[Effective 7/1/2024]

(a) The general assembly finds and declares as fact, with regard to ambulatory surgical treatment centers that terminate pregnancies, that:

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Terms Used In Tennessee Code 68-11-223 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
  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • commission: means the health facilities commission created by §. See Tennessee Code 68-11-201
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • 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
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • 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
  • Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
  • 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
  • physician: includes a podiatrist licensed under title 63, chapter 3. See Tennessee Code 68-11-201
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
(1) Over twenty-one thousand (21,000) abortions are performed annually in Tennessee;
(2) The majority of these abortions are performed in ambulatory surgical treatment centers;
(3) Gross negligence, unethical conduct and unprofessional administration of some centers have been documented by the commission, including conditions such as:

(A) The existence of unsterile and unsanitary conditions;
(B) Fire and safety violations, electrical code violations and inadequate ventilation;
(C) Improper disposal of infectious waste;
(D) Allowing patients to leave too soon after the abortion procedure;
(E) Lack of records on patients and complications;
(F) Doctors practicing without a license or without local hospital privileges; and
(G) Surgical procedures performed without a nurse in attendance;
(4) Such centers are the only medical facilities in the state that regularly perform surgery on minors without the knowledge or consent of the parents, guardian or custodian; and yet the parents, guardian or custodian are not relieved of their financial liability and familial responsibilities;
(5) Such centers should be held to similarly applicable standards as other health care related facilities;
(6) The state has a legitimate interest in protecting its citizens from exploitation, the spread of infectious diseases, and ensuring that its citizens utilizing such centers are provided with quality health care as is required in all health care facilities licensed and regulated by the state; and
(7) Many such centers do not carry or maintain adequate health care liability insurance, if any, and the state has an interest in ensuring that those persons utilizing such centers have an adequate recourse to recover financially if a health care liability action arises from the use of such facilities.
(b)

(1) In addition to complying with the rules and regulations promulgated by the commission for ambulatory surgical treatment centers, no ambulatory surgical treatment center that terminates pregnancies shall be granted a license, renewal of a license or be authorized to continue operation under this chapter, unless it complies in full with all of the following requirements:

(A) Maintenance of at least two million dollars ($2,000,000) of health care liability insurance in force, annually submitting to the commission proof of such insurance coverage;
(B) Satisfaction of all applicable regulations and requirements of the commission for compliance with state and local building codes, including electrical, plumbing, fire and other building and safety codes, except where the commission determines that a waiver is appropriate;
(C) Is not in violation of commission regulations that directly impact the health care of multiple patients with such scope and magnitude as to clearly show consistent and willful neglect of the regulations, fundamental flaws in the facility‘s operation, or knowing failure to comply with the commission’s rules;
(D)

(i) The administrator of such facility shall be:

(a) A licensed physician, licensed practical nurse, registered nurse, or have a college degree from a four-year accredited institution and experience in a health-related field; and
(b) Of good moral character.
(ii) For purposes of subdivision (b)(1)(D)(i), “administrator” means the person who is responsible for the operation of the medical facility where pregnancies are terminated;
(E) No employee providing direct patient care, officer, director, or owner of the facility, or if a corporation, a stockholder who owns fifty-one percent (51%) or more of the stock in the corporation, shall have been convicted of or pleaded nolo contendere to a felony or any crime involving moral turpitude within five (5) years immediately preceding the date of application; and
(F) No employee providing direct patient care, officer, director, or owner of the facility, or if a corporation, a stockholder who owns fifty-one percent (51%) or more of the stock in the corporation, shall have been convicted of or pleaded nolo contendere to any violation of this chapter.
(2) The commission shall suspend or revoke a license of such center if a violation of this subsection (b) occurs following the issuance or renewal of a license.
(3) In addition to any other lawful disciplinary action under this part, the commission may assess a civil penalty not exceeding two thousand dollars ($2,000) for each violation of this subsection (b).
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