Ambulatory Surgery CON application form - Revised April 2024

• pdf Version (April 2024)
• Word Version (April 2024) - Word Document
• Surgery standards guidance (March 2023)

Comprehensive Care (Nursing Home) and Extended Care Application for CON, Revised January 2024

• pdf Version (January 2024)
• Word Version (January 2024)
• Required Tables Package (Revised 5/1/17)

Home Health Application for CON - Revised July 2024

 Documentation of Applicant's Qualifications

• CON Review Stardards for Home Health Agency Services - How to Satisfy (2022)
• Qualifying Document - Maryland Home Health Agency, Hospital or Nursing Home (2022)
• Qualifying Document - Existing Medicare Certified Home Health Agency another State (2022)
• Qualifying Document - Residential Service Agency Providing Skilled Nursing Services (2022)

      Home Health CON Application Forms (MHCC is not currently accepting Home Health Applications)

• pdf version (Revised (7/10/24)
• Word Version (Revised 7/10/24)

Hospital/Acute Care Application for CON, revised July 2024

Please note that the application is posted in two parts, an application form and a set of required tables 

• pdf Version of application form (Revised 7/11/24)
• Word Version of application form (Revised 7/11/24) 
• Required Tables Package (Revised 5/1/17)

Hospice Application for CON

• pdf Version (Revised 7/10/24)
• Word Version (Revised 7/10/24)

CON application form for Alcoholism and Drug Abuse Intermediate Care Facility Treatment Services

• pdf Version (July 2024)
• Word Version (July 2024)
• Table Package (4/25/18) 
• ICF Standards Guildance 

CON application form for projects other than hospital, comprehensive care facility, home health, ambulatory surgery, drug/alcohol and hospice

• pdf Version (Revised 7/11/24)
• Word Version (Revised 7/11/24) 

 Application for Certificate of Conformance - Primary and Elective Percutaneous Coronary Intervention

• pdf Version (updated 10/14/15)
• Word Version (updated 10/14/15)