Certificate of Need (CON) Program

• Applicant: Greater Regional Health
  Project:  Purchas DaVinci Robotic Surgical System
  Received: October 28, 2025
  City: Creston | County: Union
  Estimated Cost: $2,800,000
• Applicant: Southeast Iowa Regional Medical Center 
  Project:  Add 5 acute care beds to increase acute care beds from 263 to 268. 
  Received: October 2, 2025
  City: West Burlington | County: Des Moines
  Estimated Cost: $0
• Applicant: Hegg Memorial Hospital
  Project:  Add MRI unit and acquire MRI equipment 
  Received: July 29, 2025
  City: Rock Valley | County: Sioux
  Estimated Cost: $2,850,000
• Applicant: Cardiology Consultants
  Project: Establish cardiac catheterization service
  Received: Feb. 5, 2025
  City: Clinton | County: Clinton
  Estimated Cost: $3,350,000

• Applicant: Clear Lake Surgical Center
  Project:  Establish an ambulatory surgical center 
  Received: October 10, 2025
  City: Clear Lake | County: Cerro Gordo
  Estimated Cost: $6,600,000
• Application

• Applicant: Southeast Iowa Behavioral Healthcare Center (SIBHC)
  Project:  Convert 16 existing intermediate care facilities (ICF) / for person with mental illness(PMI) beds to nursing facility beds.
  Received: August 27, 2025
  City: Keokuk| County: Lee
  Decision Issued: October 20, 2025
• Applicant: Sioux Center Health
  Project:  Purchase of Equipment DaVinci Xi Robot Surgery System
  Received: September 25, 2025
  City: Sioux City | County: Sioux County
  Decision Issued: October 20, 2025
• Applicant: Southeast Iowa Regional Medical Center
  Project:  Purchase Di Vinci Surgical Robot
  Received: August 6, 2025
  City: West Burlington | County: Des Moines
  Decision Issued: September 24, 2025
• Applicant: St. Anthony Regional Hospital 
  Project:  Purchase and Installation of a Fixed PET/CT Scanner 
  Received: August 21, 2025
  City: Carrol | County: Carroll
  Decision Issued: September 24, 2025
• Applicant: Winneshiek County Medical Hospital d/b/a WinnMed
  Project: Purchase Di Vinci Surgical Robot
  Received: July 15, 2025
  City: Decorah | County: Winneshiek
  Decision Issued: September 4, 2025
• Applicant: Orange City Area Health System
  Project: Purchase Di Vinci Surgical Robot
  Received: July 19, 2025
  City: Orange City | County: Sioux 
  Decision Issued: September 4, 2025
• Applicant: Surgical Partners of Iowa
  Application Received: March 12, 2025
  Project: Establish an ambulatory surgical center and clinic
  City: Urbandale | County: Dallas
  Decision Issued: August 15, 2025
• Applicant: Northwest Iowa Ambulatory Surgery Center (NW ASC)
  Application Received: March 12, 2025
  Project: Establish an ambulatory surgical center
  City: Orange City | County: Sioux
  Decision Issued: June 23, 2025  Rehearing Decision Issued: September 4, 2025
• Applicant: UnityPoint Health, Iowa Methodist Medical Center 
  Application Received: March 12, 2025
  Project: Acquisition of Equipment DaVinci Xi Robot Surgery System 
  City: Des Moines | County: Polk
  Decision Issued: June 23, 2025
• Applicant: UnityPoint Health, Trinity Regional Medical Center
  Application Received: March 12, 2025
  Project: Acquisition of Equipment DaVinci Xi Robot Surgery System
  City: Fort Dodge | County: Webster
  Decision Issued: June 23, 2025
• Applicant: CCRC of Tiffin, LLC
  Application Received: May 18, 2023
  Project: 40 Bed Nursing Facility
  City: Tiffin | County: Johnson
  Extension Issued: June 23, 2025
• Applicant: UnityPoint Health, Waterloo Allen Hospital
  Application Received: July 17, 2024
  Project: Allen Project Third Cardiac Catheterization Lab
  City: Waterloo | County: Black Hawk
  Extension Issued: June 23, 2025
• Applicant: Oaknoll Retirement Residence
  Application Received: March 11, 2024
  Project: Addition of 12 Licensed Nursing Beds
  City: Iowa City | County: Johnson
  Extension Issued: June 23, 2025

