Dear CON Family,



I am excited to celebrate our first anniversary of the HFSRB newsletter. As I show up for work every day or as I show up at home, I get caught up in the tasks. What is next on the list to be done? What needs to be done for the next Board meeting?  What projects will be on the agenda? Are the state agency reports complete? Or at home…is the grass mowed? Does my son, Dom, have enough money in his lunch account? What mess did I leave that I now need to address to do my part to keep a clean, orderly home? We all have those issues, those deadlines and projects we are working through, but do we ever slow down to be present? This newsletter helps me to do just that. 

HFSRB aligns with the Illinois Department of Public Health (“IDPH”) through the administrative processes IDPH carries out for the Board and our shared mission of ensuring the public’s health. IDPH is always working on ways to improve its ability to fulfill its role in the health and welfare of the people of Illinois. One recent change was to place several IDPH Boards, including HFSRB, under the Office of the Assistant Director. With that in mind, I would like to take this opportunity to introduce the esteemed Assistant Director of IDPH, Janice Phillips, PhD, RN, CEMP, FADLM, FAAN. In the last six months of getting to know the Assistant Director, I could not find a more caring person. She cares deeply about health care, especially in Illinois. Dr. Phillips truly wants to partner with us and shares the same vision of transparency and open communication, not only with IDPH but with all the stakeholders. Today, we discussed ways to improve collaboration between the HFSRB and the Hospital Licensing Board.

This brings me back to my original thoughts on this newsletter and my comments in the first HFSRB newsletter. HFSRB is a regulatory body. However, it is important to remember that it regulates community health care assets. Providers and their respective trade organizations are valuable partners to HFSRB in ensuring these community health care assets are accessible to all Illinois residents. As I take a moment to reflect and be present, I contemplate how to nurture and protect those community health care assets. I think we do this by partnering with the industry and fostering open communication and transparency.  

As stated in the last quarterly newsletter, 2026 has been an extremely busy year, and 2027 appears to offer much of the same. For starters, we will be having meetings in new locations this coming year. A complete list of locations has not yet been finalized. But we are trying out Illinois State University’s Bone Student Center for the November and December meetings. Please watch our website for finalized locations. The Board is interviewing for a project review manager and a rules reviewer. We are working towards hiring for a compliance coordinator and, given the most recent legislative session, we will be adding a project reviewer and a data position to oversee and manage the legislative initiatives of collecting hospital financial data and oversight of changes of ownership for long-term developmental disability (“DD”) facilities and day training programs. 

As our partners, I welcome your ideas, insights, and experiences. Over the years, this process has evolved to improve outcomes. But we cannot do this alone and hope it continues to work well across the industry. So, thank you, CON family, for your trust and patience. 

For your convenience, I have included a bio for Dr. Janice Phillips. Again, I welcome your thoughts and look forward to continued discussions on moving healthcare for all Illinoisans forward. Let’s plan together.

Sincerely yours,

John P. Kniery

Meet IDPH Assistant Director Dr. Janice Phillips

Janice Phillips, PhD, CENP,FADLN

Assistant Director, Illinois Department of Public Health

Dr. Janice Phillips is an experienced clinician, researcher, educator, nurse regulator, author, and public policy advocate in the health care arena. Janice is the recipient of the Martin Luther King Jr. Humanitarian Award, the University of Illinois College of Nursing SAGE Award, The National Black Nurses’ Association Lifetime Achievement Award, four distinguished alumni awards and others. She is the author of over 150 articles and five co-edited textbooks including the 2021 publication “Health Equity and Nursing: Achieving Equity through Policy, Population Health, and Interprofessional Collaboration.” Her Op-eds have appeared in Scientific American, U.S. News and World Report, the Hill and others.

In 2000, Janice was inducted into the American Academy of Nursing for her distinguished contributions to addressing breast cancer disparities nationally and internationally. Dr. Phillips holds a BSN from North Park College, an MS in Community Health from St. Xavier School of Nursing, and a PhD in Public Health Nursing from the University of Illinois College of Nursing.

On July 10, 2023, Governor Pritzker appointed Dr. Phillips to serve as the Assistant Director of the Illinois Department of Public Health (IDPH) and received Senate confirmation the following year. As Assistant Director, she oversees efforts focused on promoting and protecting the health of Illinoisians and others through numerous programs, policies, and initiatives throughout the state. She has dedicated her career to improving the health and wellbeing of underserved populations.

Highlighted Application Content

Change in the Bed Count of a Health Care Facility

77 IAC 1130.140: Change on the Bed Count of a Health Care Facility



Board rules allow a health care facility to increase its bed/station count without a permit. Some things to know about this process are:

· The maximum number of beds that can be added to a healthcare facility are the lesser of 20 beds or 10% of the overall bed capacity.

· The maximum number of End Stage Renal Dialysis (ESRD) stations that can be added are the lesser of 3 stations or 10% of the overall station count.

·   The maximum station/bed additions are allowed once every two years. The two-year cycle begins once the facility management confirms the prior bed/station additions are licensed and operational, so it’s important to inform the Board of the date when the newly added beds/stations become operational. 

