The board may
suspend or revoke a license for:
Violation of federal statutes or rules;
(b) Violation of state statutes or the rules
as set forth in this chapter;
Permitting, aiding or abetting the commission of any illegal act in the nursing
(d) Conduct or practice found
by the board to be detrimental to the health, safety, or welfare of the
residents of the nursing home; and,
(e) Failure to renew the license.
The board may consider all
factors which it deems relevant, including but not limited to the following,
when determining sanctions:
(a) The degree of
sanctions necessary to ensure immediate and continued compliance;
(b) The character and degree of impact of the
violation on the health, safety and welfare of the residents in the
(c) The conduct of the
facility in taking all feasible steps or procedures necessary or appropriate to
comply or correct the violation; and,
(d) Any prior violations by the facility of
statutes, rules or orders of the commissioner or the board.
The Board shall have the
authority to place a facility on probation. To be considered for probation, a
facility must have had at least two (2) separate substantiated complaint
investigation surveys within six (6) months, where each survey had at least one
deficiency cited at the level of substandard quality of care or immediate
jeopardy, as those terms are defined at
. None of the surveys can have been
initiated by an unusual event or incident self reported by the facility.
(a) If a facility meets the criteria for
probation, the board may hold a hearing at its next regularly scheduled meeting
to determine if the facility should be placed on probation. Prior to initiating
such a hearing, the board shall provide notice to the facility detailing what
specific non-compliance the board had identified that the facility must respond
to at the probation hearing.
Prior to imposing probation, the board may consider and address in its findings
all factors which it deems relevant, including, but not limited to, the
1. What degree of sanctions is
necessary to ensure immediate and continued compliance; and
2. Whether the non-compliance was an
unintentional error or omission, or was not fully within the control of the
3. Whether the
nursing home recognized the non-compliance and took steps to correct the
identified issues, including whether the facility notified the department of
the non-compliance either voluntarily or as required by state law or
4. The character
and degree of impact of the non-compliance on the health, safety and welfare of
the patient or patients in the facility; and
5. The conduct of the facility in taking all
feasible steps or procedures necessary or appropriate to comply or correct the
facility's prior history of compliance or non-compliance.
(4) If the Board places a facility
on probation, the facility shall detail in a plan of correction those specific
actions, which when followed, will correct the non-compliance identified by the
(5) During the period of
probation, the facility must make reports on a schedule determined by the
board. These reports must demonstrate and explain to the board how the facility
is implementing the actions identified in its plan of correction. In making
such reports, the board shall not require the facility to disclose any
information protected as privileged and confidential under any state or federal
law or regulation.
(6) The Board is
authorized at any time during the probation to remove the probational status of
the facility's license, based upon information presented to it showing that the
conditions identified by the board have been corrected and are reasonably
likely to remain corrected.
Board must rescind the probational status of the facility if it determines that
the facility has complied with its plan of correction as submitted and approved
by the board, unless the facility has additional non-compliance that warrants
an additional term of probation as defined in T.C.A. §
(8) A single period of probation for a
facility shall not extend beyond twelve (12) months. If the board determines
during or at the end of the probation that the facility is not taking steps to
correct non-compliance or otherwise not responding in good faith pursuant to
the plan of correction, the board may take any additional action as authorized
(9) The hearing to place a
facility on probation and judicial review of the board's decision shall be in
accordance with the Uniform Administrative Procedures Act.
When a nursing home is found by the
department to have committed a violation of this chapter, the department will
issue to the facility a statement of deficiencies. Within ten (10) days of the
receipt of the statement of deficiencies, the facility must return a plan of
correction indicating the following:
the deficiency will be corrected;
(b) The date upon which each deficiency will
(c) What measures or
systemic changes will be put in place to ensure that the deficient practice
does not recur; and,
(d) How the
corrective action will be monitored to ensure that the deficient practice does
failure to submit a plan of correction in a timely manner or a finding by the
department that the plan of correction is unacceptable shall subject the
nursing home's license to possible disciplinary action.
(12) Whenever the commissioner exercises the
authority to suspend the admission of any new resident(s) to the nursing home
because of detrimental conditions, as provided by T.C.A. §
nursing home shall post a copy of the commissioner's order upon the public
entrance doors of the facility and prominently display it there for so long as
it remains effective. During the suspension of admissions, the nursing home
shall inform any person who inquires about the admission of a new resident of
the provisions of the order and make a copy of the order available.
(13) Any licensee or applicant for a license,
aggrieved by a decision or action of the department or board, pursuant to this
chapter, may request a hearing before the board. The proceedings and judicial
review of the board's decision shall be in accordance with the Uniform
Administrative Procedures Act, T.C.A. §§
4-5-101, et seq.
Reconsideration and Stays. The Board
authorizes the member who chaired the Board for a contested case to be the
agency member to make the decisions authorized pursuant to rule
petitions for reconsiderations and stays in that case.
Tenn. Comp. R. &
Original rule filed
March 27, 1975; effective April 25, 1975. Repeal and new rule filed July 14,
1983; effective August 15, 1983. Amendment filed March 13, 1986; effective
April 12, 1986. Amendment filed December 30, 1986; effective February 13, 1987.
Repeal and new rule filed January 31, 2000; effective April 15, 2000. Amendment
filed May 24, 2004; August 7, 2004. Amendment filed March 1, 2007; effective
May 15, 2007.
Authority: T.C.A. §§
4-5-219, 4-5-312, 4-5-316, 4-5-317,
68-11-202, 68-11-204, and 68-11-206 through 68-11-209.