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SB1369 • 2026

Health Care

AN ACT to amend Tennessee Code Annotated, Title 4; Title 33; Title 68; Title 71 and Chapter 985 of the Public Acts of 2024, relative to certificates of need.

Healthcare
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
Watson, Garrett
Last action
2026-05-18
Official status
Effective date(s) 07/01/2030, 07/01/2028, 05/05/2026
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Health Care

Present law generally requires that a person obtain a certificate of need to establish a hospital, other than a mental health hospital.

What This Bill Does

  • Present law generally requires that a person obtain a certificate of need to establish a hospital, other than a mental health hospital.
  • Effective July 1, 2028, this bill adds that a certificate of need will not be required to establish an acute care hos pital, which this bill defines to mean a hospital with a primary focus on patients with an average length of stay of 25 days or less.
  • ON MARCH 26, 2026, THE SENATE ADOPTED AMENDMENTS #1, #2, AND #3 AND PASSED SENATE BILL 1369, AS AMENDED.
  • AMENDMENT #1 adds authorization for the health facilities commission to license acute care hospitals and requires that any person, partnership, association, or corporation, this state, a county or local government unit, and any division, department, board, or agency of a government unit, shall not establish, conduct, operate, or maintain an acute care hospital in Tennesse e without a license.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Amendment 1-0 to HB0819

Plain English: House Health 1 Amendment No.

  • House Health 1 Amendment No.
  • 1 to HB0819 Terry Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA0594 014682 - 1 - by deleting "July 1, 2028" in subdivision (6) in SECTION 1 and substituting "July 1, 2030".
Amendment 2-0 to HB0819

Plain English: House Finance, Ways, and Means 1 Amendment No.

  • House Finance, Ways, and Means 1 Amendment No.
  • 2 to HB0819 Hicks G Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA0801 016115 - 1 - by deleting "July 1, 2028" in subdivision (6) in SECTION 1 and substituting "July 1, 2030".
Amendment 3-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 3 to HB0819 Williams Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA0893 016524 - 1 - by inserting the following immediately preceding SECTION 14 and redesignating SECTION 14 accordingly: SECTION __.
Amendment 4-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 4 to HB0819 Williams Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1049 017534 - 1 - by inserting the following immediately preceding the effective date section and redesignating effective date section accordingly: SECTION __.
Amendment 5-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 5 to HB0819 Garrett Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1050 017522 - 1 - by deleting all language after the enacting clause and substituting: SECTION 1.
Amendment 6-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 6 to HB0819 Williams Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1071 017599 - 1 - by deleting the language "described in this subsection (b) for acute care hospitals licensed on or after July 1, 2030" and substituting "described in this subsection (b) for acute care hospitals licensed on or after July 1, 2028".
Amendment 7-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 7 to HB0819 Williams Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1073 017595 - 1 - by inserting the following immediately preceding the effective date section and redesignating effective date section accordingly: SECTION __.
Amendment 8-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 8 to HB0819 Williams Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1113 017865 - 1 - by inserting the following immediately preceding the effective date section and redesignating the effective date section accordingly: SECTION __.
Amendment 9-0 to HB0819

Plain English: Amendment No.

  • Amendment No.
  • 9 to HB0819 Garrett Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* HA1126 017910 - 1 - by deleting all language after the enacting clause and substituting: SECTION 1.
Amendment 1-0 to SB1369

Plain English: Senate Health and Welfare 1 Amendment No.

  • Senate Health and Welfare 1 Amendment No.
  • 1 to SB1369 Crowe Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* SA0774 015300 - 1 - by deleting all language after the enacting clause and substituting: SECTION 1.
Amendment 2-0 to SB1369

Plain English: Senate Health and Welfare 2 Amendment No.

  • Senate Health and Welfare 2 Amendment No.
  • 2 to SB1369 Crowe Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* SA0775 016012 - 1 - by inserting the following as new, appropriately designated sections immediately preceding the effective date section, and redesignating the effective date section accordingly: SECTION __.
Amendment 3-0 to SB1369

Plain English: Senate Health and Welfare 3 Amendment No.

  • Senate Health and Welfare 3 Amendment No.
  • 3 to SB1369 Crowe Signature of Sponsor AMEND Senate Bill No.
  • 1369 House Bill No.
  • 819* SA0776 016108 - 1 - by inserting the following as new, appropriately designated sections immediately preceding the effective date section, and redesignating the effective date section accordingly: SECTION __.

