(a) There is created a health facilities commission that has jurisdiction and powers relating to the licensing and regulation of healthcare facilities, as described in § 68-11-202; the certificate of need program described in part 16 of this chapter; the development of the criteria and standards to guide the commission when issuing certificates of need; conducting of studies related to health care, which must include a needs assessment; and related reporting of healthcare institutions subject to this chapter.
Terms Used In Tennessee Code 68-11-203 v2
Ambulatory surgical treatment center: means any institution, place, or building devoted primarily to the maintenance and operation of a facility for the performance of surgical procedures or any facility in which a surgical procedure is utilized to terminate a pregnancy. See Tennessee Code 68-11-201
Assisted-care living facility: means a facility, building, establishment, complex or distinct part thereof that accepts primarily aged persons for domiciliary care and services as described in this section. See Tennessee Code 68-11-201
Commissioner: means the commissioner of health, the commissioner's authorized representative, or in the event of the commissioner's absence or a vacancy in the office of commissioner, the deputy commissioner of health. See Tennessee Code 68-11-201
Conflict of interest: means a matter before the commission in which the member or employee of the commission has a direct interest or indirect interest that is in conflict or gives the appearance of conflict with the discharge of the member's or employee's duties. See Tennessee Code 68-11-201 v2
Contract: A legal written agreement that becomes binding when signed.
Direct interest: means a pecuniary interest in the persons involved in a matter before the commission, and applies to the commission member or employee, the commission member's or employee's relatives, or an individual with whom or business in which the member or employee has a pecuniary interest. See Tennessee Code 68-11-201 v2
Executive director: means the executive director of the health facilities commission. See Tennessee Code 68-11-201
Facility: means any institution, place or building providing health care services that is required to be licensed under this chapter. See Tennessee Code 68-11-201
Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
Hospital: means any institution, place, building or agency represented and held out to the general public as ready, willing and able to furnish care, accommodations, facilities and equipment for the use, in connection with the services of a physician or dentist, of one (1) or more nonrelated persons who may be suffering from deformity, injury or disease or from any other condition for which nursing, medical or surgical services would be appropriate for care, diagnosis or treatment. See Tennessee Code 68-11-201
Indirect interest: means a personal interest in the persons involved in a matter before the commission that is in conflict with the discharge of the commission member's or employee's duties. See Tennessee Code 68-11-201 v2
Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
Needs assessment: means an annual report that measures access to health care in this state, particularly as to emergency and primary care. See Tennessee Code 68-11-201 v2
Nursing home: means any institution, place, building or agency represented and held out to the general public for the express or implied purpose of providing care for one (1) or more nonrelated persons who are not acutely ill, but who do require skilled nursing care and related medical services. See Tennessee Code 68-11-201
Quorum: The number of legislators that must be present to do business.
Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
(b)(1) The commission consists of fifteen (15) members, including:
(A) The comptroller of the treasury, or an employee of the office of the comptroller of the treasury, designated by the comptroller;(B) The commissioner of disability and aging, or an employee of the department of disability and aging, designated by the commissioner;(C) The director of TennCare, or an employee of the division of TennCare, designated by the director;(D) Four (4) members appointed by the speaker of the senate, to include:
(i) One (1) consumer member;(ii) One (1) individual who has recent experience as an executive officer of a hospital or hospital system who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;(iii) One (1) representative of the nursing home industry who may be appointed from lists of qualified persons submitted by interested healthcare groups, including, but not limited to, the Tennessee Health Care Association; and(iv) One (1) duly licensed physician who may be appointed from lists of qualified persons submitted by interested medical groups, including, but not limited to, the Tennessee Medical Association;(E) Four (4) members appointed by the speaker of the house of representatives, to include:
(i) One (1) consumer member;(ii) One (1) individual who has recent experience as an executive officer of a hospital or hospital system who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;(iii) One (1) representative of the nursing home industry who may be appointed from lists of qualified persons submitted by interested healthcare groups, including, but not limited to, the Tennessee Health Care Association; and(iv) One (1) duly licensed physician who may be appointed from lists of qualified persons submitted by interested medical groups, including, but not limited to, the Tennessee Medical Association; and(F) Four (4) members appointed by the governor, to include:
