ON APRIL 27, 2022, THE SENATE ADOPTED AMENDMENTS # 2 AND 3, AND PASSED SENATE BILL 2466, AS AMENDED.
AMENDMENT #2 requires the board of licensing health facilities to report to the health facilities commission instead of the department of health in the matter of licensing healthcare facilities.
This amendment transfers all administrative rules in effect on the effective date of this amendment that were promulgated by the board for licensing health facilities while attached to the department of health to the health facilities commission on the effective date of this amendment.
Under present law, a physician office must be certified by the board of medical examiners and have a site survey completed by the department of health in order to perform office-based surgery. This amendment transfers the authorization to conduct site surveys in this manner from the department of health to the health facilities commission.
This amendment specifies that the commission's employees, except for public health nursing consultants, fire and building code inspectors, and facilities construction specialists, are executive service and serve at the pleasure of the executive director.
Under present law, a certificate of need is required for a change in the location of existing or certified facilities providing healthcare services and healthcare institutions. However, the executive director may issue an exemption for the relocation of existing healthcare institutions and approved services if the executive director determines that:
(1) At least 75 percent of patients to be served are reasonably expected to reside in the same zip codes as the existing patient population; and
(2) The relocation will not reduce access to consumers, particularly those in underserved communities; those who are uninsured or underinsured; women and racial and ethnic minorities; TennCare or medicaid recipients; and low-income groups.
This amendment changes the applicable percentage from 75 to 95 percent, and adds the requirement that the payor mix will not include an increase in commercial insurance. Under present law, the executive director must notify the agency of an exemption granted pursuant to the above provisions within two business days of the date the executive director grants the exemption; this amendment changes the notice requirement to be at the next regularly scheduled commission meeting.
Under present law, a certificate of need is not required for actions in a county that, as of January 1, 2021:
(A) Is designated as an economically distressed eligible county by the department of economic and community development; and
(B) Has no hospital that is actively licensed located within the county.
This amendment removes that "as of January 1, 2021" time restriction.
Under present law, a person that provides positron emission tomography services or magnetic resonance imaging services pursuant to the above provisions must be accredited by The Joint Commission or the American College of Radiology in the modalities provided by that person and submit proof of the accreditation to the commission within two years of the initiation of service. Also, a person that provides positron emission tomography services or magnetic resonance imaging services pursuant to the above provisions and that fails to comply with the accreditation requirement is subject to licensure sanction. This amendment adds that a person that provides a service other than those described in these provisions, or establishes a healthcare institution must submit proof of accreditation by an appropriate external peer-review organization for the service or facility to the commission within two years of the date of initiation of service or licensure of the healthcare institution.
This amendment removes a present law requirement for an annual report by persons who perform certain actions, such as cardiac catheterization.
This amendment requires the governor to designate one individual as an alternate commission member for each of the following of the governor's appointments: the person who has recent experience as an executive officer of a hospital or hospital system; the representative of the nursing home industry; the licensed physician; the representative of the home care industry; the consumer member; and the representative of the ambulatory surgical treatment center industry. The alternate will serve when the alternate member's respective regularly appointed member is unable to participate in a matter before the commission due to the member's absence or because of the member's recusal due to a conflict of interest. Each alternate commission member will be subject to the same qualifications that apply to the appointment of the alternate member's respective regularly appointed member.
Under present law, a healthcare institution wishing to oppose a certificate of need application must be located within a thirty-five-mile radius of the location of the action proposed. This amendment adds that the institution must also have served patients within that radius within the 365 days immediately preceding the date of the filing the certificate of need application.
Under present law, a certificate of need and activity the certificate authorizes becomes void if the actions the certificate authorizes have not been performed for a continuous period of one year after the date the certificate of need is implemented. With respect to a home care organization, this provision applies to each county for which the home care organization is licensed. This amendment changes the applicable time period from one to two years and, in regard to home care organizations, provides that that provisions apply to whether the home care organization provides home health services anywhere within its service area, and not on the basis of each county for which the home care organization is licensed.
This amendment clarifies that costs of contested case proceeding and appeals, including the administrative law judge's costs, deposition costs, expert witness fees, and reasonable attorney's fees, must be assessed against the losing party in the contested case.
AMENDMENT #3 specifies that the executive director has the exclusive authority to appoint, terminate, and control staff employees, rather than giving such authority to the commission and the executive director.
This amendment makes all of the commission's employees executive service who serve at the pleasure of the executive director.
This amendment prohibits the assessment of costs against a losing party in a contested case proceeding or appeal if the commission's decision to approve that party's certificate of need application is being appealed in the contested case.
This amendment adds a requirement that the department of health make available to the executive director of the health facilities commission all internal audits that pertain to the board for licensing healthcare facilities, the office of health care facilities, or the support staff of those entities, including, but not limited to, complaint investigations, surveying, human resources, or the office of general counsel.