Bill History

  1. 2026-05-18 Tennessee General Assembly

    Effective date(s) 07/01/2030, 07/01/2028, 05/05/2026

  2. 2026-05-18 Tennessee General Assembly

    Pub. Ch. 887

  3. 2026-05-18 Tennessee General Assembly

    Comp. became Pub. Ch. 887

  4. 2026-05-05 Tennessee General Assembly

    Signed by Governor.

  5. 2026-04-23 Tennessee General Assembly

    Transmitted to Governor for action.

  6. 2026-04-21 Tennessee General Assembly

    Signed by H. Speaker

  7. 2026-04-21 Tennessee General Assembly

    Signed by Senate Speaker

  8. 2026-04-20 Tennessee General Assembly

    Enrolled and ready for signatures

  9. 2026-04-17 Tennessee General Assembly

    Sponsor(s) Added.

  10. 2026-04-16 Tennessee General Assembly

    Concurred, Ayes 28, Nays 1 (Amendment 8 - HA1113)

  11. 2026-04-16 Tennessee General Assembly

    Concurred, Ayes 26, Nays 1 (Amendment 9 - HA1126)

  12. 2026-04-15 Tennessee General Assembly

    Placed on Senate Message Calendar for 4/16/2026

  13. 2026-04-14 Tennessee General Assembly

    Placed on Senate Message Calendar for 4/16/2026

  14. 2026-04-13 Tennessee General Assembly

    Passed H., as am., Ayes 84, Nays 11, PNV 1

  15. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 7 - HA1073)

  16. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 6 - HA1071)

  17. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 4 - HA1049)

  18. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 3 - HA0893)

  19. 2026-04-13 Tennessee General Assembly

    H. adopted am. (Amendment 8 - HA1113)

  20. 2026-04-13 Tennessee General Assembly

    H. adopted am. (Amendment 9 - HA1126)

  21. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 5 - HA1050)

  22. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 2 - HA0801)

  23. 2026-04-13 Tennessee General Assembly

    Am. withdrawn. (Amendment 1 - HA0594)

  24. 2026-04-13 Tennessee General Assembly

    Subst. for comp. HB.

  25. 2026-04-13 Tennessee General Assembly

    Sponsor(s) Added.

  26. 2026-04-13 Tennessee General Assembly

    Comp. SB subst.

  27. 2026-04-08 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/13/2026

  28. 2026-04-08 Tennessee General Assembly

    Reset on cal. for 4/13/2026

  29. 2026-04-06 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/8/2026

  30. 2026-04-06 Tennessee General Assembly

    Reset on cal. for 4/8/2026

  31. 2026-03-30 Tennessee General Assembly

    Rcvd. from S., held on H. desk.

  32. 2026-03-30 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/6/2026

  33. 2026-03-30 Tennessee General Assembly

    Reset on cal. for 4/6/2026

  34. 2026-03-30 Tennessee General Assembly

    Sponsor(s) Added.

  35. 2026-03-26 Tennessee General Assembly

    Engrossed; ready for transmission to House

  36. 2026-03-26 Tennessee General Assembly

    Sponsor(s) Added.

  37. 2026-03-26 Tennessee General Assembly

    Passed Senate as amended, Ayes 27, Nays 3, PNV 3

  38. 2026-03-26 Tennessee General Assembly

    Senate adopted Amendment (Amendment 3 - SA0776)

  39. 2026-03-26 Tennessee General Assembly

    Senate adopted Amendment (Amendment 2 - SA0775)

  40. 2026-03-26 Tennessee General Assembly

    Senate adopted Amendment (Amendment 1 - SA0774)

  41. 2026-03-26 Tennessee General Assembly

    H. Placed on Regular Calendar for 3/30/2026

  42. 2026-03-25 Tennessee General Assembly

    Sponsor(s) Added.

  43. 2026-03-25 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 3/26/2026

  44. 2026-03-24 Tennessee General Assembly

    Placed on Senate Regular Calendar for 3/26/2026

  45. 2026-03-24 Tennessee General Assembly

    Rec. for pass. if am., ref. to Calendar & Rules Committee

  46. 2026-03-18 Tennessee General Assembly

    Sponsor(s) Added.