1. Before applying for a certificate of need (CON), the sponsor of a proposed new institutional service or changed institutional health service shall submit to HHS, a letter of intent to offer or develop a service requiring a certificate of need.
2. Letters of intent must be submitted to the department not less than 30 days prior to the submission of an application for a CON.
3. The Department of Inspections, Appeals, and Licensing's (DIAL) Health and Safety Division reviews and approves all facility bed increases prior to issuing a new or amended license.  If you will be submitting a CON application for a facility that will have a nursing facility or hospital license, notification to the department at the time the letter of intent is filed is highly recommended. Contact the DIAL Health and Safety Division for more information. In addition, nursing home beds have to be approved for compliance by the State Fire Marshal’s Office. Please contact them in advance of submitting your application to describe your project.
4. Letters of intent should be submitted as soon as possible after initiation of the planning process and before substantial expenditures are made.
5. Letters of intent shall include the following information:
   1. A brief description of the proposed project, including facility name and sponsor;
   2. The project’s location, including county; and
   3. The project’s estimated cost (site costs, land improvements, facility costs, and movable equipment).

Note: A CON application may not be accepted if the information contained in the application materially differs from the information provided in the letter of intent (i.e., facility name; sponsor; capital expenditure; and location, including county).

6. Letters of intent are valid for one year from the date they are received by the department. The sponsor may renew the validity of a letter of intent by providing written notification to the department prior to the one-year expiration date.
7. Submit letters of intent
8. Upon receipt of a letter of intent the department will issue a letter of response. Please keep this letter for further reference.
9. A list of active letters of intent is posted on the CON website.
10. For more information contact CON staff.

PLEASE READ PRIOR TO COMPLETING AN APPLICATION

Reviewability Determination

If the reviewability of a project is in question a Reviewability Determination may be requested prior to the submission of an application. See IAC 481—2202.3 for more information and/or contact CON staff at CertificateOfNeed@hhs.iowa.gov.

NOTE: If a Reviewability Determination results in having to file a CON application, the applicant may apply as soon as they receive the determination. 

Moratorium on new Nursing Facilities

As of July 1, 2023, there is a moratorium on new nursing facility beds until June 30, 2026. [Iowa Code Chapter 135C.35A].  If a nursing facility would like to seek a waiver from the moratorium they must submit a request to the CON staff at CertificateOfNeed@hhs.iowa.gov.

NOTE: If a Moratorium request results in an approval, the applicant may apply as soon as they receive the approval. 

Guidelines on How to Apply for Certificate of Need

1. Prior to completing an application, review Iowa Code sections 10A.711 - 729 and Iowa Administrative Code (IAC) 481—chapters 2202 and 2203. These materials will provide information about Certificate of Need (“CON”) and the application process.
2. The applicant will file an electronic copy of the entire application (including any attachments). Certificate of Need Application Form
3. Once the application is submitted the applicant will receive information on how to electronically pay the appropriate CON filing fee, per section Iowa Code section 135.63.  

PLEASE NOTE: ICF/ID’s and ICF/PMI’s are exempt from the CON filing fee.

4. CON staff will review the application for completeness upon receipt. Within fourteen (14) days of acceptance, the application will be deemed complete, or a request for additional information will be issued.
5. If a request for additional information is issued, responses to the questions must be made in writing and delivered electronically to CertificateOfNeed@hhs.iowa.gov.
6. Affected party letters in support or opposition can be submitted to the applicant or to CertificateOfNeed@hhs.iowa.gov.
7. An applicant may withdraw its application at any time without prejudice. Application fees are subject to refund based on the schedule listed in IAC 481— 2202.4(2)(b). It is the responsibility of the applicant to notify CON staff regarding whom the refund check should be made to and where it should be sent.
8. The application, other materials in the project file and any evidence offered at the public hearing are considered public record and are available for public inspection, copying, and disclosure under Iowa Open Records Law – Iowa Code Chapter 22.

An affected party may submit a letter of support or opposition to a specific project, appear at the public hearing to provide oral testimony either in support or opposition, or both. An affected party is not required to submit written testimony in order to appear as an affected party at the public hearing. Neutral letters can also be provided.  Public hearings can be found on the Public Meetings Calendar.

Iowa Code section 10A.711

Iowa Administrative Code (IAC) 481—2202.1.

NOTE: Any dissatisfied party who is an affected person with respect to the application, may request a rehearing in accordance with Iowa Code chapter 17A and rules of the department. If a rehearing is not requested or an affected party remains dissatisfied after the request for rehearing, an appeal may be taken in the manner provided by Iowa Code chapter 17A. 

Letter of Intent

Reviewability Determination

Certificate of Need Application Form

Certificate of Need Bed Utilization Statistics Form

6-Month Progress Report

Extension Request

Additional Forms

Reduction in Bed Capacity

Deletion of Health Service

Closure of Health Facility

Redistribution of Beds