HB 819 - SB 1369
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
March 14, 2025
Fiscal Analyst: Christine Drescher | Email: christine.drescher@capitol.tn.gov | Phone: 615-741-2564
HB 819 - SB 1369
SUMMARY OF BILL: Establishes that acute care hospitals are exempt from the
requirement of obtaining a certificate of need (CON) beginning July 1, 2028.
FISCAL IMPACT:
NOT SIGNIFICANT
Assumptions:
• Pursuant to the proposed legislation, “acute care hospital” is a hospital with a primary focus
on patients with an average length of stay of 25 days or less. For the purpose of this analysis
it is assumed that all hospitals that are not designated long-term care would fit this
definition.
• It is expected that all 149 hospitals licensed with the HFC will be considered an acute care
hospital.
• Tennessee Code Annotated § 68-11-1602(2) defines a CON as a permit granted by the
Health Facilities Commission (HFC) to a person for services specified as requiring a
certificate of need at a designated location.
• According to the Rules of the Tennessee Health Facilities Commission § 0702-10-02(5), the
application fee for a CON is $2.25 per $1,000 of estimated project costs, with a minimum
of $3,000 and a maximum of $45,000.
• Pursuant to Tenn. Code Ann. § 68-11-1620(b), the HFC is required to be self-sufficient.
• Tennessee Code Annotated § 68-11-1620(c) authorizes the HFC to collect annual fees from
healthcare providers. According to information provided by the HFC, total annual fees
collected from hospitals in FY23-24 was $603,500.
• The HFC will have the ability to collect sufficient revenues from other sources to offset any
reduction in CON applications beginning in FY28-29.
• The total number of acute care hospitals that will result from not having to apply for and
receive a CON prior to being established cannot be reasonably assumed.
• The proposed legislation can be handled within existing HFC personnel and resources and
without any increase in state expenditures.
HB 819 - SB 1369 2
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director