· Facilities can add less than the maximum amount described and add the remaining number of bed/stations to reach the maximum before two year wait period expires. The bed/station additions combined cannot exceed the earlier described maximum amounts.  

· If you have any questions about this process, please feel free to reach out to IHFSRB staff.   

Post-Approval Compliance Checklist

The Permit (or Exemption) is Step One:

Post-Approval Compliance Checklist

Receiving six affirmative votes from the Health Facilities and Services Review Board (“Board” or “HFSRB”) is a critical step for providers hoping to establish a new health care facility or effectuate a change of ownership; it is not, by any means, the end of the permit/exemption holder’s duties.

A Certificate of Need (“CON”) or Certificate of Exemption (“COE”) creates a continuing obligation to comply with the terms and conditions of the approval, all of which are outlined in the Board’s administrative rules.

The following is a “checklist” of some of the key post-approval requirements under 77 Ill. Adm. Code 1130. Please note that it is not a substitute for reviewing the specific requirements attached to your permit or exemption, statutory requirements, or any other rules governing your particular project.

CON PERMIT HOLDERS

Financial Terms and Conditions

·      Identify and note the financial commitment period

·      Will at least 33% of the project costs be committed by the deadline?

·      Will the permit holder need to request an extension of the financial commitment period?

·      Requests for the extension of the financial commitment period and the appropriate fee must be submitted at least 45 days before expiration to avoid any late fees, as outlined in 77 Ill. Adm. Code 1130.720 and 730.

·      Running tab of actual project costs

·      Permit holders should monitor the actual project costs throughout the duration of the project to assist in identifying possible cost overruns as soon as possible

·      Depending on the timing of the cost overruns, a permit holder may need to file an alteration (if the cost overrun does not exceed 10% of the total project cost) or a new CON application (where the cost overrun exceeds 10% of the total project cost).

Scope of the Project

·      Is the project being established/constructed/modified exactly as approved in terms of square footage, site location, services offered, equipment, financing, and/or ownership?

·      Before making any significant changes to the project, consider whether the proposed change will require an alteration under 77 Ill. Adm. Code 1130.750.

·      STOP and ask for guidance from HFSRB staff before making any material changes to an approved project.

Timing and Reporting

·      Is the project on track to be completed by the approved completion date?

·      Evaluate the status of the project well in advance of the approved completion date and act proactively if the permit holder has identified possible delays in completing the project.

·      If a permit holder knows that they will not be able to complete the project by the approved completion date, they must submit a permit renewal request and appropriate fee at least 45 days before the expiration of the CON permit, as outlined in 77 Ill. Adm. Code 1130.740.

·       If the project is expected to take more than 12 months to complete, has the permit holder submitted the required annual progress reports no later than 30 days after the anniversary date of the Board’s approval as required under 77 Ill. Adm. Code 1130.760?

·      If the project is completed, has the permit holder provided the project completion and final realized costs/costs overrun report within 90 days following the project completion date as required by 77 Ill. Adm. Code 1130.770?

NOTE: If a permit holder decides not to continue with an approved project or cannot continue due to material changes that prevent completion, the permit holder has a duty to comply with the permit relinquishment process outlined in 77 Ill. Adm. Code 1130.775.

COE Holders

A COE does not mean that an exemption holder does not have to worry about continuing obligations. Section 1130.570 outlines several requirements governing the validity of an exemption and post-approval reporting obligations.

Exemption holders should first make note of the meaning of the term “completion,” which is defined differently depending on the type of exemption.  

1)  for change of ownership of a health care facility, the date that a new license has been issued (or, if licensing is not applicable, Medicare and/or Medicaid certification has been obtained), or a stock transfer has been accomplished, or a majority change in voting membership or sponsorship of a not-for-profit corporation has been accomplished, or the transfer of assets has occurred, or the merger or consolidation has been accomplished, whichever is applicable;

2) for discontinuations, the date the entire health care facility or category of service ceases operation, such as when the facility stops providing services to patients or surrenders its license to the Department.

COE—Change of Ownership—Key Terms

·      Within 90 days after closing—submit a report stating whether the transaction was completed in accordance with the key terms submitted and approved by the Board.

NOTE: If the key terms of a change of ownership change from the terms approved by the Board, a new COE application is required.

COE—Change of Ownership—Final Transaction Documents

·      Within 90 days after the change of ownership—submit the completion report confirming the change of ownership has been effected.

COE—Discontinuation

·      No later than 90 days after the completion date—submit a report confirming the discontinuation has been effected. 



Rulemaking Updates

On September 2, 2026, HFSRB's rules regarding the Cardiac Catheterization category of service were updated. The changes included revising utilization standards, updating peer review requirements, amending physician referrals, changing the unnecessary duplication of service criterion, and establishing new accreditation standards. In addition, the rules associated with the Organ Transplant and Kidney Transplant categories of service, the Subacute Care Hospital Model, and the Children's Respite Care Center Alternative Health Care Mode were repealed. These rule changes were published in the September 18^th edition of the Illinois Register. To view these changes, go to this website and go to Register Pages 13737 (for Part 1100) and 13763 (for Part 1110): Acj94a - Rules Acted Upon This Issue With Effective Dates.

