Certificate of Need Consulting
A Certificate of Need (CON) is a state approval a healthcare provider must obtain before building a facility, adding beds, buying major equipment, or launching certain services. PDA prepares, submits, and defends CON applications — with a 350+ application track record and an 87% approval rate across ten states.
- 350+Applications submitted
- 87%Approval rate
- $1B+Project value represented
- 10States of experience
What's included
Every filing is built on original market and financial analysis — sized to the review criteria, and structured to hold up under public comment and legal challenge.
- Application strategy & pre-filing feasibility — service definition, batch positioning, gap analysis against the State Medical Facilities Plan.
- Market & demographic forecasts — GIS mapping, service-area definition, utilization projections tuned to state methodology.
- Financial forecasting — pro forma modeling, payer mix, sensitivity analysis, and capital-cost validation.
- Competitive analysis & public-support strategy — anticipating opposition, mobilizing community and stakeholder testimony.
- State health plan petitions — reshaping the batch you'll file into by petitioning for need-determination changes.
- Contested-case & litigation support — expert testimony, cross-examination preparation, appellate analysis.
How we approach a CON
Winning CONs are not written — they're engineered. We start by mapping the state's methodology and the competitive field, then build the evidentiary record backward from what the agency and, if needed, an Administrative Law Judge will need to affirm the decision.
We work as an integrated team with counsel from day one. Where litigation is likely, our analytical choices are made with cross-examination in mind — every assumption footnoted, every model reproducible, every conclusion defensible.
Who it's for
Our CON clients include hospitals and health systems, ambulatory surgery operators, imaging providers, skilled-nursing and post-acute operators, and behavioral health providers.
We also advise state agencies on need methodology and program design — the other side of the same regulatory table. See our government and public-sector practice.
Where we work
Our CON practice spans North Carolina, Connecticut, Delaware, Florida, Georgia, Maryland, Oregon, South Carolina, Utah, and West Virginia.
See the CON states overview for state-by-state guidance, or start with the primer: What is a Certificate of Need?
Frequently asked questions
What is a Certificate of Need?
- A Certificate of Need (CON) is a state approval a healthcare organization must obtain before certain projects — building or expanding a facility, adding beds, acquiring major medical equipment, or offering new services. It requires proving the project is needed in the community.
Which states require a Certificate of Need?
- Roughly three dozen states and Washington, D.C., maintain some form of CON program, though requirements vary widely and change over time. PDA has prepared applications in North Carolina, Connecticut, Delaware, Florida, Georgia, Maryland, Oregon, South Carolina, Utah, and West Virginia. [VERIFY current state list before publishing.]
What is PDA's CON approval rate?
- 87% across 350+ applications representing more than $1 billion in project value.
How long does the CON process take?
- It varies by state and project, typically several months to over a year including review, public comment, and any appeals. [VERIFY per state.]
What goes into a CON application?
- Typically a demonstration of community need, market and demographic analysis, financial forecasts, competitive analysis, and alignment with the state health plan — plus a strategy to withstand comment and competing applications.
Can PDA help if our application is challenged?
- Yes. We provide litigation support and expert analysis for contested and competing CON cases.
Turn a complex healthcare challenge into a clear plan.
Whether you're weighing a new service line, preparing a Certificate of Need, planning a facility investment, or aligning leadership on direction — we can help you see the path forward.
Schedule a consultation