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PUBLIC CHAPTER NO. 1136
SENATE BILL NO. 2431
By Jackson
Substituted for: House Bill No. 2110
By Boyd, Reedy
AN ACT to amend Tennessee Code Annotated, Title 33; Title 63 and Title 68, relative to health
facility regulation.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 68-1-108(a), is amended by deleting the
last sentence of the subsection and substituting:
The commissioner shall prescribe conditions under which the processed and verified data
are available to the public, and shall establish policies for the release of HIPAA-compliant
limited use data sets, including, but not limited to, providing data for certificate of need
applicants to the health facilities commission no later than seven (7) days after a request is
made by the commission.
SECTION 2. Tennessee Code Annotated, Section 68-1-119(a), is amended by deleting the
last sentence of the subsection and substituting:
The commissioner of health shall prescribe conditions under which the processed and
verified data are available to the public, and shall establish policies for the release of HIPAA-
compliant limited use data sets, including, but not limited to, providing data for certificate of
need applicants to the health facilities commission no later than seven (7) days after a
request is made by the commission.
SECTION 3. Tennessee Code Annotated, Section 68-11-201, is amended by adding the
following as new subdivisions:
( ) "Burn unit" means a specialized hospital department providing intensive,
comprehensive care for severe burn injuries from heat, chemicals, or electricity;
( ) "Magnetic resonance imaging" means a non-invasive diagnostic technique that
produces computerized images of internal body tissues and is based on nuclear magnetic
resonance of atoms within the body induced by the application of radio waves;
( ) "Neonatal intensive care unit" means a specialized hospital department providing
intensive, comprehensive care for neonates at Level II, Level Ill, or Level IV institutions, as
defined and licensed by the commission;
( ) "Positron emission tomography" means a nuclear medicine imaging scan that
shows how organs and tissues are functioning by detecting metabolic activity;
SECTION 4. Tennessee Code Annotated, Section 68-11-202, is amended by adding the
following as a new subsection:
(k)(1) The commission may determine eligibility for a licensed hospital for designation
as a critical access hospital under the medicare rural hospital flexibility program to the
fullest extent permitted by the medicare rural hospital flexibility program.
SB 2431
(2) The entity proposing to establish a critical access hospital shall publish
notice of its intent to do so in a newspaper of general circulation in the county where
the hospital will be located and in contiguous counties. The notice must be published
at least twice within a fifteen-day period.
(3) A hospital licensed under this part that is located within the same county or
a contiguous county may file a written objection to the proposal with the commission
within thirty (30) days of the last publication date.
(4) The executive director shall issue a written determination of:
(A) Eligibility or non-eligibility; and
(8) Proof of publication as required by subdivision (k)(2).
(5)(A) The executive director shall notify the commission of the determination
of eligibility or non-eligibility pursuant to subdivision (k)(4)(A) at the next
regularly scheduled commission meeting; and
(8) An eligibility determination by the executive director pursuant to
subdivision (k)(4)(A) is subject to commission review in the same manner as
described in § 68-11-277(9) and (h).
SECTION 5. Tennessee Code Annotated, Section 68-11-202(a)(1), is amended by deleting
the subdivision and substituting:
(1) The commission may license and regulate hospitals, recuperation centers, nursing
homes, homes for the aged, residential HIV supportive living facilities, assisted-care living
facilities, home care organizations, residential hospices, birthing centers, prescribed child
care centers, renal dialysis clinics, ambulatory surgical treatment centers, outpatient
diagnostic centers, adult care homes, traumatic brain injury residential homes, burn units,
neonatal intensive care units, magnetic resonance imaging services, and positron emission
. tomography services.
SECTION 6. Tennessee Code Annotated, Section 68-11-203(e)(7)(8), is amended by
deleting the subdivision and substituting:
(B)(i) Except as provided in subdivision (e)(7)(B)(ii), a member or employee of the
commission, upon determining that a matter scheduled for consideration by the
commission results in a conflict with a direct interest, shall immediately notify the
executive director and is recused from any deliberation of the matter, making any
recommendation, testifying concernin·g the matter, or voting on the matter. The
member or employee shall join the public during the proceedings.
(ii) Notwithstanding subdivision (e)(7)(B)(i), a member or employee of the
commission may participate in the commission's action on a matter if the member or
employee of the commission publicly acknowledges such interest, when the member
or employee of the commission, or a relative of the commission member or employee:
(a) Is employed by' or owns or controls an interest of less than five
percent (5%) in the persons involved in a matter before the commission;
(b) Did not participate in the matter for persons involved in a matter
before the commission; and
(c) Is not as an officer, director, trustee, partner, or similar position of
the persons involved in a matter before the commission.
