TN Code § 68-11-1609 (2021)
2021 Tennessee Code|Title 68 - Health, Safety and Environmental Protection|Chapter 11 - Health Facilities and Resources|Part 16 - Tennessee Health Services and Planning Act of 2002|§ 68-11-1609. Decision on Application

  The agency shall, upon consideration of an application and review of the evaluation and other relevant information:  Approve part or all of the application and grant a certificate of need, upon any lawful conditions that the agency deems appropriate and enforceable on the grounds that those parts of the proposal appear to meet applicable criteria;  Any condition or conditions that are placed on a certificate of need, and that appear on the face of the certificate of need when issued, shall also be made a condition or conditions of any corresponding license issued by the department of health or department of mental health and substance abuse services. Notwithstanding any law to the contrary, any such conditions survive the expiration of the certificate of need, and remain effective until removed or modified by the agency. Such conditions shall become a requirement of licensure and shall be enforced by the respective licensing entity;   The holder of a license or certificate of need that has a condition placed on it by the agency may subsequently request that the condition be removed or modified, for good cause shown. The agency shall consider the request and determine whether or not to remove or modify the condition. The procedure for requesting such a determination shall be as provided by agency rules. If the holder of the license or certificate of need is aggrieved by the agency's decision, it may request a contested case hearing as permitted by this part;     Disapprove part or all of the application and deny a certificate of need on the grounds that the applicant has not affirmatively demonstrated that those parts of the proposal meet the applicable criteria; or   Defer decisions for no more than ninety (90) days to obtain a clarification of information concerning applications properly before the agency, if there are no simultaneous review applications being concurrently considered by the agency with the deferred application.     No certificate of need shall be granted unless the action proposed in the application is necessary to provide needed health care in the area to be served, can be economically accomplished and maintained, will provide health care that meets appropriate quality standards and will contribute to the orderly development of adequate and effective health care facilities or services. In making such determinations, the agency shall use as guidelines the goals, objectives, criteria and standards in the state health plan. Until the state health plan is approved and adopted, the agency shall use as guidelines the current criteria and standards adopted by the state health planning and advisory board, and any changes implemented by the planning division pursuant to § 68-11-1625. Additional criteria for review of applications shall also be prescribed by the rules of the agency. Notwithstanding any other provision of this subsection (b), when considering applications for new nursing home beds from the one hundred twenty-five (125) bed medicare skilled nursing facility (SNF) bed pool authorized in § 68-11-1622, the agency shall apply the criteria in this subsection (b). All other applications for new nursing home beds shall be governed solely by § 68-11-1621. During each fiscal year after June 30, 2016, until June 30, 2021, the agency shall issue no certificates of need for new nursing home beds during each fiscal year other than the one hundred twenty-five (125) medicare SNF beds per year authorized in § 68-11-1622.   A certificate of need is valid for a period not to exceed three (3) years for hospital projects, and two (2) years for all other projects, from the date of its issuance and after such time shall expire; provided, however, that the agency may, in granting the certificate of need, allow longer periods of validity for certificates of need for good cause shown. Subsequent to granting the certificate of need, the agency may extend a certificate of need for a period upon application and good cause shown, accompanied by a nonrefundable reasonable filing fee, as prescribed by rule. An extension cannot be issued to any applicant, unless substantial progress has been demonstrated. A certificate of need that has been extended shall expire at the end of the extended time period. The decision whether to grant such an extension is within the sole discretion of the agency, and is not subject to review, reconsideration, or appeal.   A certificate of need that has expired is null and void, and of no effect. No revocation proceeding is required. No license or occupancy approval may be issued by the department of health or the department of mental health and substance abuse services for any activity for which a certificate of need has become null and void.   The agency's decision to approve or deny an application shall be final and shall not be reconsidered after the adjournment of the meeting in which the matter was considered. This subsection (e) does not limit the right to file a petition for a contested case hearing pursuant to § 68-11-1610, nor does it limit the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, part 3, pertaining to contested case hearings.   Written notice of the decision of the agency approving, disapproving, or deferring an application, or parts of an application, shall be transmitted to the applicant, simultaneous review applicants, the department of health, the department of mental health and substance abuse services, the department of intellectual and developmental disabilities, and others upon request.    Subject to subdivision (g)(2), any health care institution wishing to oppose a certificate of need application must file a written objection with the agency and serve a copy on the contact person for the applicant, not later than fifteen (15) days before the agency meeting at which the application is originally scheduled. An application for which the agency has received opposition shall be designated on the agency's agenda as an opposed application.   A health care institution or other person may appear before the agency and express opposition to an application without complying with the requirements of subdivision (g)(1); provided, that if a health care institution does not provide notice of its opposition as required by subdivision (g)(1), and if such health care institution initiates a contested case pursuant to § 68-11-1610, then such health care institution shall be solely responsible for the agency's costs of the contested case proceeding and shall reimburse to the applicant the filing fee paid by the applicant, notwithstanding any other law. Noncompliance with subdivision (g)(1) shall not preclude a health care institution from intervening in a contested case proceeding initiated by the applicant.     The agency shall maintain continuing oversight over any certificate of need that it approves on or after July 1, 2016. Oversight by the agency shall include requiring annual reports concerning continued need and appropriate quality measures as determined by the agency. The agency may impose conditions on a certificate of need that require the demonstration of compliance with continued need and quality measures; provided, that conditions for quality measures may not be more stringent than those measures identified by the applicant in the applicant's submitted application.   If an applicant's application is denied by the agency, then the applicant shall receive on request a refund equal to twenty-five percent (25%) of the examination fee for its application.