1. (1) Projects Subject to a Comparative Review. Unless subject to expedited review under Section 408.036(2), F.S., and subsection (2) of this rule, or exempted under Section 408.036(3), F.S., and Rule 59C-1.005, F.A.C., the following projects are subject to comparative review and the batching cycle procedures specified in Rule 59C-1.008, F.A.C., and will be reviewed in accordance with procedures set forth in subsection 59C-1.010(3), F.A.C.:

   1. (a) The addition of beds in community nursing homes or intermediate care facilities for the developmentally disabled (ICF/DD) by new construction or alteration, unless exempt pursuant to Section 408.036(3)(m), F.S.
   2. (b) The new construction or establishment of additional health care facilities, including a replacement health care facility when the proposed project site is not located on the same site or within one mile of the existing health care facility, if the number of beds in each licensed bed category will not increase and unless exempt pursuant to Section 408.036(3)(j), F.S.
   3. (c) The conversion from one type of health care facility to another that requires a certificate to establish.
   4. (d) The establishment of a Hospice or Hospice inpatient facility.

2. (2) Projects Subject to Expedited Review. Unless reviewable under Section 408.036(1), F.S., above or exempted under Section 408.036(3), F.S., the following projects are subject to expedited review, and will be reviewed in accordance with procedures set forth in subsection 59C-1.010(4), F.A.C.:

   1. (a) Sheltered nursing home beds.
   2. (b) Transfer of a Certificate of Need.
   3. (c) Replacement of a nursing home, if the proposed project site is within a 30-mile radius of the replaced nursing home. If the proposed project site is outside the subdistrict where the replaced nursing home is located, the prior six-month occupancy rate for licensed community nursing homes in the proposed subdistrict must be at least 85 percent in accordance with the Agency’s most recently published inventory. The nursing home license holder is the only entity that may submit the application to replace the nursing home, pursuant to paragraph 59C-1.008(1)(h), F.A.C.
   4. (d) Replacement of a nursing home within the same district, if the proposed project site is outside a 30-mile radius of the replaced nursing home but within the same subdistrict or a geographically contiguous subdistrict within the district. In the case that a proposed project site is in a geographically contiguous subdistrict within the district, the prior six-month occupancy rate for licensed community nursing homes for that subdistrict must be at least 85 percent in accordance with the Agency’s most recently published inventory.

   5. (e) Relocation of a portion of the nursing home’s licensed beds to a licensed facility or to establish a new facility within the same district, or a geographically contiguous district if the relocation is within a 30-mile radius of the existing facility and the total number of nursing home beds in the state does not increase as a result of this project.

      1. Applications submitted under this paragraph must be submitted by the licensed nursing home proposing to add the beds or by the applicant proposing to establish a new facility. A letter from the facility from which the beds are being relocated must be submitted certifying that beds will be delicensed should the CON be awarded to the applicant.

      2. The relocation of beds under this paragraph shall be limited to a portion of beds such that the occupancy rate of the remaining licensed beds of the facility from which beds are being relocated does not exceed 92 percent.

   6. (f) New construction of a community nursing home in a retirement community pursuant to the provisions in Section 408.036(2)(e), F.S.

Rulemaking Authority 408.034(8), 408.15(8) FS. Law Implemented 408.033, 408.035, 408.036(1), (2), 408.037, 408.038, 408.039 FS. History–New 1-1-77, Amended 11-1-77, 9-1-78, 6-5-79, 4-25-80, 2-1-81, Formerly 10-5.04, Amended 11-24-86, 11-17-87, 1-31-91, 1-1-92, Formerly 10-5.004, Amended 9-10-92, 1-9-95, 11-4-97, 12-12-00, 11-12-01, 8-1-05, 3-16-16, 8-8-21, Joint Administrative Procedures Committee Objection Filed–See FAR Vol. 51, No. 53, March 18, 2025, Amended 12-7-25, Amendment resolved Joint Administrative Procedures Committee objection 12-7-25, Florida Administrative Register Vol. 52, No. 21, February 2, 2026.