(iii) A member or employee of the commission with an indirect interest shall
publicly acknowledge such interest, unless the member is recused from deliberation
on, making a recommendation regarding, testifying concerning, or voting on the
matter.
SECTION 7. Tennessee Code Annotated, Se.ction 68-11-204(a), is amended by adding the
following as a new: subdivision: •
{4) Magnetic resonance imaging and positron emission tomography that are not used
for diagnostic purposes do not require a license under this part.
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SECTION 8. Tennessee Code Annotated, Section 68-11-204(a)(1), is amended by deleting
subdivisions (R) and (S) and substituting:
(R) Except as provided in subdivision (a)(4), magnetic resonance imaging; or
(S) Except as provided in subdivision (a)(4), positron emission tomography.
SECTION 9. Tennessee Code Annotated, Section 68-11-206(a), is amended by adding the
following as a new subdivision:
(9)(A) If the commission conducts a site visit required for initial licensure or licensure
renewal, then the commission may require an applicant or licensee to pay the actual
and reasonable costs of the site visit, which include, but are not limited to, the
following:
(i) All costs absorbed by the commission in connection with the site
visit, including all site reviewer time, travel, and lodging incurred during the
site review; and
(ii) All costs absorbed by the commission for the use of facilities and
personnel to complete the site review;
(B) Prior to the expiration of sixty (60) days from completion of the site visit,
the commission shall send to the applicant or licensee, by certified mail, return receipt
requested, and by regular United States mail, a final costs assessment for all site
review costs; and
(C) All costs paid to the commission under this part remain with the
commission.
SECTION 10. Tennessee Code Annotated, Section 68-11-207(a), is amended by adding the
following as a new subdivision:
(4) Failure to obtain accreditation within the time prescribed by an applicable
certificate of need exemption in§ 68-11-1607.
SECTION 11. Tennessee Code Annotated, Section 68-11-208(a), is amended by deleting
the subsection and substituting:
(a)(1) The commission and each board, committee, or council established in this title
that does not already have authority to utilize screening panels may utilize one (1) or
more screening panels in its investigative and disciplinary process to assure that
complaints filed and investigations conducted are meritorious and appropriate.
(2) The activities of a screening panel and any mediation or arbitration
sessions are not an open meeting of an agency for purposes of title 8, chapter 44,
and remain confidential. The members of ·a screening panel, mediators, and
arbitrators have a deliberative privilege and the· same immunity as provided by law for
the boards and are not subject to deposition or subpoena to testify regarding any
matter or issue raised in any contested case, criminal prosecution, or civil lawsuit that
may result from or that is incide~t to cases processed before the panel.
(3) A screening panel has the authority to administer an oath to a witness. Any
documents or records produced at the screening panel are exempt from disclosure as
a public record pursuant to title 10, chapter 7, until there is a filing of a notice of
charges. •
(4) Members of a screening panel may be drawn from among the membership
of the relevant board, and members may be appointed by the relevant board. Non-
board r11embers must meet the. requirements· of membership for the relevant board
and may include a consumer member. A board member serving on a panel shall not
participate in a contested case involving any matter heard by the panel.
(5) _Each screening panel must be instructed as to the statutes, rules, and
philosophies of the relevant board as it pertains to disciplinary action and procedures
that must be followed by the panel. Each screening panel must be provided with a
copy.of Tennessee Supreme Court Rule 31 for review by members of the screening
panel for general guidance as to the principles of mediation and alternative dispute
resolution.
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(6) A board shall not compel any party to participate in a screening panel, and
no prejudice is incurred if a party chooses not to participate in a screening panel or to
accept the offer of a screening panel.
SECTION 12. Tennessee Code Annotated, Section 68-11-210(9), is amended by deleting
the subsection and substituting:
(g) No later than December 31, 2028, the commission shall ensure the date of the
most recent inspection for each nursing home licensed under this part is no more than fifteen
(15) months prior to December 30, 2028.
SECTION 13. Tennessee Code Annotated, Section 68-11-213, is amended by adding the
following as new subsections:
(m)(1) If the commission imposes sanctions on a licensee following a disciplinary
proceeding, then the commission may require the licensee to pay the actual and
reasonable costs of the investigation and prosecution of the disciplinary proceeding,
which include, but are not limited to, the following:
(A) All costs absorbed by the commission in connection with the
investigation and prosecution of the matter, including all investigator time,
travel, and lodging incurred during the prosecution;
(8) All costs absorbed by the commission for the use of facilities and
personnel for prosecution of the matter;
(C) All costs assessed against the commission for the appearance
fees, transcripts, time, travel, and lodging of administrative law judges, court
reporters, and witnesses required in the prosecution of the matter; and
(D) All costs attributed to and assessed against the commission in
connection with the prosecution of the matter, including all attorney and
paralegal time, travel, and lodging incurred during the prosecution of the
matter.
