Hospitals and Health Care Facilities - As enacted, extends by four years to June 30, 2029, the current 125-bed limitation on the number of new nursing home beds for which the health facilities commission may issue a certificate of need per fiscal year. - Amends TCA Section 68-11-1619.

114th Regular Session (2025-2026) Introduced by Rusty Crowe

Extends the 125-conversion-per-year cap for new nursing home beds to June 30, 2029, keeping the same limit and framework.

Pub. Ch. 65

#hospitalsandhealthcarefacilities

Overview

Purpose: Extend the existing 125-bed annual limit on certificates of need (CON) for new nursing home beds that the Health Facilities Commission (HFC) may issue per fiscal year.

Effective date: Upon becoming law; public welfare requiring it. The recent enactment date shown is March 25, 2025.

Sponsor: Senator Crowe; House sponsor: Atchley (co-sponsor noted in materials).

What the bill does

Extends the bed-conversion cap period: The current statutory language limiting the HFC to issuing up to 125 CONs for new nursing home beds per fiscal year is extended from June 30, 2025, to June 30, 2029.

Scope of restriction remains the same: The cap applies to the number of CONs (or equivalent bed conversions) the HFC may authorize annually for new nursing home beds (including swing beds) in Tennessee.

Key provisions and changes

Amendment to TCA § 68-11-1619(a): Replaces the target date “until June 30, 2025” with “until June 30, 2029.”

No other substantive changes: The bill does not change the bed-count cap (still 125 CONs per fiscal year) or modify how CONs are allocated, nor any other provisions related to the CON process.

Affected parties and impact

Health Facilities Commission (HFC): Continues to administer the CON process with a cap of up to 125 new nursing home bed CONs per fiscal year through June 30, 2029.

Nursing home developers and operators: Their ability to obtain CONs for new nursing home beds remains subject to the 125-bed-per-year cap through 2029.

Hospitals and healthcare facilities: Indirect effects may include continued constraints on converting hospital beds to nursing home use, depending on whether those beds fall under the CON framework.

Procedural and timeline notes

Legislative history highlights:

Passed both chambers in March 2025.
Signed by the Governor and enacted as Public Chapter 65 (effective date March 25, 2025), with effective implementation noted as applicable upon becoming law.

Fiscal note: Describes the impact as not significant; extending the cap to 2029 is not expected to produce substantial fiscal or operational effects for state or local governments.

Effective date: The act takes effect as required by public welfare, with related statutory changes applicable through June 30, 2029.

Bottom line

SB 515 extends the current 125-bed-per-year CON cap for new nursing home beds by four years, moving the sunset from June 30, 2025, to June 30, 2029. The change maintains the same annual limit, preserving the existing framework for the HFC’s approval of bed-conversion projects without introducing new costs or reforms beyond the extended timeframe.

Bill