Hospital
The Maryland Health Care Commission (MHCC) regulates hospital services in Maryland to support accessible, high-quality, and cost-effective care across acute, surgical, obstetrical, psychiatric, rehabilitation, chronic, organ transplant services, and other specialized services. This page provides an overview of how hospital services are regulated, along with access to facility data, reports, and information on Certificate of Need and related regulatory processes.
State Health Plan
View COMAR 10.24.08-21 for the State Health Plan for hospital services across specialties.
About Hospitals in Maryland
Hospitals in Maryland provide a broad range of services, including acute care, general surgical services, inpatient obstetrical services, organ transplantation, psychiatric care, rehabilitation, chronic and other specialized services. These services are typically delivered within licensed general hospitals or specialty hospitals and are designed to meet varying levels of patient need across the continuum of care.
The Maryland Health Care Commission (MHCC) regulates hospital services through the Certificate of Need (CON) program, which applies to the establishment of new hospitals, the expansion or relocation of hospital facilities, and the introduction of certain new or specialized services (e.g., obstetrics, organ transplant programs, or psychiatric services). Through the CON process, MHCC evaluates whether proposed hospital projects are consistent with the State Health Plan, demonstrate population-based need, are cost-effective, and whether or not they will result in unnecessary duplication of services.
These regulatory activities support MHCC’s core mission to ensure that health care services are accessible, high-quality, and cost-effective for Maryland residents. By overseeing the development and distribution of hospital services, MHCC promotes an efficient health care delivery system, aligns resources with community needs, and helps control overall health care costs while maintaining appropriate access to essential and specialized services.
Quick Facts: Hospitals
Maryland hospitals provide acute care, surgical, obstetrical, psychiatric, rehabilitation, chronic, and organ transplant services across licensed general and specialty hospitals.
Establishing, relocating, or expanding bed capacity
- Requires Certificate of Need (CON) review
Adding specialized services
- Requires CON review for services such as obstetrics, organ transplant, and psychiatric care
Change of ownership
- Notice of Acquisition required; CON review not typically required
Facility Data and Reports
Quality & Performance
Access information on the quality and performance of hospitals in Maryland.
Facility Data
Request public use files containing inventory and utilization information on hospitals in Maryland.
Reports
Browse staff reports and recommendations on hospital services in Maryland, prepared by the Commission in accordance with the State Health Plan, along with the annual Chartbook.
Regulatory Process
The CON process begins with the submission of a Letter of Intent (LOI), followed by a pre-application conference with MHCC staff. The applicant then files a formal CON application, which is reviewed by MHCC for completeness. Once deemed complete, the application enters a formal review period that includes opportunities for public comment and, if applicable, comparative review with competing applications. The CON review schedules are posted on the MHCC website at mhcc.maryland.gov.
MHCC staff evaluate the application in accordance with the State Health Plan and applicable review criteria, including project need, cost-effectiveness, impact on existing providers, financial feasibility and health equity. A staff report and recommendation are prepared and presented to the Commission. The Commission then issues a final decision to approve, approve with conditions, or deny the application.
Following approval, the applicant must meet applicable conditions and will be required to obtain first use approval from MHCC prior to initiating services.
The Commission administers an annual survey application, conducted by the Acute Care team around the second quarter of every year.
Acquisitions or changes of ownership involving a hospital do not typically require a Certificate of Need (CON); however, the Maryland Health Care Commission (MHCC) must be notified of the transaction. The applicant is required to submit a Notice of Acquisition, including details of the proposed ownership structure, pre and post-transaction organizational charts, and a description of the transaction.
MHCC reviews the submission to determine whether the proposed change constitutes a change in control and to ensure that no additional services, bed capacity changes, or service expansions are proposed that would otherwise require CON approval.