Certificate of Need - Intermediate Health Care Facilities

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*sb0444*

SENATE BILL 444
J3 6lr1336
HB 1515/25 – HGO CF HB 498
By: Senator Kramer
Introduced and read first time: February 2, 2026
Assigned to: Finance
Committee Report: Favorable
Senate action: Adopted
Read second time: February 16, 2026

CHAPTER ______

AN ACT concerning 1

Certificate of Need – Intermediate Health Care Facilities 2

FOR the purpose of repealing the exemption from the certificate of need requirement for a 3
change in bed capacity for certain intermediate care facilities that offer substance 4
use disorder treatment services; altering the circumstances under which a certificate 5
of need is not required for a change in bed capacity at an intermed iate health care 6
facility that offers medically managed substance use disorder treatment services; 7
exempting from the certificate of need requirement, under certain circumstances, the 8
establishment or operation of an intermediate health care facility that offers 9
medically managed residential substance use disorder treatment services; and 10
generally relating to certificates of need for intermediate health care facilities. 11

BY repealing and reenacting, with amendments, 12
Article – Health – General 13
Section 19–120(f) and (h) 14
Annotated Code of Maryland 15
(2023 Replacement Volume and 2025 Supplement) 16

BY adding to 17
Article – Health – General 18
Section 19–120(p) 19
Annotated Code of Maryland 20
(2023 Replacement Volume and 2025 Supplement) 21

2 SENATE BILL 444

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2

Article – Health – General 3

19–120. 4

(f) Except as provided in [subsection] SUBSECTIONS (g)(2)(iii) AND (P) of this 5
section, a certificate of need is required before a new health care facility is built, developed, 6
or established. 7

(h) (1) A certificate of need is required before the bed capacity of a health care 8
facility is changed. 9

(2) This subsection does not apply to any increase or decrease in bed 10
capacity if: 11

(i) For a health care facility that is not a hospital, during a 2 –year 12
period the increase or decrease would not exceed the lesser of 10 percent of the total bed 13
capacity or 10 beds; 14

(ii) 1. The increase or decrease would change the bed capacity 15
for an existing medical service; and 16

2. A. The change would not increase total bed capacity; 17

B. The change is maintained for at least a 1–year period; and 18

C. At least 45 days prior to the change, the hospital provides 19
written notice to the Commissio n describing the change and providing an updated 20
inventory of the hospital’s licensed bed complement; 21

(iii) 1. At least 45 days before increasing or decreasing bed 22
capacity, written notice of intent to change bed capacity is filed with the Commission; 23

2. The Commission in its sole discretion finds that the 24
proposed change: 25

A. Is pursuant to the consolidation or merger of two or more 26
health care facilities, [or] conversion of a health care facility or part of a facility to a 27
nonhealth–related use, OR A CHANGE IN BED C APACITY AT AN INTERM EDIATE CARE 28
FACILITY THAT OFFERS MEDICALLY MANAGED RE SIDENTIAL SUBSTANCE USE 29
DISORDER TREATMENT S ERVICES AND HAS A CU RRENT LICENSE ISSUED BY THE 30
SECRETARY; 31

SENATE BILL 444 3

B. Is not inconsistent with the State health plan or the 1
institution–specific plan developed by the Commission; 2

C. Will result in the delivery of more efficient and effective 3
health care services; and 4

D. Is in the public interest; and 5

3. Within 45 days of receiving notice, the Commission 6
notifies the health care facility of its finding; 7

(iv) The increase or decrease in bed capacity is the result of the 8
annual licensed bed recalculation provided under § 19–307.2 of this title; or 9

(v) 1. The increase or decrease in bed capacity will occur in[: 10

A. An intermediate care facility that offers residential or 11
intensive substance–related disorder treatment services and has a current license issued 12
by the Secretary; or 13

B. An] AN existing general hospice program that has a 14
current license issued by the Secretary; and 15

2. At least 45 days before increasing or decreasing bed 16
capacity, written notice of the intent to change bed capacity is filed with the Commission. 17

(P) A CERTIFICATE OF NEED IS NO T REQUIRED FOR THE E STABLISHMENT 18
OR OPERATION OF AN I NTERMEDIATE CARE FAC ILITY THAT OFFERS ME DICALLY 19
MANAGED RESIDENTIAL SUBSTANCE USE DISORDER TREATMENT SERVICES IF: 20

(1) WRITTEN NOTICE OF THE INTENT TO ESTABLISH OR OPERATE 21
THE INTERMEDIATE CARE FACILITY IS FILED WITH THE COMMISSION AT LEAST 45 22
DAYS BEFORE ESTABLISHMENT; AND 23

(2) THE COMMISSION IN ITS SOL E DISCRETION FINDS T HAT THE 24
PROPOSED INTERMEDIATE CARE FACILITY: 25

(I) IS NOT INCONSISTENT WITH THE STATE HEALTH PLAN; 26

(II) WILL RESULT IN THE DE LIVERY OF MORE EFFIC IENT AND 27
EFFECTIVE HEALTH CARE SERVICES; AND 28

(III) IS IN THE PUBLIC INTEREST. 29

4 SENATE BILL 444

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 1
October 1, 2026. 2

Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.