HB1905, enacted as Public Chapter No. 848, creates the “Tennessee Nursing Education Integrity and Oversight Act.” The bill establishes a two-year moratorium on the Board of Nursing’s acceptance and approval of applications from nursing education programs that are not based in Tennessee and that seek to operate, enroll students, or place students for clinical experiences in the state. Existing out-of-state programs that were already approved before the act takes effect may keep their approval during the moratorium, but they must provide data and information requested by the Board of Nursing and the Tennessee Center for Nursing Advancement, including preceptor lists, placement statistics, and program outcomes.
During the moratorium, the Tennessee Center for Nursing Advancement, working with the Board of Nursing, must develop and recommend new approval standards for out-of-state nursing programs that use Tennessee clinical sites or Tennessee-licensed preceptors. Those standards must address verification of preceptors, tracking Tennessee residents enrolled in out-of-state programs, annual reporting, faculty supervision, clinical oversight, data collection, administrative costs, and protections for Tennessee patients and preceptors. The center must publish a report with recommended standards by June 30, 2027, and then issue annual public reports on oversight activities and findings.
The bill also preserves the Board of Nursing’s enforcement authority during the moratorium and specifically exempts certain out-of-state nurse anesthesia educational programs from the new restrictions if they meet accreditation, institutional authorization, certification-preparation, licensure, supervision, and board-approval requirements. Those programs may place students in Tennessee for clinical training without obtaining additional authorization solely for that purpose.
Overall, the bill tightens state oversight of nursing education programs that rely on Tennessee clinical placements, while creating a temporary pause to allow state agencies to build a more structured approval and reporting framework. It amends Tennessee Code Annotated Titles 49 and 63, but its operative changes are concentrated in Title 63, Chapter 7, governing nursing education and Board of Nursing authority.
The general sentiment reflected in the committee votes appears largely supportive, with strong majorities advancing the bill in both the House Health Subcommittee and House Health Committee. The main point of contention is the moratorium itself: supporters appear to view it as necessary to protect quality, accountability, and patient safety, while the lone dissenting votes suggest concern about restricting access or burdening out-of-state programs and clinical placement pipelines. The explicit exemption for nurse anesthesia programs indicates an effort to narrow the bill’s reach and address a specific sector that may have been viewed as different from other out-of-state nursing programs.
The bill adds a new part to Tennessee Code Annotated Title 63, Chapter 7, creating a temporary regulatory pause on new approvals for out-of-state nursing education programs and requiring enhanced reporting from already-approved programs. It expands the role of the Tennessee Center for Nursing Advancement and the Board of Nursing in developing standards, collecting data, and publicly reporting on out-of-state clinical placements, while preserving existing enforcement authority. It also carves out a specific exemption for qualifying out-of-state nurse anesthesia programs, meaning those programs are not subject to the moratorium if they meet the listed conditions.
Committee action suggests the bill was generally well received, with 7-1 approval in the House Health Subcommittee and 19-1 approval in the House Health Committee. The discussion context provided does not include transcript remarks, but the vote margins indicate broad support for the bill’s oversight and accountability goals. The presence of a small number of opposing votes suggests some concern about the practical effects of limiting out-of-state nursing programs during the moratorium period.
The central controversy is the two-year moratorium on approval of out-of-state nursing programs, which supporters frame as a needed pause to improve oversight, data collection, and protection of Tennessee patients and preceptors. Opponents likely objected to restricting program approvals and clinical placements, potentially affecting nursing education access, workforce pipelines, and students who rely on out-of-state programs. A secondary point of contention is the special exemption for nurse anesthesia programs, which may have been included to avoid disrupting a distinct accreditation and training pathway while still tightening oversight of other programs.