During the Spring 2026 legislative session, the Illinois General Assembly passed several bills which affect HFSRB, including:

1. Public Act 104-0782 (House Bill 5000) – Amends Section 8.5(a) of the Planning Act; repeals the January 1, 2027, inoperative date affecting a change of ownership among related persons. The Public Act also amends the Illinois Antitrust Act and requires health care entities to notify the Illinois Attorney General within 30 days before a merger or affiliation to include a covered transaction even if the parties to the transaction are not themselves a health care facility or provider organization but own or control, directly or indirectly, one or more of the two or more health care facilities or provider organizations that will be under common ownership or affiliation if the transaction is consummated. The Public Act takes effect on January 1, 2027.

2.  Public Act 104-0661 (House Bill 4728) – Amends the Planning Act by creating a new Section 5.7. This new Section requires HFSRB to regulate ownership changes and disclosures from:

a.  Adult developmental training services;

b.  Community Living Facilities;

c. Facilities licensed under the Medically Complex / Developmentally Disabled Facilities Act;

d.  Facilities licensed under the Intellectual Disabilities / Developmentally Disabilities Act;

e.  Community Developmental Service Agencies; and

f.  Institutions and Group Homes for children.

This Public Act takes effect on July 1, 2027.

3.  Public Act 104-0557 (House Bill 4757) – Amends Sections 5, 6.2, 8.5, 8.7, and 13 of the Planning Act.

a.  Section 5 – Language is revised to state: “A permit shall be valid only for the defined construction or modifications, site determined by legal street address or corresponding legal description, project amount, and person or persons names in the application for such permit.

b.  Section 6.2(c) – Notice of a public hearing shall be made no less than 10 business days before the hearing, by certified mail to the applicant, and not less than 10 business days before the hearing, by publication on the State Board’s website, in the principal office and website (if available) of the local government in the area or community to be affected, and at the location where the hearing will be held. A publication in a newspaper is no longer required.

c.  Section 8.5 – When an application for an exemption for a change of ownership of a health care facility or discontinuation of a category of service is deemed complete, State Board staff will post a notice on the State Board’s website and in the principal office and website (if available) of the local government in the area or community to be affected and afford the public an opportunity for a public hearing. A publication in a newspaper is no longer required.

d.  Section 8.7(e) – An application for permit is required for the discontinuation of a hospital regardless of whether the hospital is licensed independently or licensed under a dual campus license.

This Public Act takes effect on January 1, 2027.

4.  Public Act 104-0470 (Senate Bill 3365)

a.  Section 13(b)(1) of the Planning Act is amended and requires hospitals to report the following financial and utilization data annually to the State Board:

i)  Most recent audited financial statements;

ii)  Most recent month-end balance sheet detailing assets, liabilities, and net worth at the end of the month immediately preceding the annual reporting cycle;

iii)  Most recent income statement for the month immediately preceding the annual reporting cycle summarizing the revenues, expenses, and net income;

iv)  Total number of inpatient days, outpatient visits, and discharges by payer, including but not limited to, Medicare, Medicaid fee-for-service, Medicaid managed care, commercial coverage, and other payers;

v)  Total inpatient gross revenues by payer, including, but not limited to, Medicare, Medicaid fee-for-service, Medicaid managed care, commercial coverage, and other payers; and

vi)  Total outpatient gross revenues by payer, including, but not limited to, Medicare, Medicaid fee-for-service, Medicaid managed care, commercial coverage, and other payers.

vii) Submission of financial and utilization data is due to the State Board 90 days after the effective date of this Public Act and thereafter, the data shall be due annually on the regular schedule set by the State Board for questionnaires.

viii) If a hospital does not file the required data within 90 days after the close of the annual reporting period, the State Board shall fine the hospital not more than $5,000 per week for failure to comply.

b.  Section 13(b)(2)(A) of the Planning Act is amended to state that the State Board shall keep confidential all data submitted under this Section.

This Public Act took effect on June 16, 2026. However, the requirements for HFSRB take effect on January 1, 2027.

Data Update: 2025 ASTC and ESRD Profiles

I am pleased to announce that the 2025 Ambulatory Surgical Treatment Center (ASTC) and End-Stage Renal Disease (ESRD) Profiles are now available on our Inventories & Data page: https://hfsrb.illinois.gov/inventories-data.html. They cover every facility that submitted a 2025 annual survey, with information on services, utilization, patient volumes, payer mix, finances and staffing. The Long-Term Care profiles are complete and will be posted after the Board approves them.

ASTC results show continued growth in outpatient surgery. Operating-room cases rose about 6.5% and patients served rose about 8%, led by orthopedics, podiatry and pain management. This growth matches the shift in surgical volume away from hospitals that the hospital profiles showed.

ESRD results show steady capacity but softer demand. Certified dialysis stations held flat statewide, while in-center treatments and new dialysis patients both declined.

I hope these profiles make Illinois facility data easier to understand and more useful for health planning, policy development and informed decision-making.

Kenton Tilford

HFSRB Data Manager

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