Rules & Regulations of the State of Tennessee Title 0820 - Land Surveyor Examiners
Overview: Tennessee Title 0720 - Health Facilities Commission (HFC)
The Tennessee Health Facilities Commission (HFC) regulates the development, construction, and expansion of health care facilities in Tennessee. The Commission’s primary purpose is to ensure that the growth of health care infrastructure aligns with community needs and state health planning goals.
The rules under Title 0720 provide standards for:
Certificate of Need (CON) applications
Review criteria and public hearings
Approval, denial, or modification of projects
Enforcement and penalties
Key Provisions of Title 0720
1. Certificate of Need (CON) Program
Rule: Any person or entity planning to build, expand, or significantly modify a health care facility must obtain a Certificate of Need from the HFC before proceeding.
Facilities covered include hospitals, nursing homes, ambulatory surgical centers, and certain outpatient services.
CON applications require detailed project descriptions, cost estimates, and demonstration of public need.
Applicants must show the project will not duplicate existing services unnecessarily or increase health care costs unjustifiably.
Case Law:
Memphis Health Network v. Tennessee Health Facilities Commission, 2002 Tenn. App.
The court upheld the Commission’s denial of a CON application for a new surgical center because the applicant failed to demonstrate sufficient community need, emphasizing the Commission’s broad discretion in interpreting “need” consistent with public health goals.
2. Application Process and Public Hearings
Rule: The Commission holds public hearings to allow stakeholders and community members to provide input on proposed projects.
Notice of application must be published.
Interested parties can submit written comments or attend hearings.
The Commission considers economic impact, accessibility, and quality of care.
Case Law:
Johnson v. Tennessee Health Facilities Commission, 2010 Tenn. App.
A challenger argued inadequate public notice violated due process. The court ruled the Commission met notice requirements and provided a fair hearing, confirming that procedural fairness is key but does not require perfection if substantial compliance is met.
3. Review Criteria
Rule: The HFC reviews applications based on statutory and regulatory criteria, including:
Need for the service or facility in the area
Availability of less costly alternatives
Impact on existing facilities and health care costs
Financial feasibility and viability of the project
Quality of care and access for underserved populations
Case Law:
Smith v. Tennessee Health Facilities Commission, 2015 Tenn. App.
Smith challenged approval of a new nursing home arguing inadequate consideration of economic impact. The court deferred to the Commission’s expertise and affirmed the decision, noting courts rarely substitute their judgment for agency expertise absent arbitrary or capricious action.
4. Conditions on Approval
Rule: The Commission can approve CONs with conditions to address community concerns or regulatory compliance.
Conditions may limit the scope or scale of construction.
Applicants must comply with conditions or risk revocation.
Modifications require further Commission approval.
Case Law:
Healthcare Partners, Inc. v. Tennessee Health Facilities Commission, 2017 Tenn. App.
The court supported the Commission’s imposition of conditions to ensure community health needs were met and excessive duplication avoided, emphasizing the Commission’s role in balancing interests.
5. Enforcement and Penalties
Rule: Operating without a CON or violating conditions can lead to penalties including fines, injunctions, or forced cessation of operations.
The Commission can refer violations to the Attorney General.
Facilities may be barred from participating in state health programs.
Case Law:
Tennessee Health Facilities Commission v. Southern Hospital Group, 2013 Tenn. App.
Southern Hospital operated an expansion without a CON. The court granted injunctive relief to halt operations, affirming the Commission’s authority to enforce compliance and protect public health.
Summary of Tennessee Title 0720
The Health Facilities Commission regulates construction and expansion of health care facilities through the Certificate of Need process.
The process ensures health care resources are allocated efficiently and meet community needs.
The Commission’s decisions are generally afforded deference by courts, which emphasize the agency’s expertise and broad discretion.
Due process requirements (notice and hearing) are essential but flexible.
Enforcement powers are robust to ensure compliance.
Public participation and transparency are central to the review process.
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