[Effective 7/1/2024]

(a)

Attorney's Note

Under the Tennessee Code, punishments for crimes depend on the classification. In the case of this section:
ClassPrisonFine
class B misdemeanorup to 6 monthsup to $500
For details, see Tenn. Code § 40-35-111
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Terms Used In Tennessee Code 68-11-213 v2

  • Adult care home: means a single family residence licensed pursuant to this part in which twenty-four-hour residential care, including assistance with activities of daily living, is provided in a homelike environment to no more than five (5) adults who are elderly or have a disability. 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
  • commission: means the health facilities commission created by §. 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
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • 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
  • Home for the aged: means a home represented and held out to the general public as a home which accepts primarily aged persons for relatively permanent, domiciliary care. See Tennessee Code 68-11-201
  • 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
  • Patient: includes , but is not limited to, any person who is suffering from an acute or chronic illness or injury or who is crippled, convalescent or infirm, or who is in need of obstetrical, surgical, medical, nursing or supervisory care. See Tennessee Code 68-11-201
  • Person: means any individual, partnership, association, corporation, other business entity, state or local governmental agencies and entities, and federal agencies and entities to the extent permitted by federal law. See Tennessee Code 68-11-201
  • Prescribed child care center: means a nonresidential child care, health care/child care center providing physician prescribed services and appropriate developmental services for six (6) or more children who are medically or technology dependent and require continuous nursing intervention. See Tennessee Code 68-11-201
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • 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
  • Statute: A law passed by a legislature.
  • Traumatic brain injury residential home: means a facility owned and operated by a community-based traumatic brain injury (TBI) adult care home provider in which residential care, including assistance with activities of daily living, is provided in a homelike environment to disabled adults suffering from the effects of a traumatic brain injury as defined in §. See Tennessee Code 68-11-201
(1) The commission is authorized to initiate proceedings seeking injunctive and any other form of relief available in law or equity against any person who owns, operates, manages or participates in the operation of or management of any facilities required to be licensed under this part, or any resident or residents in any facility required to be licensed under this part, without having the license required by this part.
(2) The commission may also seek such relief against any person who owns, operates, manages or participates in the operation or management of any facility required to be licensed under this part, if such person or facility violates this part, rules, regulations or orders issued under this part, or terms and conditions of the license.
(3) Proceedings under this section may be initiated in the chancery court of Davidson County or the chancery court of the county in which all or part of the activities complained of occur.
(b)

(1) Within five (5) working days after concluding an inspection or investigation, the executive director may initiate type A civil penalty proceedings by mailing a notice to the facility, stating the executive director’s decision to suspend the admissions of new patients.
(2) Within ten (10) working days after concluding an inspection or investigation, the health facilities commission shall mail to the nursing home the executive director’s order, which must detail the alleged facts and pertinent law with particularity, and must also inform the nursing home of its right to contest the action.
(c) If consent is not obtained and the area sought to be inspected is a closed or non-public area, right of entry and inspection shall not be made by the commission, unless a civil warrant, upon probable cause, is first obtained authorizing such entry or inspection.
(d) Inspections conducted pursuant to this section shall be conducted in a manner so as to minimize disruption.
(e) If a determination is made by the commission that a facility or entity is subject to the requirements of licensure under this part, a notice shall be issued by the commission stating the determination and requiring that application for licensure must be made to the commission within thirty (30) days of the receipt of that notice. The thirty-day application period does not serve to waive any civil penalties that may be assessed for unlicensed operation of a facility under this part.
(f) Failure of a facility or entity requiring licensure to make application to the commission for licensure within thirty (30) days from the date of the receipt of the notice may result in the initiation of injunctive relief and any other relief available in law or equity against any person who owns, operates, manages, or participates in the management of a facility or entity.
(g) In addition to requiring that a facility or entity make application for licensure, the commission may immediately initiate a petition for injunctive relief or any other relief available in law or equity. The commission may direct the facility or entity to immediately cease and desist operations when the health, safety, or welfare of the patients or residents requires emergency action. If the facility or entity does not comply with the directive to cease and desist, then the commission may initiate proceedings for injunctive relief and any other relief available in law or equity.
(h)

(1) It is unlawful for any person to receive or accept any patient or patients or any resident or residents in any facility required to be licensed under this part without having applied for and obtained a license as required by this part.
(2) A violation of this requirement is a Class B misdemeanor.
(3) Each day of operation without a license constitutes a separate offense.
(i)

(1) The commission may assess a civil penalty not to exceed five thousand dollars ($5,000) against any person or entity operating an assisted care living facility, home for the aged, adult care home, or traumatic brain injury residential home without having the license required by this chapter. Each day of operation is a separate violation.
(2) The health facilities commission is authorized to establish as part of its comprehensive system of quality assurance and enforcement a system for assessing civil monetary penalties, including appropriate due process, for assisted care living facilities, homes for the aged, adult care homes, and traumatic brain injury residential homes that are in serious violation of state laws and regulations, resulting in endangerment to the health, safety, and welfare of residents.
(3) All penalties for adult care homes or traumatic brain injury residential homes shall be deposited by the commission with the state treasurer to a general fund account specifically designated for the purpose of providing adult care home educational training programs and continuing education requirements for adult care home providers and traumatic brain injury residential home providers, resident managers, substitute caregivers and staff. The commissioner of finance and administration shall determine the appropriate use for these funds.
(4) Beginning one hundred eighty (180) days after the promulgation of regulations under this part by the commission, the commission may assess a civil penalty not to exceed three thousand dollars ($3,000) against any licensed assisted-care living facility for admitting or retaining residents not meeting the definition of assisted-care facility resident set forth in this chapter. Each such resident shall constitute a separate violation.
(j)

(1) The commission may assess a civil penalty not to exceed one thousand dollars ($1,000) against any person or entity operating a prescribed child care facility without the license required by this chapter or in violation of any other statute or regulation promulgated under this chapter. Each day of operation is a separate offense.
(2) The commission is specifically authorized to promulgate regulations for the assessment and procedures to be used in the assessment of civil penalties against a prescribed child care center, including, but not limited to, a schedule of the minimum and maximum penalties, factors to be considered in making the assessment, procedures to be used in the assessment, appeals, and finality of assessments.
(3) The commission is authorized to conduct contested cases regarding appeals of the penalties assessed pursuant to this subsection (j).
(k)

(1) After notification of deficiencies following a licensure or complaint survey, any facility licensed under this part has ten (10) days from the date of notification to submit an acceptable plan of correction. Should the facility submit a plan of correction that is deemed unacceptable by the commission, then the facility has an additional ten (10) days from the date of notification that the plan of correction is unacceptable to submit an acceptable plan of correction. The commission shall provide a facility with no less than three (3) opportunities to submit an acceptable plan of correction and provide clear guidelines so that the facility understands what a plan of correction must include to be deemed acceptable.
(2) If a facility is not able to submit an acceptable plan of correction after three (3) attempts, then a representative from the facility shall appear before the commission and submit a plan of correction for the commission’s approval.
(l) After receipt of an acceptable plan of correction, the commission shall promptly revisit a facility or conduct an administrative review within fourteen (14) business days, unless waived by the facility or licensee, to determine whether the cited deficiencies have been corrected in accordance with the plan. If the same or different deficiencies are cited on the third revisit survey, then the commission may pursue disciplinary action against the facility before the commission, including seeking reimbursement for the unrecouped costs associated with subsequent revisit surveys that were incurred by the commission.
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