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IN THIS ISSUE:
Letter from the Administrator | Part 1130 Updates | Data Updates | Application Checklist | Upcoming Board Meetings & Deadlines
| | Letter from the Administrator | | |
Dear CON Family,
How about this, the first ever HFSRB newsletter! A special thanks to our intern Carmen Chastain for making our General Counsel’s vision a reality!
I hope you all have been able to enjoy your summer and, most recently, the July 4th holiday. Unlike our grammar school days when we enjoyed a time off from school to play and relax, as working adults, summer is actually a time of growth—both professionally and personally. Toss in the celebration of our country’s independence, and it’s a season of renewed dedication to our core and founding principles.
In my short time as Board Administrator, my focus has been “Back to the Basics”: Getting back to justifying “need,” back to “providing said documentation,”; and plainly, getting back to planning!
To this end, we are reviewing all our rules and the Health Facilities Planning Act. As highlighted below, we have completed rulemaking to establish birth centers, update our definitions, modernize allowable alteration for post-permit cost increases (increase from 7% to 10%), and adjust our fees due to inflationary pressures. We are actively drafting rules for cardiac cauterizations, small format/neighborhood hospitals, and issues relating to exemption applications.
As most of you know, I am in my third year as administrator of the Health Facilities and Services Review Board (HFSRB), but I’m not "new" to the CON process or HFSRB. I have been practicing as a CON consultant since February 1997. Over the last 28 years, I have cultivated a philosophy of adherence to rules and process, without losing sight of real-world market pressures. In practice, this philosophy aims to make the regulatory process as close to real market situations as possible, while promoting access to services, as well as, planning and development principles. So, as we look at our rules and updates, my focus is on how to guide this regulatory process, a process that is needed to ensure orderly and essential healthcare services are developed, safety net providers are maintained, and the underserved, underinsured, or uninsured have access to quality care. I believe all this can be accomplished while allowing the healthcare industry to be nimble enough to adjust to industry changes, promote innovation, and balance accessibility with sustainability.
This is a delicate dance. However, I am confident your HFSRB staff understands and remains focused on developing this vision further. But this is not all on the HFSRB and its staff. We need you and the healthcare industry as partners! We need our application and documentation to get back to the essence of our process… Planning! To this end, HFSRB staff has been reaching out to the associations and industry representatives to be our partners in the evaluation and re-imagination of this process, its rules, and most importantly, its substance. I invite you to collaborate with us in growth and renewed dedication to our core principles... Let’s plan together.
Sincerely yours,
John P. Kniery
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HFSRB staff is pleased to announce the adoption of newly revised rules that took effect on July 1, 2025. The revised rules streamline several processes and include modifications to certain aspects of application review procedures, as well as a revised fee structure designed to better align with current operational needs. The revisions reflect HFSRB and its staff’s commitment to promoting transparency, reducing administrative burden, and supporting the timely development of essential healthcare facilities across the State of Illinois.
We encourage everyone to review the detailed changes outlined here (Changes to 1130) and contact our office with any questions regarding implementation.
These changes include:
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New definitions: Business day, Calendar day, Completion or Project Completion, Exemption Holder, Financial Commitment Date, Initiation of a Category of Service, Permit Holder, Post-permit or Post-permit Period, Stay or Stayed, and Vice Chairman.
Revised definitions: Capital Expenditure, Capital Expenditure Minimum, Category of Service, Change of Ownership Among Related Persons, Charity Care, Financial Commitment, Major Medical Equipment, Newspaper of Limited Circulation, Non-clinical Service Area, Out-of-State Facility, Person, State Board Staff Report, and Site.
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Exemption Applications
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$5,000 for an exemption (other than an exemption for a change of ownership).
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$5,000 for an exemption for a change of ownership between related persons.
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For an exemption for a change of ownership, the fee is the greater of $5,000 or 0.22% of the fair market value of the transaction. Fee shall not exceed $150,000.
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CON Applications
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Initial fee of $5,000 must accompany the application.
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After the total project cost is determined, the balance of the fee is calculated as follows:
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Cost less than $2,250,000, the fee is $5,000.
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Cost at or above $2,250,000, the fee is 0.22% of the total project cost. Fee shall not exceed $150,000.
- If an application is modified and the modification results in an increase in the project cost, the fee is recalculated. If the modification results in another Notification of Opportunity for Public Hearing, an additional fee of $4,000 will be assessed.
