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50-State Regulatory Atlas Data and maps Certificate of need: hospice

Licensing · Map layer

States confirmed to require a certificate of need for hospice (2026)

3 states are confirmed to require a certificate of need for hospice (2 verified, 1 provisional); 48 are not confirmed.

Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.

States confirmed to require a certificate of need for hospice (2026)
  • Required 3
  • Not confirmed 48
Question
Does the state require a certificate of need before a hospice opens?
Service category
Hospice
Jurisdictions
50 states and DC
Population
New hospices
Effective
Varies by state; see each finding
As of
2026-10-17
Last verified
October 17, 2026
Methodology
Only states whose hospice certificate-of-need program was confirmed in a source are marked. No authoritative current national list was found, so every other state is “not confirmed”, not “no”.

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Every state

StateAnswerValueVerification
AlabamaUnresolvedNot confirmed
AlaskaUnresolvedNot confirmed
ArizonaUnresolvedNot confirmed
ArkansasUnresolvedNot confirmed
CaliforniaUnresolvedNot confirmed
ColoradoUnresolvedNot confirmed
ConnecticutUnresolvedNot confirmed
DelawareUnresolvedNot confirmed
District of ColumbiaUnresolvedNot confirmed
FloridaYesThe Agency for Health Care Administration runs hospice need determinations and certificate-of-need awards; the source found is a news report.Provisional
GeorgiaUnresolvedNot confirmed
HawaiiUnresolvedNot confirmed
IdahoUnresolvedNot confirmed
IllinoisUnresolvedNot confirmed
IndianaUnresolvedNot confirmed
IowaUnresolvedNot confirmed
KansasUnresolvedNot confirmed
KentuckyUnresolvedNot confirmed
LouisianaUnresolvedNot confirmed
MaineUnresolvedNot confirmed
MarylandUnresolvedNot confirmed
MassachusettsUnresolvedNot confirmed
MichiganUnresolvedNot confirmed
MinnesotaUnresolvedNot confirmed
MississippiUnresolvedNot confirmed
MissouriUnresolvedNot confirmed
MontanaUnresolvedNot confirmed
NebraskaUnresolvedNot confirmed
NevadaUnresolvedNot confirmed
New HampshireUnresolvedNot confirmed
New JerseyUnresolvedNot confirmed
New MexicoUnresolvedNot confirmed
New YorkUnresolvedNot confirmed
North CarolinaYesNorth Carolina’s State Medical Facilities Plan sets need determinations for hospice home-care offices and inpatient beds (Tables 13G and 13H).Verified
North DakotaUnresolvedNot confirmed
OhioUnresolvedNot confirmed
OklahomaUnresolvedNot confirmed
OregonUnresolvedNot confirmed
PennsylvaniaUnresolvedNot confirmed
Rhode IslandUnresolvedNot confirmed
South CarolinaUnresolvedNot confirmed
South DakotaUnresolvedNot confirmed
TennesseeYesHospice certificate-of-need applications are filed with the Health Facilities Commission under its hospice and residential-hospice standards.Verified
TexasUnresolvedNot confirmed
UtahUnresolvedNot confirmed
VermontUnresolvedNot confirmed
VirginiaUnresolvedNot confirmed
WashingtonUnresolvedNot confirmed
West VirginiaUnresolvedNot confirmed
WisconsinUnresolvedNot confirmed
WyomingUnresolvedNot confirmed

Answer and verification are separate: “Unresolved” or “Not confirmed” means the research could not settle the question, never “no”. Editorial policy.

Published by Paloma Health Technologies Research Desk · Editorial leadership: Nick, RN, BSN · Last source verification: October 17, 2026 · View editorial methodology · Report a correction

Last reviewed: Oct 17, 2026Official source linksBuilt for all 50 statesEditorial policy