Managing Healthcare Compliance in Tennessee

Sarah Jones
Outline of Tennessee over a healthcare photo

The landscape of healthcare compliance in Tennessee is marked by distinct rules and regulations that must be adhered to by organizations across the state. For all healthcare entities, from individual providers to large organizations, navigating through these state-specific regulatory frameworks is crucial to ensure the delivery of safe and ethical healthcare services. 

Healthcare organizations in Tennessee need to be able to keep up with regulatory changes and quickly adapt. This article serves as a comprehensive primer, highlighting the key elements of healthcare compliance that are specific to Tennessee.

Tennessee Healthcare Compliance Resources

Let’s start with the important state government agencies you’ll need to work with:

  • The Tennessee Department of Health (TDOH) plays a vital role in promoting the health and wellbeing of Tennessee residents. Through various departments and initiatives, regulations and policies, the TDOH aims to ensure the public’s health is protected, diseases are prevented, and quality healthcare services are accessible. 
  • The Tennessee Hospital Association (THA) is a membership organization that represents and supports hospitals and health systems across Tennessee, advocating for their interests and working to enhance healthcare quality and accessibility for all Tennesseans.
  • TennCare is Tennessee’s managed Medicaid agency. It administers and oversees the state’s Medicaid programs, providing essential healthcare services to low-income individuals and families in Tennessee.
  • The Tennessee Board of Medical Examiners is the regulatory body responsible for licensing and overseeing medical professionals in Tennessee, ensuring that they meet the necessary standards to provide safe and competent medical care.
  • The Tennessee Department of Mental Health and Substance Abuse Services Office of Licensure oversees the certification and regulation of mental health and substance abuse service providers in Tennessee, ensuring adherence to state standards for quality and safety.

These agencies help maintain the integrity and quality of healthcare services in Tennessee, protecting the public and promoting patient safety. The resources provided by these Tennessee state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Tennessee.

Regulations Unique to Tennessee

To meet the standards of healthcare compliance in Tennessee, there are a few additional regulations.

Certificate of Need Regulations

In Tennessee, the Certificate of Need (CON) program, managed by the Division of Health Planning, is designed to foster improvement in healthcare access, quality, and cost-efficiency through the orderly management of the state’s healthcare system. Significant changes were made to the program as of July 1, 2016. These changes include the scope of services overseen, eased restrictions on new home care agencies, the removal of the need for HSDA approval to replace or relocate medical equipment originally requiring a CON, and alterations to the funding structure of the Tennessee Health Facilities Commission (HFC) (formerly the Health Services Development Agency), which is responsible for decisions on CON applications. Compliance leaders should note that the Division of Health Planning continuously revises CON standards and criteria in order to ensure alignment with the evolving needs of Tennessee’s healthcare sector.

State HIPAA Laws

While the Health Insurance Portability and Accountability Act (HIPAA) is the foundational standard for the safeguarding of protected health information (PHI), Tennessee’s privacy laws exceed baseline expectations by providing more comprehensive protection for consumers’ health information than the federal mandates under HIPAA. It is crucial that individual healthcare providers, organizations, and compliance professionals have a firm grasp on Tennessee’s strict guidelines for handling sensitive patient data.

Tips To Manage Healthcare Compliance in Tennessee

Effectively managing healthcare compliance in Tennessee is a critical responsibility for healthcare organizations, as it ensures the delivery of high-quality care while adhering to legal and regulatory requirements. Here are some key strategies to help healthcare organizations manage compliance effectively:

  • Conduct State-Specific Training: Provide ongoing training and education to staff that is customized to your state’s regulations as well as your facility. If using a learning management system, ensure the vendor offers Tennessee-approved training.
  • Organize Policies By Requirement: Including “TN” in every document that is required by the state will make it much easier for you to find these documents in an online system when a surveyor is onsite. It is also best practice to include the standard you are meeting for additional clarity.
  • Establish a System for Monitoring Risk: Being able to identify compliance risks before they become incidents or violations can save the entire organization time and money. Identifying trends and consistently reviewing reports can signal issues, such as training not being completed or a large number of incidents in one location.
  • Use Compliance Management Software: Accreditation surveyors say organizations that use compliance software are more prepared for onsite visits and surveys. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

By implementing these strategies and fostering a culture of compliance within your healthcare organization, you can effectively manage healthcare compliance, reduce risks, and provide the best possible care to your patients while staying within legal boundaries.

Credentialing Compliance in Tennessee

Tennessee’s medical credentialing process has several distinctive features. When applying for initial licensure, healthcare professionals are required to submit an official transcript from their educational institution directly to the Tennessee Board Office, either by mail or email. This ensures direct verification of their educational qualifications​​. Additionally, the Tennessee Department of Health has simplified the licensure process by implementing an online application system. This user-friendly process allows healthcare professionals to apply for an initial license, pay the application fees electronically, and upload necessary documents, making the process more efficient and accessible​​.

Of note, Tennessee is also a participant in the Interstate Medical Licensure Compact (IMLC), which provides a streamlined pathway for physicians seeking to practice in multiple states. This compact allows for a more efficient process of obtaining licenses across state lines, provided the applicants meet the rigorous qualifications​​. These features collectively enhance the efficiency, accessibility, and rigor of the medical credentialing process in Tennessee.

Meet Tennessee Compliance Requirements With MedTrainer 

While the path may be complex, healthcare providers who prioritize compliance will not only avoid legal troubles but also enhance the quality of care they provide to their patients in Tennessee

MedTrainer’s all-in-one compliance platform can streamline management of Tennessee healthcare compliance. MedTrainer seamlessly consolidates your organization’s policies, incident reports, safety plans, HR documents, contracts, and more. This centralized repository ensures all employees have easy access to essential information. The course library is curated to align with regulatory and accreditation requirements, and courses are regularly added and updated to ensure the most current information. Learn more about MedTrainer today!