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Back to SB 1369
Tennessee General Assembly· SB 1369Signed by Governor.

Health Care - As enacted, revises law relative to the operation of acute care hospitals. - Amends TCA Title 4; Title 33; Title 68; Title 71 and Chapter 985 of the Public Acts of 2024. SB1369 has been assigned Public Chap, the official text

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ff Slate Jennessee

                              PUBLIC CHAPTER NO. 887

                                                    SENATE BILL NO. 1369

   By Watson, Roberts, Stevens, Gardenhire, Harshbarger, Crowe, Bailey, Bowling, Reeves,
                                                                Hatcher

                                             Substituted for: House Bill No. 819

        By Garrett, Russell, Hawk, Kumar, Lamberth, Sparks, Littleton, Faison, Tim Hicks, Boyd,
Helton-Haynes, Alexander, Maberry, Reedy, Lafferty, Hill, Travis, Barrett, Hulsey, Rudd, McCalmon,

     Crawford; Mr. Speaker Sexton; Eldridge, Sherrell, Vital, Bricken, Hale, Renea Jones, Cepicky

AN ACT to amend Tennessee Code Annotated, Title 4; Title 33; Title 68; Title 71 and Chapter 985 of
          the Public Acts of 2024, relative to certificates of need.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:

          SECTION 1. Tennessee Code Annotated, Section 68-11-1602(10)(8), is amended by adding
the following as a new subdivision:

                    ( ) An acute care hospital;

          SECTION 2. Tennessee Code Annotated, Section 68-11-1602, is amended by adding the
following as a new subdivision:

                    ( ) "Acute care hospital" means a hospital with a primary focus on patients with an
          average length of stay of twenty-five (25) days or less;

          SECTION 3. Tennessee Code Annotated, Section 68-11-1607, is amended by adding the
following as a new subsection:

                    ( ) This part does not require a certificate of need to establish or operate an acute
          care hospital.

          SECTION 4. Tennessee Code Annotated, Section 68-11-204(a)(1), is amended by adding
the following as a new subdivision:

                    ( ) Acute care hospital;

          SECTION 5. Tennessee Code Annotated, Section 68-11-202(a)(1 ), is amended by adding
"acute care hospitals," immediately preceding "recuperation centers".

          SECTION 6. Tennessee Code Annotated, Section 68-11-1602(10)(8), is amended by adding
the following as a new subdivision:

                    ( ) A satellite emergency department;

          SECTION 7. Tennessee Code Annotated, Section 68-11-1607(a)(6), is amended by deleting
the subdivision and substituting:

                    (6) Except as provided in subsection (x), the establishment of a satellite inpatient
          facility by a hospital at a location other than the hospital's main campus.

          SECTION 8. Tennessee Code Annotated, Section 68-11-1607(x)(1), is amended by deleting
"and subject to subdivision (x)(3),".
SB 1369

          SECTION 9. Tennessee Code Annotated, Section 68-11-1607(x)(3), is amended by deleting
the subdivision.

          SECTION 10. Tennessee Code Annotated, Section 68-11-1607(y), is amended by deleting
the subsection.

          SECTION 11. Tennessee Code Annotated, Section 68-11-204(a)(1), is amended by adding
the following as a new subdivision:

                    ( ) Satellite emergency department;

          SECTION 12. Tennessee Code Annotated, Section 68-11-204, is amended by adding the
following as a new subsection:

                    ( ) A person or entity shall not establish or operate a satellite emergency department
          unless the satellite emergency department is licensed as an outpatient department of a
          hospital licensed under this title.

          SECTION 13. Tennessee Code Annotated, Section 68-11-205(g)(1)(A)(iii), is amended by
deleting the subdivision.

          SECTION 14. Tennessee Code Annotated, Section 68-11-202(a)(1), is amended by adding
"satellite emergency departments," immediately preceding "recuperation centers".

          SECTION 15. Tennessee Code Annotated, Section 68-11-1602(10)(8), is amended by
adding the following as a new subdivision:

                    ( ) An agency, institution, facility, or place, whether publicly or privately owned or
          operated, that provides cardiac catheterization;

          SECTION 16. Tennessee Code Annotated, Section 68-11-1607(a)(3)(E), is amended by
deleting the subdivision.

          SECTION 17. Tennessee Code Annotated, Section 68-11-204(a)(1), is amended by adding
the following as a new subdivision:

                    () Cardiac catheterization;

          SECTION 18. Tennessee Code Annotated, Section 68-11-204, is amended by adding the
following as a new subsection:

                    ( )(1) A person or entity shall not initiate or provide cardiac catheterization services
                    unless the facility providing such services is licensed as an outpatient department of a
                    hospital licensed under this title.

                              (2) Subdivision ( )(1) does not apply to a facility providing cardiac
                    catheterization services that was in operation as of the effective date of this act.

          SECTION 19. Tennessee Code Annotated, Section 68-11-202(a)(1), is amended by adding
"cardiac catheterizations," immediately preceding "recuperation centers".

          SECTION 20. Tennessee Code Annotated, Title 68, Chapter 11, Part 2, is amended by
adding the following as a new section:

                    (a) As used in this section, "acute ca"re hospital" means a hospital with a primary
          focus on patients with an average length of stay of twenty-five (25) days or less.

                    (b) In addition to licensing standards and requirements applicable to all acute care
          hospitals, the commission is authorized to adopt by rule licensing standards as described in
          this subsection (b) for acute care hospitals licensed on or after July 1, 2030. Such standards
          must include, at a minimum, requirements that an acute care hospital:

                              (1) Participate in the TennCare .medi~al assistance program and provide an
                    amount of care to patients who are TennCare enrollees that is comparable to similarly
                    situated acute care hospitals; and

                              (2) Provide an amount of charity care that is comparable to similarly situated
                    acute care hospitals.

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SB 1369
                   (c) In developing licensing standards pursuant to this section, the commission shall

         complete a report by January 1, 2031, that includes a compilation of payor mix information by
         geographical area and type of medical treatment or procedure. The payor mix information
         must include percentages of patients who are TennCare enrollees, medicare patients, or
         charity care patients. The report must be developed with participation from and input of
         various stakeholders, including existing acute care hospitals, physicians, nonprofit hospitals,
         rural hospitals, investor-owned hospitals, and others at the discretion of the commission.
         SECTION 21.

                   (a) For the purpose of promulgating rules, this act takes effect upon becoming a law,
         the public welfare requiring it.

                   (b) For all other purposes:
                             (1) Sections 1-5 take effect July 1, 2030, the public welfare requiring it;
                             (2) Sections 6-19 take effect July 1, 2028, the public welfare requiring it; and
                             (3) The remainder of this act takes effect upon becoming a law, the public

                   welfare requiring it.

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         SENATE BILL NO. 1369

PASSED:  April 16, 2026

                                      RANDY McNALL
                         SPEAKER OF THE SENATE

                         CAMER----XTON,SPEAKER
                         HOUSE OF REPRESENTATIVES

rvb O APPROVED this C:Jl:L day of          2026

         Iii,,"'-~ r
                       BILL LEE, GOVERNOR
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