2023 Tennessee Code › Title 68 - HEALTH, SAFETY AND ENVIRONMENTAL PROTECTION (§§ 68-1-NEW — 68-221-1319) › HEALTH (§§ 68-1-NEW — 68-6-201) › Chapter 11 - HEALTH FACILITIES AND RESOURCES (§§ 68-11-101 — 68-11-2308) › Part 2 - REGULATION OF HEALTH AND RELATED FACILITIES (§§ 68-11-NEW — 68-11-277) › Section 68-11-206 - Application for license - Form of contents - Procedure - Term of license - Renewal - Inactive status

(a)
Any person, partnership, association, corporation, any state, county or local governmental unit, or any division, department, board or agency of the governmental unit, in order to lawfully establish, conduct, operate or maintain a hospital, recuperation center, nursing home, home for the aged, residential HIV supportive living facility, assisted-care living facility, home care organization, residential hospice, birthing center, prescribed child care center, renal dialysis clinic, outpatient diagnostic center, ambulatory surgical treatment center, adult care home or traumatic brain injury residential homes in this state, shall obtain a license from the commission, upon the approval and recommendation of the commission in the following manner:
(1)
The applicant shall submit an application on a form to be prepared by the commission with the approval of the commission, showing that the applicant is of reputable and responsible character and able to comply with the minimum standards for a facility and with rules and regulations lawfully promulgated under this part. The application shall contain the following additional information:
(A)
The name or names of the applicant or applicants;
(B)
The type of institution to be operated;
(C)
The location of the institution;
(D)
The name of the person or persons to be in charge of the institution or, for adult care home applicants, the name of the resident manager, if applicable;
(E)
A certification that the applicant has implemented a policy of informing its employees of their obligations under §
71-6-103
to report incidents of abuse or neglect;
(F)
If an application for a nursing home license, a list of all nursing homes that the applicant, or any person or entity holding a majority legal or equitable interest in the applicant, owns or operates and, if the applicant has not operated a nursing home in this state for a continuous period of twenty-four (24) months preceding the application, the information specified in §
68-11-804(c)(1)
for each such nursing home located outside this state; and
(G)
Such other information as the commission, with the approval of the commission, may require;
(2)
(A)
In addition to the requirements in subdivision (a)(1), an application for an adult care home or traumatic brain injury residential home license shall include the following additional information:
(i)
The maximum number of residents;
(ii)
Type of license;
(iii)
If any residents are family members of the applicant;
(iv)
Names and locations of all other facilities in and outside this state for which the applicant has any license and the compliance history of each facility, including penalties, suspensions or other disciplinary actions;
(v)
The extent to which a resident manager, substitute caregivers and other staff will be used in the facility;
(vi)
A list of any unsatisfied judgments;
(vii)
Past or pending litigation against the applicant;
(viii)
Unpaid local, state and federal taxes;
(ix)
Notification regarding any bankruptcy filings made by the applicant;
(x)
Demonstration of the applicant's financial ability to maintain sufficient financial resources to support the operating costs of the adult care home or traumatic brain injury residential home; and
(xi)
A comprehensive business plan for the first two (2) years of operation;
(B)
The commission shall promulgate regulations specifying additional financial requirements, such as bonds or liability insurance;
(C)
An adult care home provider shall obtain a separate license for each adult care home. An adult care home provider may, upon operation of a licensed adult care home for a minimum period of one (1) year and completion of an annual licensure survey without any findings of noncompliance resulting in penalties, suspensions or other disciplinary actions, submit application to separately license a second adult care home. Only upon operation of two (2) licensed adult care homes for a consecutive period of at least one (1) year, licensure survey in each facility without any findings of noncompliance resulting in penalties, suspensions or other disciplinary actions, may an adult care home provider submit application to separately license additional adult care homes. The commission may grant an exception to the one-at-a-time license requirement for Level 2 adult care homes for nursing facilities, assisted-care living facilities and other providers when such nursing facility, assisted-care living facility or provider has demonstrated expertise in delivering the specialized services necessary to the specified population that would be served by the licensed adult care homes. The commission may establish in regulations a limit on the total number of adult care homes that can be operated by a single adult care home provider;
(D)
A Level 2 license allows an adult care home provider to serve adults requiring specialized services. As used in this section, "specialized services" means services provided to ventilator dependent residents and residents with a traumatic brain injury as defined in §
68-55-101
. The applicant shall specify the type of license sought as a part of its application. The commission shall promulgate regulations specifying additional requirements for a Level 2 license;
(E)
A license authorized by this part allows a traumatic brain injury residential home provider to serve disabled adults suffering from the effects of a traumatic brain injury as defined in §
68-55-101
. A traumatic brain injury residential home provider shall not be required to obtain a Level 2 or any other licensure, other than a license to operate its day services through a separate facility licensed by this state. The commission shall promulgate regulations specifying additional requirements for traumatic brain injury residential home licensure consistent with this part;
(3)