(i) One (1) registered nurse, who may be appointed from lists of qualified persons submitted by interested groups, including, but not limited to, the Tennessee Nurses Association;(ii) One (1) representative of the home care industry who may be appointed from lists of qualified persons submitted by interested home care groups, including, but not limited to, the Tennessee Association for Home Care. The initial term for the home care industry representative is two (2) years. Upon the expiration of that term, the home care industry representative is appointed for a three-year term pursuant to subsection (c);(iii) One (1) representative of the assisted-care living facility industry; and(iv) One (1) representative of the ambulatory surgical treatment center industry.(2) The governor and each speaker shall consult with interested groups, including, but not limited to, the organizations listed in subdivision (b)(1) to determine qualified persons to fill positions with the commission.(3) In making appointments to the health facilities commission, the governor and the speakers shall strive to ensure that racial minorities, females, persons sixty (60) years of age and older, and the three (3) grand divisions are represented.(4) The consumer members must be persons who are knowledgeable of health needs and services and who are further knowledgeable by training or experience in healthcare facility design or construction, financing of healthcare services or construction, reimbursement of healthcare services, or general healthcare economics. The consumer members shall not be a direct provider of healthcare goods or services.(c)(1) A member of the commission shall not serve beyond the expiration of the member’s term, whether or not a successor has been appointed by the governor or the speakers of the senate and the house of representatives.(2)(A) Except as otherwise provided in subdivisions (c)(2)(B) and (C), commission members are appointed for three-year terms. A commission member may serve consecutive terms, and there is no limit upon the number of consecutive or non-consecutive terms that a member may serve.(B) The comptroller of the treasury, the commissioner of disability and aging, and the director of TennCare, or their respective designees, are not limited to a term of years.(C) In order to stagger the initial terms of the consumer members of the commission, the following initial terms apply:
(i) The initial term for the consumer member appointed pursuant to subdivision (b)(1)(D)(i) is three (3) years; and(ii) The initial term for the consumer member appointed pursuant to subdivision (b)(1)(E)(i) is two (2) years.(3) If a member is absent from three (3) consecutive, regularly scheduled public meetings of the commission, then the individual’s membership is automatically terminated, and the position is considered vacant.(d)(1) Each member of the commission shall be reimbursed for all travel and other necessary expenses.(2) Expenditures must be claimed and paid in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration, and approved by the attorney general and reporter.(e)(1) At the first meeting in each even-numbered year, the commission shall elect officers. The chair of the commission must be a consumer member to serve a term as chair for two (2) years. A member shall not serve more than two (2) consecutive terms as chair. A member of the commission may serve as vice chair, which is a term of two (2) years. A member shall not serve more than two (2) consecutive terms as vice chair.(2) Meetings of the commission must be held as frequently as its duties may require, and no less frequently than eight (8) times each fiscal year.(3) A majority of appointed members, not including vacant positions, constitutes a quorum.(4) An action of the commission is not effective unless the action is concurred in by a majority of commission members present and voting.(5) The chair may only vote if there is a tie among the other members present and voting.(6) The commission shall record by name the votes taken on all actions of the commission.(7)(A) All commission members shall annually review and sign a statement acknowledging the statute, rules, and policies concerning conflicts of interest.(B)(i) A member, upon determining that a matter scheduled for consideration by the commission results in a conflict with a direct interest, shall immediately notify the executive director and is recused from any deliberation of the matter, from making any recommendation, from testifying concerning the matter, or from voting on the matter. The member shall join the public during the proceedings.(ii) A member with an indirect interest shall publicly acknowledge such interest, unless the member is recused from deliberation on, making a recommendation regarding, testifying concerning, or voting on the matter.(iii) All members shall make every reasonable effort to avoid even the appearance of a conflict of interest. If a member is uncertain whether the relationship justifies recusal, then the member shall follow the determination by the legal counsel for the commission.(iv) A determination by the commission or a court that a member of the commission with a direct interest failed to provide notice and be recused from deliberations of the matter, from making any recommendation, from testifying concerning the matter, or from voting on the matter, results in the member’s automatic termination from the commission and the position is considered vacant. The member is not eligible for appointment to any commission, board, or commission of this state for a period of two (2) years.(v) The executive director, upon determining that a conflict exists for the executive director or a member of the staff, shall notify the chair of the commission and take such action as the chair prescribes and pursuant to this part.(f) In addition to the powers granted elsewhere in this part, the commission has the duty and responsibility to:
(1) Promulgate rules and policies deemed necessary by the commission for the fulfillment of its duties and responsibilities under this part;(2) Promulgate rules and policies deemed necessary by the commission for the fulfillment of its duties and responsibilities under part 16 of this chapter, including, but not limited to, criteria to guide the commission in the issuance of certificates of need;(3) Conduct studies related to health care, including a needs assessment that must be updated at least annually; and(4)Contract when necessary for the development of criteria and standards to guide the commission when issuing certificates of need and for the implementation of the certificate of need program described in this part.