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Extension of Financial Commitment
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Extension request must be submitted at least 45 days before the financial commitment date and are assessed a fee of $1,000. A request received less than 45 days prior to the financial commitment date is assessed an additional fee of $500.
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Permit Renewal
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A renewal shall be submitted at least 45 days prior to the project completion date and are assessed a fee of $1,000. A renewal received less than 45 days prior to the project completion date will be assessed an additional fee of $500.
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Permit Alteration
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An alteration request shall be submitted at least 45 days prior to the project completion date. The fee is as follows:
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The alteration does not increase the project cost; the fee is $1,000.
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An alteration that increases the project cost; fee is the greater of $1,000 or 0.22% of the increase in the project cost. The fee shall not exceed $50,000.
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An alteration request received less than 45 days prior to the project completion date, a $500 late fee is assessed.
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2024 Year-End Summary: Healthcare System Performance
Key Highlights
Volume Growth Continues: The healthcare system saw solid expansion in 2024, with inpatient days up 3.5% and outpatient visits growing 3.0%. This growth occurred alongside a 1.7% increase in births, indicating sustained community health needs.
Critical Care Demand Surges: ICU utilization jumped significantly, with patient days up 8% and occupancy rising 4.5 percentage points to 68.9%. This reflects both population aging and more complex case mix.
Outpatient Revenue Outpaces Inpatient: While inpatient revenue grew 2.7%, outpatient revenue expanded 4.4% to $28.93 billion, reinforcing the continued shift toward ambulatory care.
Bright Spots
Cardiac Services Excel: Cardiac catheterization procedures grew 9% and cardiac surgery cases increased 12%, while lung transplants tripled year-over-year.
Operational Efficiency: Average length of stay decreased 0.2 days system-wide, and maternal services achieved higher births despite fewer birthing rooms, indicating improved productivity.
2025 Strategic Priorities
As we deal with shocks due to federal funding changes, we should keep a close eye on rural hospitals and try to ensure we’re giving them the help they need to stay competitive in an increasingly challenging marketplace
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We will explore ESRD and ASTC facilities for 2024 at the August 12th Board Meeting.
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Before you submit your applications for review, ensure that the following items are addressed:
□ Completion date
□ All applicants are identified
□ Correct number of beds, stations, and surgical specialties
□ All pages numbered
□ Completed project "Cost and Sources of Funds" page
□ The correct address of the licensed facility
□ Ensure Applicants are compliant with reporting requirements for APORS (Adverse Pregnancy Outcome Reporting System), the ISCR (Illinois State Cancer Registry), and HFSRB's hospital and long-term care questionnaires.
Reminder: The submission of additional information during the review period may result in an extension of the review process and/or a change in the date on which the Board considers your proposed project. (See 77 III. Adm. Code 1130.640).
| | Upcoming Meetings and Deadlines | |
August 12, 2025
- Embassy Suites Peoria
- Public Comment Deadline: July 29, 2025
September 25, 2025
- Bolingbrook Golf Club
- Public Comment Deadline: September 15, 2025
November 18, 2025
- Bolingbrook Golf Club
- Public Comment Deadline: November 4, 2025
- 60-Day Deadline: September 4, 2025
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All correspondence must be received through HFSRB’s official email address (dph.hfsrb@illinois.gov). Correspondence submitted through other emails will not be considered received and will not be processed or reviewed.
Applications for Certificate of Need permits, Certificate of Exemptions, and requests for Extension of Financial Commitment, Permit Renewal, and Permit Alteration can be submitted via dph.hfsrb@illinois.gov.
In lieu of this process, applications and requests can be submitted to HFSRB’s principal office: 525 West Jefferson Street, 2nd Floor, Springfield, Illinois 62761. At this time, all fees associated with the above-referenced applications and requests must be mailed to HFSRB's principal office in Springfield.
HFSRB will take no action on any request that requires a fee until the fee payment is received at HFSRB’s principal office.
Any written public comments regarding a proposed project must be received by HFSRB staff at least (twenty) 20 days PRIOR TO the meeting at which the proposed project is scheduled for consideration.
Written comments may be submitted via email at DPH.HFSRB@illinois.gov or by mailing them to:
Illinois Health Facilities & Services Review Board
525 W. Jefferson St., 2nd Floor
Springfield, IL 62761
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For information on the deadlines associated with pending projects, please make sure to check out the "Project Search" tab on the HFSRB website by clicking here
Access information about the Certificate of Need process and Application materials by clicking here
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