  47. 2026-03-18 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 8, Nays 1 PNV 0

  48. 2026-03-18 Tennessee General Assembly

    Placed on cal. Finance, Ways, and Means Committee for 3/24/2026

  49. 2026-03-18 Tennessee General Assembly

    Rec for pass if am by s/c ref. to Finance, Ways, and Means Committee

  50. 2026-03-17 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/18/2026

  51. 2026-03-17 Tennessee General Assembly

    Action deferred in Senate Health and Welfare Committee to 3/18/2026

  52. 2026-03-11 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/17/2026

  53. 2026-03-11 Tennessee General Assembly

    Action deferred in Senate Health and Welfare Committee to 3/18/2026

  54. 2026-03-11 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 3/18/2026

  55. 2026-03-11 Tennessee General Assembly

    Action Def. in s/c Finance, Ways, and Means Subcommittee to 3/18/2026

  56. 2026-03-11 Tennessee General Assembly

    Sponsor(s) Added.

  57. 2026-03-05 Tennessee General Assembly

    Sponsor(s) Added.

  58. 2026-03-04 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/11/2026

  59. 2026-03-04 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 3/11/2026

  60. 2026-03-04 Tennessee General Assembly

    Assigned to s/c Finance, Ways, and Means Subcommittee

  61. 2026-03-03 Tennessee General Assembly

    Rec. for pass. if am., ref. to Finance, Ways, and Means Committee

  62. 2026-02-25 Tennessee General Assembly

    Placed on cal. Health Committee for 3/3/2026

  63. 2026-02-25 Tennessee General Assembly

    Sponsor(s) Added.

  64. 2026-02-17 Tennessee General Assembly

    Sponsor(s) Added.

  65. 2025-04-01 Tennessee General Assembly

    Taken off notice for cal. in Health Committee

  66. 2025-03-26 Tennessee General Assembly

    Assigned to General Subcommittee of Senate Health and Welfare Committee

  67. 2025-03-26 Tennessee General Assembly

    Placed on cal. Health Committee for 4/1/2025

  68. 2025-03-26 Tennessee General Assembly

    Sponsor(s) Added.

  69. 2025-03-26 Tennessee General Assembly

    Rec. for pass by s/c ref. to Health Committee

  70. 2025-03-19 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/26/2025

  71. 2025-03-19 Tennessee General Assembly

    Placed on s/c cal Health Subcommittee for 3/26/2025

  72. 2025-03-19 Tennessee General Assembly

    Action Def. in s/c Health Subcommittee to 3/26/2025

  73. 2025-03-12 Tennessee General Assembly

    Placed on s/c cal Health Subcommittee for 3/19/2025

  74. 2025-03-03 Tennessee General Assembly

    Sponsor(s) Added.

  75. 2025-02-27 Tennessee General Assembly

    Sponsor(s) Added.

  76. 2025-02-24 Tennessee General Assembly

    Sponsor(s) withdrawn.

  77. 2025-02-24 Tennessee General Assembly

    Sponsor(s) Added.

  78. 2025-02-18 Tennessee General Assembly

    Sponsor(s) Added.

  79. 2025-02-13 Tennessee General Assembly

    Sponsor(s) Added.

  80. 2025-02-12 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Health and Welfare Committee

  81. 2025-02-12 Tennessee General Assembly

    Sponsor(s) Added.

  82. 2025-02-10 Tennessee General Assembly

    Sponsor(s) Added.

  83. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  84. 2025-02-10 Tennessee General Assembly

    Assigned to s/c Health Subcommittee

  85. 2025-02-06 Tennessee General Assembly

    Filed for introduction

  86. 2025-02-06 Tennessee General Assembly

    P2C, ref. to Health Committee

  87. 2025-02-05 Tennessee General Assembly

    Sponsor(s) Added.

  88. 2025-02-05 Tennessee General Assembly

    Sponsor(s) withdrawn.

  89. 2025-02-05 Tennessee General Assembly

    Intro., P1C.

  90. 2025-02-04 Tennessee General Assembly

    Sponsor(s) Added.

  91. 2025-02-04 Tennessee General Assembly

    Filed for introduction

Official Summary Text

Present law generally requires that a person obtain a certificate of need to establish a hospital, other than a mental health hospital. Effective July 1, 2028, this bill adds that a certificate of need will not be required to establish an acute care hos
pital, which this bill defines to mean a hospital with a primary focus on patients with an average length of stay of 25 days or less.

ON MARCH 26, 2026, THE SENATE ADOPTED AMENDMENTS #1, #2, AND #3 AND PASSED SENATE BILL 1369, AS AMENDED.