At a minimum, Level 2 adult care home providers serving ventilator-dependent residents shall meet all of the following requirements:
(A)
Have an audible, redundant alarm system located outside of resident's room to alert the adult care home provider or resident manager of a resident disconnection or ventilator failure;
(B)
Have a functioning emergency back-up generator adequate to maintain electrical service for residents' needs until regular service is restored;
(C)
All ventilators shall be equipped with internal battery backup systems;
(D)
A backup ventilator shall be available at all times;
(4)
The commission shall promulgate in regulation additional licensure requirements that define appropriate health and safety standards necessary to protect the health and welfare of residents. Specific elements to be addressed include, but are not limited to:
(A)
Facility and building standards;
(B)
Minimum size and number of bedrooms and bathrooms;
(C)
Number of residents to a bedroom and a bathroom;
(D)
Sanitation;
(E)
Hazardous waste disposal;
(F)
Disaster preparedness;
(G)
Medication administration and storage; and
(H)
Resident record requirements;
(5)
(A)
The commission shall maintain current information on all licensed adult care home providers. The information shall include:
(i)
Name, location and mailing address of the facility;
(ii)
Description of the facility;
(iii)
Date of last inspection;
(iv)
Penalties;
(v)
Suspensions; and
(vi)
Other disciplinary actions;
(B)
The information shall be made available upon request to a prospective resident, resident, or family member;
(6)
If the commission determines that a license for any facility will not be granted, it shall so notify the applicant. The decision of the commission shall be final;
(7)
If the commission finds that the applicant complies with this part and the rules and regulations promulgated under this part, then the commission shall recommend and approve the issuance of a license, and thereupon a license shall be issued by the commission licensing the applicant to operate the facility for the remainder of the fiscal year; and
(8)
Each license to operate a facility shall expire annually on the anniversary date of its original issuance and shall become invalid on that date unless renewed. A licensee may renew its license within sixty (60) days following the license expiration date upon payment of the renewal fee in addition to a late penalty established by the commission for each month or fraction of a month that payment for renewal is late; provided, that the late penalty shall not exceed twice the renewal fee. If a licensee fails to renew its license within sixty (60) days following the license expiration date, then the licensee shall reapply for licensure in accordance with the rules established by the commission. However, during the transition period, renewed licenses may be issued at prorated monthly renewal fee rates for terms of no less than five (5) months nor more than eighteen (18) months. A license shall not be assignable or transferable, shall be issued only for the premises named in the application, shall be posted in a conspicuous place in the facility, and may be renewed from year to year.
(b)
(1)
Upon request by a licensee, the commission shall have authority to place a license in an inactive status for a period determined by the commission upon a finding that:
(A)
The licensee has a need to temporarily suspend operations; and
(B)
The licensee intends to continue operations after a period of suspension.
(2)
Placing a license in an inactive status shall not relieve the licensee from the annual license fees imposed by §
68-11-216
.
(c)
Any condition placed on the issuance of a certificate of need pursuant to §
68-11-1605
shall be deemed a condition on any subsequently issued license under this section.
(d)
(1)
This subsection (d) controls the recovery and collection of civil monetary penalties for which a facility or individual is liable under this part.
(2)
An action to recover or collect a civil monetary penalty owed pursuant to this part shall not be taken until:
(A)
The facility or individual has waived the right to a contested case hearing pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, part 3;
(B)
The time allowed for the facility or individual to demand a contested case hearing has expired without a demand being made or a denial filed; or
(C)
A final administrative order has been entered pursuant to §
4-5-314
.
(3)
If the full amount of the civil monetary penalty owed pursuant to this part has not been received in full within sixty (60) days from the occurrence of an event described in subdivision (d)(2), or received by the due date specified by order, then the executive director of the health facilities commission shall immediately proceed to recover such amount, plus interest computed at the applicable formula rate as defined in §
47-14-102
, retroactive to the earliest date of occurrence of an event described in subdivision (d)(2), by one (1) or more of the following means:
(A)
Directing the reduction of the amount owed from any balance otherwise due from the state to the facility and directing a remittance of the amount to the health facilities commission;
(B)
Adding such amounts to the licensing fee, with renewal of the license pursuant to subdivision (a)(8) and §
68-11-216
contingent upon the prior payment of such costs; or
(C)
Bringing an action in circuit or chancery court to recover such amounts.
Amended by 2023 Tenn. Acts, ch. 466, s 39, eff. 7/1/2024.
Amended by 2023 Tenn. Acts, ch. 466, s 3, eff. 7/1/2023.
Amended by 2022 Tenn. Acts, ch. 1119, Secs.s 28, s 29, s 30 eff. 7/1/2022.
Amended by 2022 Tenn. Acts, ch. 1119, s 27, eff. 7/1/2022.
Acts 1947, ch. 13, § 8; C. Supp. 1950, § 5879.7 (Williams, § 4432.8); Acts 1968, ch. 522, § 2; 1971, ch. 225, § 4; 1974, ch. 495, §§ 4, 5; 1975, ch. 276, §§ 4-7; 1976, ch. 471, §§ 4-7; T.C.A. (orig. ed.), § 53-1307; Acts 1987, ch. 312, § 7; 1992, ch. 805, § 4; 1993, ch. 234, § 15; 1994, ch. 747, § 5; 1996, ch. 674, § 5; 1996, ch. 818, § 3; 1998, ch. 1021, § 4; 2000, ch. 616, § 1; 2000, ch. 981, § 85; 2001, ch. 285, §§ 5 - 7; 2001, ch. 438, §§ 7 - 10; 2004, ch. 917, § 4; 2008 , ch. 846, § 1; 2009 , ch. 186, § 13; 2009 , ch. 327, § 1; 2009 , ch. 579, § 8; 2012 , ch. 635, § 1; 2012, ch. 1086, §§ 9 - 11.