AN ACT to amend Tennessee Code Annotated, Title 52; Title 56 and Title 71, relative to prescribed pediatric extended care centers.
SB1936 creates a new licensing and regulatory framework for “prescribed pediatric extended care centers” in Tennessee. These centers are defined as nonresidential facilities, operated for profit or not for profit, that provide basic services to at least four medically dependent or technologically dependent minors who are not related to the owner or operator. The bill sets out detailed definitions for covered minors, basic services, controlling persons, and related terms, and it limits services to children and young adults age 20 or younger who require ongoing technology-based skilled nursing care or similar support.
The bill requires any person operating such a center to obtain an initial or renewal license from the Department of Health, with a separate license for each facility. It establishes application requirements, including financial documentation, zoning verification, background checks for key individuals, and a sworn compliance affidavit. It also imposes operational rules such as license display, recordkeeping, inspections, corrective action plans, late fees, administrative fines, injunction authority, closure notice requirements, and criminal penalties for operating without a license. Centers may not be co-located with child care agencies or other licensed facilities, and they may not provide 24-hour care; instead, they are limited to services of up to 12 hours in a 24-hour period and a maximum patient capacity of 60.
In addition to the licensing provisions, the bill directs the Department of Health to promulgate rules covering staffing, building standards, sanitation, patient records, transportation, and family-centered services. It also preserves parental or guardian involvement in treatment decisions and states that admission to a center does not replace a TennCare private duty nursing benefit when medically necessary. Transportation services are addressed separately, with the department required to set minimum standards while allowing parents or guardians to decline transportation.
The bill also amends TennCare law to require the bureau to provide coverage and benefits for TennCare enrollees receiving services at a prescribed pediatric extended care center, subject to federal approval. The TennCare director must seek any necessary federal waiver by December 31, 2026. The act takes effect immediately for rulemaking purposes, with the rest of the law effective January 1, 2027.
Because there are no committee transcripts or recorded votes included, the overall sentiment cannot be measured from debate or roll-call history. Based on the bill text alone, the measure appears policy-driven and regulatory in nature, with a focus on creating a structured care option for medically fragile children while ensuring oversight, safety, and Medicaid/TennCare reimbursement pathways. Potential areas of contention likely include the new licensing burden, the scope of TennCare coverage, the 12-hour service limit, and the interaction between these centers and existing private duty nursing or other pediatric care arrangements.
SB1936 would add a new part to Title 52 governing prescribed pediatric extended care centers and would also amend Title 71 to require TennCare coverage for services provided at those centers, contingent on federal approval. It would place these facilities under Department of Health licensure, inspection, enforcement, and rulemaking authority, while creating new compliance obligations for owners, operators, employees, subcontractors, and volunteers. It also creates a new misdemeanor offense for operating without a license and authorizes administrative fines, injunctions, and closure-related notice requirements.
No committee discussion or voting record was provided, so there is no direct evidence of support or opposition from legislators in the available materials. The bill’s structure suggests a generally supportive or constructive policy approach toward expanding regulated care options for medically dependent children, paired with strong oversight provisions. At the same time, the detailed licensing and TennCare provisions indicate that implementation concerns, cost, and regulatory scope could be points of debate.
The main likely points of contention are the requirement that centers obtain state licenses and comply with extensive operational standards, the prohibition on operating alongside child care agencies or other licensed facilities, and the limits on service duration and patient capacity. TennCare coverage is also a significant issue because it depends on federal approval and may raise questions about fiscal impact and waiver approval. Another possible area of disagreement is the bill’s treatment of private duty nursing, since it states that center admission does not supplant that benefit when medically necessary, which could affect how services are coordinated and paid for.