(2) The commission shall include ,in any order in which the payment of costs
has been assessed an amo,unt that is the maximum amount owed by the licensee at
the time the order is entered. Prior to the expiration of sixty (60) days from the
effective date of the order, the commission shall send to the licensee, by certified
mail, return receipt requested, and by regular United States mail, a final costs
assessment that does not exceed the maximum amount in the order.
(3) All fines, costs, and fees paid to the commission under this part remain
with the commission.
(n) The commission may use forms of non-public discipline, as established by rules
promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title
4, chapter 5.
SECTION 14. Tennessee Code Annotated, Section 68-11-816(b), is amended by deleting
"five (5) working days" and substituting "ten (10) working days".
SECTION 15.' Tennessee Code Annotated,_ Section 68-11-1602, is amended by deleting
subdivisions (3), (5), and (12).
SECTION 16. Tennessee Code Annotated, Section 68-11-1607(a)(4), is amended by
deleting the subdivision and substituting:
(4)(A) Except as provided in subdivision (a)(4)(D), a change in the location of existing
or certified facilities providing healthcare services and healthcare institutions.
However, the executive director may issue an exemption for the relocation of existing
healthcare institutions and approved -services if the executive director determines
that:
(i) At least ninety-five percent (95%) of patients to be served are
reasonably expected to reside in the same zip codes as the existing patient
population;
(ii) The relocation will not reduce access to consumers, particularly
those in underserved communities; those who are uninsured or underinsured;
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women and racial and ethnic minorities; TennCare or medicaid recipients; and
low-income groups; and
(iii) The payor mix will not include an increase in commercial
insurance.
(B) The executive director shall notify the commission of an exemption
granted pursuant to subdivision (a)(4)(A) at the next regularly scheduled commission
meeting;
(C) An exemption granted or denied by the executive director pursuant to
subdivision (a)(4)(A) is subject to commission review in the same manner as
described in§ 68-11-277(9) and (h);
(D) The relocation of the principal office of a home health agency or hospice
within its licensed service area does not require a certificate of need; and
(E) An exemption under this subdivision (a)(4) must not be issued for an
approved but unimplemented certificate of need unless the new location is within a
one-mile radius of the location specified in the certificate of need; and
SECTION 17. Tennessee Code Annotated, Section 68-11-1607(0), is amended by deleting
the subsection and substituting:
(o)(1) Within two (2) years after the date of receiving a certificate of need, an
outpatient diagnostic center must become accredited by a nationally recognized and
CMS-approved accrediting organization for each machine and each diagnostic type,
in the modalities provided by that facility as a condition of receiving the certificate of
need.
(2) An outpatient diagnostic center that fails to comply with the accreditation
requirement of subdivision (o)(1) is subject to licensure sanction under § 68-11-207
as a violation of part 2 of this chapter or of the rules, regulations, or minimum
standards issued pursuant to part 2 of this chapter.
SECTION 18. Tennessee Code Annotated, Section 68-11-1607(q)(2)(A), is amended by
deleting "accredited by The Joint Commission or the American College of Radiology" and
substituting "accredited by a nationally recognized and CMS-approved accrediting organization".
SECTION 19. Tennessee Code Annotated, Section 68-11-1607(u), is amended by deleting
the subsection and substituting:
(u)(1) A provider of positron emission tomography established without a certificate of
a need must become accredited by nationally recognized and CMS-approved
accrediting organization in the modalities provided by that person and submit proof of
the accreditation to the commission within two (2) years of the date of licensure.
(2) A provider of positron emission tomography established without a
certificate of need that fails to comply with the accreditation requirement of
subdivision (u)(1) is subject to licensure sanction under§ 68-11-207 as a violation of
part 2 of this chapter or of the rules or minimum standards issued pursuant to part 2
of this chapter.
SECTION 20. The health facilities commission shall promulgate emergency rules to
effectuate this act. The emergency rules must be promulgated as soon as practicable following the
date this act becomes a law. The emergency rules must be promulgated in accordance with the
Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
SECTION 21. For the purpose of rule promulgation, this act takes effect upon becoming a
law, the public welfare requiring it. For all other purposes, this act takes effect July 1, 2026, the
public welfare requiring it.
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SENATE BILL NO. 2431
PASSED: April 21, 2026
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RANDY ~NALLY
SPEAKER OF THE IENATE
CAMERON SEXTON, SPEAKER
HOUSE OF REPRESENTATIVES
~ APPROVED this :);)."',J day of 11 2026
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