AMENDMENT #1 adds authorization for the

health facilities commission to license acute care hospitals and requires that
any person, partnership, association, or corporation, this state, a county or local government unit, and any division, department, board, or agency of a government unit, shall not establish, conduct, operate, or maintain an acute care hospital in Tennesse
e without a license.

This amendment changes this bill's effective date from upon becoming a law for all purposes to upon becoming a law for rulemaking purposes and July 1, 2030, for all other purposes.

AMENDMENT #2 removes the present law requirement for a certificate of need to open a satellite emergency department, in counties where such requirement presently applies.

This amendment authorizes the health facilities commission to license satellite emergency departments and prohibits a person from

establishing or operating a satellite emergency department unless the satellite emergency department is licensed as an outpatient department of a licensed hospital.

AMENDMENT #3 removes the present law requirement for a certificate of need in order to provide

cardiac catheterization.

This amendment authorizes the health facilities commission to license cardiac catheterizations. This amendment prohibits a person from initiating or providing cardiac catheterization services unless the facility providing such services is licensed as an
outpatient department of a licensed hospital; provided, that such prohibition does not apply to a facility providing cardiac catheterization services is in operation as of July 1, 2030.

ON APRIL 13, 2026, THE HOUSE SUBSTITUTED SENATE BILL 1369 FOR HOUSE BILL 819, ADOPTED AMENDMENTS #9 AND 8, AND PASSED SENATE BILL 1369, AS AMENDED.

AMENDMENT #9 incorporates the provisions of Senate Amendments #1, 2, and 3, and changes the effective date for this bill's provisions concerning satellite emergency departments and cardiac catheterization from July 1, 2030, to July 1, 2028.

AMENDMENT #8 adds authorization for the health facilities commission to adopt by rule additional licensing standards for acute care hospitals licensed on or after July 1, 2030, which standards must include requirements that an acute care hospital:

(1) Participate in the TennCare medical assistance program and provide an amount of care to patients who are TennCare enrollees that is comparable to similarly situated acute care
hospitals; and

(2) Provide an amount of charity care that is comparable to similarly situated acute care hospitals.

For purposes of this amendment, "acute care hospital" means a hospital with a primary focus on patients with an average length of stay of 25 days or less.

In developing licensing standards, this amendment requires the commission to complete a report by January 1, 2031, that includes a compilation of payor mix information by geographical area and type of medical treatment or procedure. The payor mix inform
ation must include percentages of patients who are TennCare enrollees, medicare patients, or charity care patients. The report must be developed with participation from and input of various stakeholders.

ON APRIL 16, THE SENATE CONCURRED IN HOUSE AMENDMENTS #8 AND #9.

Current Bill Text

Read the full stored bill text 
HOUSE BILL 819
By Garrett

SENATE BILL 1369
By Watson

SB1369
000843
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 4;
Title 33; Title 68; Title 71 and Chapter 985 of the
Public Acts of 2024, relative to certificates of need.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Chapter 985 of the Public Acts of 2024, is amended by deleting SECTION
22 and substituting:
SECTION 22. Tennessee Code Annotated, Section 68-11-1602(10)(B), is
amended by adding the following as a new subdivision:
( ) An acute care hospital;
SECTION 23. Tennessee Code Annotated, Section 68-11-1602, is amended by
adding the following as a new subdivision:
( ) "Acute care hospital" means a hospital with a primary focus on
patients with an average length of stay of twenty-five (25) days or less;
SECTION 24. Tennessee Code Annotated, Section 68-11-1607, is amended by
adding the following as a new subsection:
( ) This part does not require a certificate of need to establish or operate
an acute care hospital.
SECTION 25. For the purpose of promulgating rules, this act takes effect upon
becoming a law, the public welfare requiring it. For all other purposes:
(1) Sections 11 and 18-21 take effect July 1, 2024, the public welfare
requiring it;
(2) Sections 1 and 2 take effect July 1, 2025, the public welfare requiring
it;

- 2 - 000843

(3) Sections 3-8 take effect December 1, 2025, the public welfare
requiring it;
(4) Sections 9, 10, and 12-15 take effect December 1, 2027, the public
welfare requiring it;
(5) Sections 16 and 17 take effect December 1, 2029, the public welfare
requiring it; and
(6) Sections 22-24 take effect July 1, 2028, the public welfare requiring it.
SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.