(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 birthing center
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 birthing center.
In order to make application for a
(a) The applicant shall submit an
application on a form prepared by the department.
(b) Each applicant for a license shall pay an
annual license fee in the amount of one thousand four hundred and four dollars
($1,404.00). The fee must be submitted with the initial application or renewal
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
birthing center until a license has been issued. Applicants shall not hold
themselves out to the public as being a birthing center until the license has
been issued. A license shall not be issued until the facility is in substantial
compliance with these rules and regulations.
(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 birthing
center 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
(a) For the purposes of licensing,
the licensee of a birthing center 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 facilities operation is transferred.
(b) A change of ownership occurs whenever
there is a change in the legal structure by which the birthing center is owned
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 canceled;
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.
(a) In order to renew a license, each
birthing center 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 1200-08-24-.02(2)(b); 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 facility by Department of Health
Tenn. Comp. R. &
rule filed March 31, 1998; effective June 12, 1998. Amendment filed November
19, 2003; effective February 2, 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. Amendment filed September 24, 2009; effective December
23, 2009. Amendment filed December 16, 2013; effective March 16, 2014.
Amendments filed March 26, 2019; effective
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.