Statutes affected:
Current Version: 4-3-104, 4-3-1016(d)(73), 4-3-1016, 4-29-245(a)(16), 4-29-245, 68-11-1602(1), 68-11-1602
Amended with SA0752, SA0957 -- 04/27/2022: 4-3-104, 4-3-1016(d)(73), 4-3-1016, 4-29-245(a)(16), 4-29-245, 68-11-1602(1), 68-11-1602, 33-2-403(b)(8), 33-2-403, 63-6-221(a), 63-6-221, 63-6-221(h), 63-6-221(i), 63-6-221(j), 63-6-221(k), 63-6-221(l), 63-9-112(f), 63-9-112, 63-9-117(a), 63-9-117, 63-9-117(h), 63-9-117(i), 63-9-117(j), 63-9-117(k), 63-9-117(l), 68-1-119, 68-11-201, 68-11-201(5)(A), 68-11-201(17)(D), 68-11-201(31)(A), 68-11-201(31)(B), 68-11-202, 68-11-203(b)(1), 68-11-203, 68-11-204(c), 68-11-204, 68-11-206(a), 68-11-206, 68-11-206(a)(1), 68-11-206(a)(1)(G), 68-11-206(a)(7), 68-11-207(a)(1), 68-11-207, 68-11-207(f)(3)(C), 68-11-207(i), 68-11-208(a), 68-11-208, 68-11-210(a), 68-11-210, 68-11-210(b), 68-11-210(c)(1), 68-11-210(c)(3)(D), 68-11-210(c)(3)(E), 68-11-210(c)(4), 68-11-210(c)(5), 68-11-210(d), 68-11-210(e), 68-11-210(f)(1), 68-11-211, 68-11-211(b), 68-11-211(c), 68-11-211(f), 68-11-211(g), 68-11-213, 68-11-214, 68-11-215(a), 68-11-215, 68-11-215(d), 68-11-216(a)(2), 68-11-216, 68-11-216(a)(5), 68-11-216(b), 68-11-219(g), 68-11-219, 68-11-221, 68-11-222(b), 68-11-222, 68-11-223, 68-11-225(c)(1), 68-11-225, 68-11-235(i), 68-11-235, 68-11-235(j), 68-11-236(h), 68-11-236, 68-11-237(h), 68-11-237, 68-11-237(l), 68-11-239(g), 68-11-239, 68-11-251(d), 68-11-251, 68-11-252, 68-11-310(a)(1), 68-11-310, 68-11-702(a), 68-11-702, 68-11-801, 68-11-802(a), 68-11-802, 68-11-803, 68-11-804, 68-11-806, 68-11-812, 68-11-813(a), 68-11-813, 68-11-813(b), 68-11-814, 68-11-815(b)(1), 68-11-815, 68-11-815(c)(3), 68-11-816(a), 68-11-816, 68-11-816(b), 68-11-820(c), 68-11-820, 68-11-826(c), 68-11-826, 68-11-827, 68-11-829(a), 68-11-829, 68-11-830, 68-11-830(d)(3), 68-11-830(6)(C), 68-11-831, 68-11-832, 68-11-902(b)(5), 68-11-902, 68-11-904(a), 68-11-904, 68-11-908(b)(1), 68-11-908, 68-11-909, 68-11-910(a)(5), 68-11-910, 68-11-1001(a), 68-11-1001, 68-11-1001(c), 68-11-1003, 68-11-1005(a), 68-11-1005, 68-11-1006, 68-11-1602(2), 68-11-1602(3), 68-11-1602(5), 68-11-1602(10), 68-11-1602(11), 68-11-1602(12), 68-11-1602(13), 68-11-1604(a), 68-11-1604, 68-11-1604(b), 68-11-1604(c), 68-11-1604(d), 68-11-1604(e), 68-11-1604(e)(4), 68-11-1604(e)(6), 68-11-1604(e)(7), 68-11-1605, 68-11-1606, 68-11-1606(b), 68-11-1606(c)(9), 68-11-1606(c), 68-11-1606(h)(2), 68-11-1606(h)(3), 68-11-1607, 68-11-1608, 68-11-1609, 68-11-1609(a)(1)(A), 68-11-1609(d), 68-11-1609(i)(1), 68-11-1610, 68-11-1611, 68-11-1612(a), 68-11-1612, 68-11-1613, 68-11-1614, 68-11-1616, 68-11-1617, 68-11-1617(5), 68-11-1618, 68-11-1619, 68-11-1620(a), 68-11-1620, 68-11-1620(b), 68-11-1620(c), 68-11-1621, 68-11-1623, 68-11-1623(b), 68-11-1623(c), 68-11-1624, 68-11-1625, 68-11-1626, 68-59-102, 68-59-104, 68-59-105, 68-140-321(a), 68-140-321, 68-140-321(d), 71-5-1003(c)(7), 71-5-1003, 71-5-2002(2)(C), 71-5-2002, 68-11-1604(e)(1), 68-11-1606(f), 68-11-1609(g)(1), 68-11-1609(h), 68-11-1610(h)