of Need in South Carolina, DHEC staff members evaluate applications by looking at many factors.

We look to see how the project would align with the needs of residents and geographic gaps in medical services identified in the South Carolina Health Plan. The plan, updated every two years, analyzes demographic information, projected population growth and current use of medical services in each part of the state. It uses the information to identify current and future gaps in medical care. It effectively serves as our blueprint to guide our agency's healthcare planning decisions.

This approach has resulted in the location of a nursing home in every county in South Carolina, the availability of home health services in every county in the state, and the provision or expansion of renal dialysis services to most rural counties
We determine whether the proposed project will duplicate existing services and whether there is an adequate need for the service in the area. If two (or more) proposed projects are competing to establish a particular service in an area, and we determine that approving both would create a supply that surpasses the need for this service, we will not approve more than one applicant.
We look at the total cost of the project and the expected patient charges after the project is complete. We determine whether the costs for the project are reasonable. If we approve the project and the healthcare facility exceeds the total cost submitted, we can take enforcement action. This encourages facilities to submit projects that are reasonable in cost, monitor those costs as the project proceeds, and ensure that the project is completed within budget.

For questions regarding the Certificate of Need process and program, please contact us at (803) 545-4200.