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  CERTIFICATE OF NEED INTELLIGENCE BRIEF: ARKANSAS
  The Rojas Report | conlaws.rojasreport.com/states/arkansas/
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  State:    Arkansas (AR)
  Score:    15/100
  Tier:     Mostly Free
  Rank:     18 of 51 jurisdictions

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  SUMMARY
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  In-depth analysis of Arkansas's Permit of Approval (POA) program, its impact
on healthcare competition, and market concentration data.

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  SCOPE OF REGULATION
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  * Regulated Services
  * Long-Term Care
  * Nursing home construction, adding/converting beds.
  * Home Health
  * Establishment of new hospice programs.
  * Threshold of $1,000,000 for nursing home renovations.
  * Case Law: Denial of Home Health Services

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  APPLICATION PROCESS
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  Arkansas: Permit of Approval

  Arkansas replaced its broad Certificate of Need (CON) program with a
narrower Permit of Approval (POA) system in 1987, primarily regulating long-
term care and home health services while largely exempting hospitals. This
shift has created a unique regulatory landscape that warrants close
examination.

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  MARKET CONCENTRATION
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  Threshold of $1,000,000 for nursing home renovations.

  The state uses a structured batching system for POA applications, creating
predictable but rigid timelines for market entry.

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  CASE LAW / DENIALS
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  Case Law: Denial of Home Health Services

  The most significant feature of the modern POA system is the 2001 law (Act
1800) that explicitly bars competitors from seeking judicial review of a
granted permit. This creates a one-way street for legal challenges: applicants
can sue if denied, but competitors cannot sue if a new rival is approved. This
legislative shield effectively nullifies a key accountability mechanism,
entrenching the commission's decisions and protecting approved applicants from
legal challenges by incumbents.

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  Source: The Rojas Report | conlaws.rojasreport.com/states/arkansas/
  Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments
  Generated: April 2026
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