Tennessee Senate Bill SB1369

Tennessee 2025-2026 Regular Session

• Introduced: 2/6/25
• Engrossed: 3/26/26
• Enrolled: 4/20/26
• Passed: 5/5/26

Caption

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.

Summary

SB1369 amends Tennessee’s certificate-of-need framework to create a new exemption for acute care hospitals. The bill defines an “acute care hospital” as a hospital whose primary focus is patients with an average length of stay of 25 days or less, and it provides that this part of the certificate-of-need law does not require a certificate of need to establish or operate such a hospital. In effect, the measure narrows the reach of Tennessee’s CON requirements by carving out a category of hospitals that may be opened or operated without going through the usual state approval process. The bill also amends Chapter 985 of the Public Acts of 2024 and includes staggered effective dates for different sections, with the new acute care hospital provisions taking effect July 1, 2028. The legislation is framed as a broader update to Titles 4, 33, 68, and 71, but the central policy change is the hospital licensing and CON exemption. Because the bill changes statutory definitions and exemptions, it affects the Department of Health’s regulatory oversight and the planning/entry requirements for hospital operators seeking to develop acute care facilities in Tennessee.

Impact

SB1369 would alter Tennessee Code Annotated Title 68 by adding a statutory definition of “acute care hospital” and exempting that category from the certificate-of-need requirement to establish or operate a hospital. This reduces regulatory barriers for certain hospital projects and could affect existing hospitals, prospective entrants, health systems, and communities where new facilities may be proposed. It also modifies a 2024 public act and sets a delayed implementation date for the new exemption, giving time for rulemaking and transition.

Sentiment

The available voting history suggests the bill was generally supported, but not unanimously. It received favorable committee action in the Senate Health and Welfare Committee and passed subsequent floor votes by comfortable margins in both chambers, including adoption of amendments and concurrence votes. The pattern indicates broad legislative support for the measure, with some members voting against it at each stage, reflecting limited but persistent opposition.

Contention

The main point of contention is the policy shift away from certificate-of-need oversight for acute care hospitals. Supporters likely view the exemption as a way to encourage hospital development, expand access, and reduce administrative barriers, while opponents may be concerned that weakening CON requirements could increase competition, shift profitable services away from existing hospitals, or lead to uneven distribution of care. The recorded nay votes show that some legislators remained skeptical of the exemption even as the bill advanced with strong majorities.