(1) No person,
partnership, association, corporation, or state, county or local government
unit, or any division, department, board or agency thereof, shall establish,
conduct, operate, or maintain in the State of Tennessee any hospital without
having a license. A license shall be issued only to the applicant named and
only for the premises listed in the application for licensure. Licenses are not
transferable or assignable and shall expire and become invalid annually on the
anniversary date of their original issuance. The license shall be conspicuously
posted in the hospital.
order to make application for a license:
The applicant shall submit an application on a form prepared by the
(b) Each applicant for
a license shall pay an annual license fee based on the number of hospital beds.
The fee must be submitted with the application and is not refundable.
(c) The issuance of an application form is in
no way a guarantee that the completed application will be accepted or that a
license will be issued by the department. Patients shall not be admitted to the
hospital until a license has been issued. Applicants shall not hold themselves
out to the public as being a hospital until the license has been issued. A
license shall not be issued until the facility is in substantial compliance
with these rules and regulations including submission of all information
required by T.C.A. §
or as later amended, and of all information required by the
(d) The applicant
must prove the ability to meet the financial needs of the facility.
(e) The applicant shall not use subterfuge or
other evasive means to obtain a license, such as filing for a license through a
second party when an individual has been denied a license or has had a license
disciplined or has attempted to avoid inspection and review process.
(f) The applicant shall allow the hospital to
be inspected by a Department surveyor. In the event that deficiencies are
noted, the applicant shall submit a plan of corrective action to the Board that
must be accepted by the Board. Once the deficiencies have been corrected, then
the Board shall consider the application for licensure.
A proposed change of ownership, including
a change in a controlling interest, must be reported to the department a
minimum of thirty (30) days prior to the change. A new application and fee must
be received by the department before the license may be issued.
(a) For the purposes of licensing, the
licensee of a hospital has the ultimate responsibility for the operation of the
facility, including the final authority to make or control operational
decisions and legal responsibility for the business management. A change of
ownership occurs whenever this ultimate legal authority for the responsibility
of the hospital's operation is transferred.
(b) A change of ownership occurs whenever
there is a change in the legal structure by which the hospital is owned and
constituting a change of ownership include, but are not limited to, the
1. Transfer of the facility's
2. Lease of the
Dissolution of any partnership that owns, or owns a controlling interest in,
4. One partnership is
replaced by another through the removal, addition or substitution of a
5. Removal of the general
partner or general partners, if the facility is owned by a limited
6. Merger of a
facility owner (a corporation) into another corporation where, after the
merger, the owner's shares of capital stock are cancelled;
7. The consolidation of a corporate facility
owner with one or more corporations; or,
8. Transfers between levels of
Transactions which do not constitute a change of ownership include, but are not
limited to, the following:
1. Changes in the
membership of a corporate board of directors or board of trustees;
2. Two (2) or more corporations merge and the
originally-licensed corporation survives;
3. Changes in the membership of a non-profit
4. Transfers between
departments of the same level of government; or,
5. Corporate stock transfers or sales, even
when a controlling interest.
(e) Management agreements are generally not
changes of ownership if the owner continues to retain ultimate authority for
the operation of the facility. However, if the ultimate authority is
surrendered and transferred from the owner to a new manager, then a change of
ownership has occurred.
Sale/lease-back agreements shall not be treated as changes in ownership if the
lease involves the facility's entire real and personal property and if the
identity of the leasee, who shall continue the operation, retains the exact
same legal form as the former owner.
Each hospital, except those operated by
the U.S. Government or the State of Tennessee, making application for license
under this chapter shall pay annually to the department a fee based on the
number of hospital beds, as follows:
(a) Less than 25 beds
(b) 25 to 49 beds, inclusive
(c) 50 to 74 beds, inclusive
(d) 75 to 99 beds, inclusive
(e) 100 to 124 beds, inclusive
(f) 125 to 149 beds, inclusive
(g) 150 to 174 beds, inclusive
(h) 175 to 199 beds, inclusive
For hospitals of two hundred (200) beds or more the fee shall
be two thousand eight hundred and sixty dollars ($2,860.00) plus two hundred
dollars ($200.00) for each twenty-five (25) beds or fraction thereof in excess
of one hundred ninety-nine (199) beds. The fee shall be submitted with the
application or renewal and is not refundable.
(a) In order to renew a license, each
hospital shall submit to periodic inspections by Department surveyors for
compliance with these rules. If deficiencies are noted, the licensee shall
submit an acceptable plan of corrective action and shall remedy the
deficiencies. In addition, each licensee shall submit a renewal form approved
by the board and applicable renewal fee prior to the expiration date of the
(b) If a licensee fails to
renew its license prior to the date of its expiration but submits the renewal
form and fee within sixty (60) days thereafter, the licensee may renew late by
paying, in addition to the renewal fee, a late penalty of one hundred dollars
($100) per month for each month or fraction of a month that renewal is late;
provided that the late penalty shall not exceed twice the renewal
In the event that a
licensee fails to renew its license within the sixty (60) day grace period
following the license expiration date, then the licensee shall reapply for a
license by submitting the following to the Board office:
1. a completed application for
2. the license fee
provided in rule 1200-08-01-.02(4); and
3. any other information required by the
Health Services and Development Agency.
(d) Upon reapplication, the licensee shall
submit to an inspection of the hospital by Department of Health
Tenn. Comp. R. &
rule certified June 7, 1974. Repeal and new rule filed May 22, 1986; effective
June 21, 1986. Amendment filed January 16, 1992; effective March 2, 1992.
Repeal and new rule filed March 18, 2000; effective May 30, 2000. Amendment
filed December 2, 2003; effective February 15, 2004. Amendment filed January
19, 2007; effective April 4, 2007. Public necessity rules filed April 29, 2009;
effective through October 11, 2009. Emergency rules filed October 9, 2009;
effective through April 7, 2010. Amendments filed September 24, 2009; effective
December 23, 2009. Amendment filed December 16, 2013; effective March 16, 2014.
Amendments filed March 21, 2018; to have been effective June 19, 2018. However,
on May 24, 2018, the Government Operations Committee filed a 5-day stay; new
effective date 6/24/2018.
Authority: T.C.A. §§
68-11-209, 68-11-209(a)(1), 68-11-210, 68-11-216, and Chapter 846 of the Public
Acts of 2008, § 1.