Quality Service License

Important regulatory changes will take place on December 1, 2025, regarding the licensure of Neonatal Intensive Care Units (NICUs), Magnetic Resonance Imaging (MRI)/Positron Emission Tomography (PET) services and Burn Units in the State of Tennessee.

Effective December 1st, 2025, these services will no longer require approval through the Certificate of Need process. Instead, they will transition to a state licensure requirement regulated by the Health Facilities Commission.

NICU, Burn Units, and MRI/PET services will be required to submit a completed licensure application on December 1, 2025 at the following email address: hfc.service@tn.gov Applicants will be invoiced a non-refundable licensure fee depending on the level of services indicated on the submitted application. Please do not submit licensure fees until an invoice is received from the Health Facilities Commission. Provisional approval letters based on the application submitted on December 1, 2025, will be sent to the CEO/Administrator. Licensure applications will be ratified at the next scheduled Commission meeting.

Facilities currently operating or plan to offer these services must ensure they are licensed in accordance with the new requirements by the effective date. Please note that any hospital that intends to provide NICU services but has not been approved by HFC’s Plan Review prior to December 1, 2025, will be required to submit plans to Plans Review for review/approval prior to functioning as a NICU. The plans review submittal portal is located at the following link: https://apps.tn.gov/tnhcf/ .

Links to additional information, including licensure applications and procedures, frequently asked questions, (FAQs), Policy Memos, and Draft Rules can be found in the links below on this web page.

We encourage you to begin reviewing your facilities readiness for this transition and watch for additional notifications and instructions.

If you have any questions, please contact us at hfc.service@tn.gov .

If you would like to be notified of future development relating to the Quality Service License, please email your contact information at hfc.service@tngov .
 

The State of Tennessee recognizes Neonatal Intensive Care Unit's (NICU) as Levels II, III, III with Surgery, and IV.  All NICU's are provisionally licensed at the level of care listed below.  Once the NICU has undergone a site review to verify their level of care, they will be fully licensed.

Ascension St. Thomas Midtown  (Davidson County)     Level III

Ascension St. Thomas Rutherford  (Rutherford County)     Level II

Baptist Memorial Hospital for Woment  (Shelby County)     Level III

Bradley Medical Center  (Bradley County)     Level II

Dolly Parton Children's Hospital  (Knox County)     Level III with Surgery

Erlanger East Hospital  (Hamilton County)     Level II

Erlanger Medical Center  (Hamilton County)     Level IV

Jackson Madison County General Hospital  (Madison County)     Level III

Johnson City Medical Center  (Washington County)     Level III with Surgery

Maury Regional Medical Center  (Maury County)     Level II

Methodist LeBonheur Germantown  (Shelby County)     Level III

Methodist LeBonheur Children's Hospital  (Shelby County)     Level IV

Nashville General Hospital  (Davidson County)     Level II

Parkridge Medical Center  (Hamilton County)     Level III

Regional One Health  (Shelby County)     Level III

St. Francis Hospital Memphis  (Shelby County)     Level II

TriStar Centennial Medical Center  (Davidson County)     Level III with Surgery

TriStar Hendersonville Medical Center  (Sumner County)     Level II

TriStar Horzion Medical Center  (Dickson County)     Level II

TriStar StoneCrest Medical Center  (Rutherford County)     Level II

TriStar Summit Medical Center  (Davidson County)     Level II

University of Tennessee Medical Center  (Knox County)     Level III

Vanderbilt Clarksville Hospital  (Montgomery County)     Level II

Vanderbilt Coffee Tullahoma Harton Hospital  (Coffee County)     Level II

Vanderbilt University Medical Center  (Davidson County)     Level IV

Williamson Health  (Williamson County)     Level II

Policy Memos are Commission approved policies to be used until final Rules have been established/approved.

Policy Memo for Hospitals

Policy Memo for Outpatient Diagnostic Centers

Policy Memo for Major Medical Equipment within Physician Offices

 

Draft Rules

The rulemaking process is time-consuming, and includes the following:

• A Notice of Rulemaking must be filed with the Secretary or Secretary of State's office, 52 days in advance prior to the Rulemaking Hearing.

• Written and a summary of oral comments from the Rulemaking Hearing will be presented to the Commission; the Commission will consider these and either approve, approve with minor revisions, or disapprove the Proposed Rules (Criteria & Standards must be adopted as rules, per law).

• Rulemaking Rules must be submitted to the Attorney General's Office for review; changes may be directed by the AG's office to comply with law, after which Commission staff submits revised Rulemaking Rules for review.

• Rulemaking Rules approved by the Attorney General are submitted by Commission staff to the Secretary of State's office for a 90-day posting period.

• Rules become effective after the 90-day posting.

• The Joint Government Operations Committee will review the rules and could instruct that changes must be made.
 

Draft Rules can be viewed on the Rules, Rulemaking, and Laws page (Click Here).

Currently, the procedures for the Quality Service License are in the final stages of development.

The following webinars are scheduled:

Quality Service License-Burn Center

Friday November 7, 2025, 10 AM-11 AM CST

Please join us as we host a webinar on Friday, November 7, 2025, at 10 am CST.  We will review the important regulatory changes taking effect on December 1, 2025, regarding  licensure of Burn Units  in Tennessee.

Microsoft Teams

Join the meeting now

Meeting ID: 285 975 567 956 2

Passcode: Kx79A4oM

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Quality Service License-NICU

Friday November 7, 2025,  12:00 PM-1:00 PM CST

Please join us as we host a webinar on Friday, November 7, 2025, at 12pm CST.  We will review the important regulatory changes taking effect on December 1, 2025, regarding licensure of Neonatal Intensive Care Units (NICUs) in Tennessee.

Please note that any hospital that intends to provide NICU services and has not received approval through HFC’s Plan Review before December 1, 2025, must submit plans and obtain approval prior to operating a NICU. The Plans Review number is 615-741-6998 and the submission portal is located at the following link: https://apps.tn.gov/tnhcf/.

Additional information, including licensure applications and procedures, frequently asked questions, (FAQs), Policy Memos, and Draft Rules are available at: Quality Service License Information

Join the meeting now

Meeting ID: 235 906 281 708

Passcode: mp9yX9c4

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Quality License-MRI/PET

Wednesday November 12, 2025,  10:00 AM-11:00 AM CST

Please join us as we host a webinar on Friday, November 12, 2025, at 10 am CST.  We will review the important regulatory changes taking effect on December 1, 2025, regarding licensure of MRI/PET Units in Tennessee.

Join the meeting now

Meeting ID: 287 520 356 311 4

Passcode: 4LN9HR2s