Conning the Competition

Tennessee requires CONs within five broad categories—hospital beds, beds outside hospitals, equipment, facilities and services. The state’s Health Services Department Agency manages the CON program and maintains authority to revoke CONs if recipients fail to implement their projects in a “timely manner.” Tenn. Code § 68-11-1611. The minimum CON application fee in Tennessee is $15,000. Tenn. Comp. R. & Regs. § 0720-10-02(5).

COVID-19 Response

On March 19, 2020, Governor Lee suspended certain CON requirements to allow hospitals to temporarily increase bed capacity and establish hospital and diagnostic services at any location as necessary to respond to COVID-19. See Exec. Order No. 15 (Mar. 19, 2020). The Department of Health responded by implementing temporary rules effective through October 7, 2020. See Dep’t of Health, Interpretation and Temporary Waiver of Rules Related to Treatment and Containment of COVID-19 (Apr. 1, 2020); see also sidebar on p.170.

Application Process

In Tennessee, the CON application process takes up to 60 days. Tenn. Code § 68-11-1608(c). The Agency reviews applications (called letters of intent) filed by the 10th of any month in the review cycle beginning the following month. Tenn. Code § 68-11-1607(c)(1), (5). The fee is $5.75 per $1,000 of the estimated expenditure, but not less than $15,000 or more than $95,000. Tenn. Comp. R. & Regs. § 0720-10-02(5). Competitors can intervene in the application process and can offer evidence or argument as to why an application should be denied. Tenn. Code § 68-11-1610.