Healthcare Oversight

Certificate of Need

In Maine, Certificate of Need (CON) is a regulatory program authorized by 22 MRSA Chapter 103-A (PDF) requiring certain types of healthcare providers to obtain state approval prior to making major changes in the healthcare landscape.  Changes include:

  • Mergers/acquisitions
  • New facilities/services
  • Substantial capital investments in new equipment or facilities
  • Changing access to services
  • Increases in bed complement

CON Reviews are published each year on our website.


Some actions require CON review if they cost more than a threshold amount. Many of these thresholds (PDF) are indexed each year for inflation.

How to Apply

A letter of intent describing the project and its costs must be sent to the Certificate of Need program at least 30 days before sending in an application. Instructions for writing a letter of intent can be found in the applicable facility rules:


Prior Approval for Residential Care Facilities

In Maine, certain Residential Care Facility projects, including improvements, changes of ownership, or new facilities require prior approval. Facilities looking to acquire nursing home beds for residential care should review sections 333-A and 334-A of the Certificate of Need statute (PDF). Required prior approvals are outlined in the Principles of Reimbursement – 10-144 CMR Ch. 115 (Word).

Continuing Care Retirement Communities (CCRC)

A Continuing Care Retirement Community is an approved Bureau of Insurance (BOI) Certificate of Authority program. The Healthcare Oversight program provides certain assurances to the BOI in order for a certificate to be granted.

Information regarding DHHS’s role in the process can be found at the following links:

Hospital Cooperation Act (HCA) (REPEALED April 24, 2023)

In Maine, Certificate of Public Advantage is a regulatory program authorized by the Hospital and Health Care Provider Cooperation Act -  22 MRSA Chapter 405-A allows hospitals to enter into cooperative agreements in cases where such action might normally not be allowed under anti-trust laws.