AN ACT to amend Tennessee Code Annotated, Title 4; Title 34; Title 42; Title 56; Title 63; Title 68; Title 71 and Chapter 985 of the Public Acts of 2024, relative to certificates of need.
SB0853 substantially revises Tennessee’s certificate-of-need (CON) framework, renaming Part 16 of Title 68 as the “Tennessee Healthcare Quality and Access Act of 2025” and narrowing the definition of “healthcare institution” to nursing homes. It repeals large portions of Chapter 985 of the Public Acts of 2024 and rewrites the CON approval process for nursing home and related facility actions, including construction, bed increases, bed relocations, and certain facility relocations. The bill also adds detailed procedural rules for letters of intent, simultaneous review, application completeness, independent verification of data, service of notices, and limits on communications with commission members during the CON process.
The bill creates several exemptions and special rules. Tennessee state veterans’ homes are exempt from CON requirements and their beds cannot be counted against other CON applications. Nursing homes may increase licensed beds by up to 10 beds or 10% every three years without a CON, subject to notice. CON is also not required for certain actions in economically distressed counties without an actively licensed hospital. The bill further allows the Health Facilities Commission to renew a hospital license in limited circumstances for previously licensed hospitals in smaller or economically distressed counties, and it limits continuing oversight after June 30, 2025 to CONs issued for entities that still fit the new definition of healthcare institution.
The bill’s impact on state law is broad and technical, affecting multiple titles beyond the CON chapter to conform cross-references in laws governing health care institutions, labor, public health, and related licensing provisions. It changes statutory definitions from “health care institution” to “facility” in several places, removes references to CON authority in some licensing and regulatory provisions, and makes the CON process more restrictive and more specific to nursing homes. It also requires proof of accreditation within two years for newly established healthcare institutions and sets expiration rules for CON-authorized projects, including a three-year completion window for nursing home projects.
There is no recorded committee transcript or vote history in the provided materials, so no direct legislative debate or roll-call sentiment is available. Based on the bill text, the measure appears to reflect a policy shift toward tightening and clarifying CON administration while also carving out targeted exemptions for veterans’ homes, rural or distressed counties, and modest nursing home bed expansions. The overall tone of the bill is procedural and regulatory rather than expansive, suggesting an effort to reshape how health care facility expansion is reviewed and limited in Tennessee.
Notable points of contention likely center on the scope of certificate-of-need regulation, especially whether the bill makes it easier or harder to expand health care capacity. Potential areas of dispute include the narrowing of CON coverage to nursing homes, the exemption for certain counties, the special treatment of veterans’ homes, the limits on communications with commission members, and the requirement for independent verification of applicant data. These provisions suggest tension between proponents of tighter oversight and those seeking more flexibility for providers, local governments, and underserved communities.
SB0853 amends Tennessee’s certificate-of-need statutes in Title 68 and makes conforming changes across multiple other titles. It narrows and restructures the CON regime, changes statutory definitions, adds procedural requirements for applications and commission review, creates exemptions for certain facilities and counties, and limits continuing oversight for future CONs after June 30, 2025. It also repeals or modifies portions of 2024 public act language and updates related licensing and health-care definitions in other code sections.
No committee discussion or vote record was provided, so there is no direct evidence of support or opposition from hearings or floor action. From the bill text alone, the measure appears to be a technical but policy-significant overhaul of CON administration, with a mix of regulatory tightening and targeted exemptions. Its structure suggests a generally reform-oriented approach, but one that may be viewed differently depending on whether stakeholders favor stronger oversight or greater flexibility for providers and local communities.
The main likely points of contention are the bill’s narrowing of CON coverage, the new procedural burdens on applicants, and the exemptions it creates. Health care providers may object to stricter filing, verification, and communication rules, while supporters of CON reform may favor the added transparency and limits on amendments. Rural counties, distressed counties, nursing homes, veterans’ homes, and local governments are the most directly affected parties, especially where the bill relaxes CON requirements or changes how beds and facilities are counted.