Tennessee State Laws and Regulations - Summary

Frequently Asked Questions


  1. What kinds of facilities require a license?
    Any substance abuse facility which offers treatment services for substance abuse requires a license from the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS). Substance abuse facilities Read More
  2. What kinds of facilities are exempt from licensure?
    The following facilities are exempt from licensure by Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS): Read More
  3. What kinds of facilities provide addiction services in Tennessee?

    Alcohol and Drug
    Residential Detoxification Treatment Facilities
    Alcohol and drug residential detoxification treatment facilities provide intensive twenty-four hour residential treatment for service recipients to systematically reduce or eliminate the amount of a toxic agent in the body until they cease to exhibit signs and symptoms of withdrawal.

    There are two levels of residential detoxification treatment: Read More
  4. What does it mean to be ‘licensed’ or ‘accredited’ in this industry?
    Licensing means that the facility has been granted a written notice conveying to the public that Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) has issued Read More
  5. Licensing

  6. Which body authorizes and oversees substance abuse treatment facilities in the State of Tennessee?
    In Tennessee, the Tennessee Department of Mental Health and Developmental Disabilities, Department of Mental Health and Substance Abuse Services (TDMHSAS) is responsible for... Read More
  7. What are the benefits of licensure?
    Licensure is mandatory. However... Read More
  8. Certificate of Need (Tennessee ONLY)

    What information must be provided in my initial application for a license?
    Facilities of this type sometimes encounter opposition from nearby residents or from other competing providers. Read More

  9. What kinds of licenses are available?
    There are three types of licenses. The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) may grant an initial license to... Read More
  10. What can a facility do in circumstances where an application is rejected?
    Upon receipt of the completed application and the required fees, TDMHSAS will arrange for... Read More
  11. Renewal

  12. Does a license have to be renewed?
    Licenses expire on the date printed on the face of the license. However,... Read More
  13. On-site Review

  14. What kinds of inspections might there be for licensure determination?
    The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) can send its representatives to enter and inspect any premises of any facility, or service providing mental health, developmental disabilities substance abuse, ... Read More
  15. How can a facility prepare for inspections, on-site reviews and audits?
    While the criteria are periodically updated, key subjects of review may include: Read More
  16. Why might a licensing application be unsuccessful?
    Licensing applications will be unsuccessful where there is evidence of non-compliance with licensure laws, ordinances, rules and regulations. Read More
  17. What effect does accreditation or certification on the licensing process?
    A facility or service which is voluntarily accredited or certified may be deemed by Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) to be in compliance with... Read More
  18. Zoning and Land Use

  19. What are the protections afforded to small group homes used for the purpose of residential substance abuse treatment
    Sober homes and other transitional living facilities for those recovering from alcoholism and drug addiction are generally subject to local zoning laws and regulations. Read More
  20. Are there any proximity restrictions regulating how close treatment centers may be to each other? Can I open a residential treatment center right next to one that is already there?
    There is no statewide rule or regulation preventing multiple facilities from operating in close proximity. However, many residential treatment facilities have faced... Read More
  21. Other than spacing considerations, do treatment facilities have any specific obligations to their neighbors?
    Opioid treatment facilities are the only classification of substance abuse treatment provider required to develop... Read More
  22. What are the basic physical plant requirements for treatment facilities?
    Please note, these regulations relate to space and do not constitute all environmental requirements. Facilities must also comply with rules designed to... Read More
  23. Care, Treatment and Services

    Admissions Agreement

  24. What information must be disclosed to the service recipient during intake and what should we put in our admissions agreement?
    Prior to admission, or in the case of an intoxicated service recipient, as soon as stabilization occurs, basic information about treatment services must be provided, in simple, non-technical terms and in the service recipient’s primary language. This must include... Read More
  25. Placement

  26. How does a facility decide whether a service recipient meets criteria for placement in a particular level of care?
    In order to make a determination on whether the services offered by the facility are an appropriate fit to meet the treatment requirements of the service recipient, the facility carries out an assessment of the service recipient’s prevention, treatment and rehabilitation needs. Read More
  27. What services should be offered at each different type of facility?
    Substance abuse treatment facilities must meet the needs of admitted service recipients as identified during the admission assessment process. Read More
  28. Treatment Planning

    Facilities must work with the service recipient or the person responsible for the service recipient to develop an “Individualized Program Plan”, identifying the... Read More


  29. What rules govern administration of service recipient medications?
    All medications prescribed or administered must be documented on a medications log sheet including date of prescription and administration, type, dosage, frequency, amount, and reason. Read More
  30. Service Recipient Rights

  31. What rights are guaranteed to service recipients?
    Service recipients’ rights must be respected and protected. Each facility has a responsibility to provide service recipients, or their representatives, with a copy of their rights, in a language they can understand on admission, and inform them of the complaint and appeal process. Read More
  32. Seclusion and Restraint

  33. What are the rules about restrictive practices of behavior control?
    A program may not admit someone whom it is beyond its capacity to safely manage. It is imperative to thoroughly... Read More
  34. Discharge

  35. What grounds are needed in order to dismiss a service recipient from a program?
    There are four types of discharge. Successful completion of program means that the service recipient has met the goals of their treatment/recovery plan. Read More
  36. What type of paperwork must accompany a service recipient discharge?
    It is important to ensure that sustained achievement of goals continues for service recipients post-treatment, including sobriety and successful transition to a recover oriented lifestyle in the community. Read More
  37. I need to discharge a service recipient that relapsed, but am I at risk if he or she overdoses tonight and how can I protect myself?
    The discharge of a service recipient must be handled carefully given the risks if a service recipient suffers negative health consequences in the aftermath of discharge. Read More
  38. Privacy

  39. How must clients’ privacy be protected?
    Client confidentiality is an important issue covered by both federal and state laws. These laws set forth specific requirements regarding how and when patient information may be shared and the protections that must be in place ... Read More
  40. Governance and Staffing

  41. What are the staffing requirements of a substance abuse facility?
    Facilities must ensure adequate staff to meet service recipient needs. No service recipient must have responsibility for the care of another service recipient, responsibility for the supervision of other service recipients where on-duty/on-site staff are not present or responsibilities granting them access to confidential information. Read More
  42. Payment

  43. How must I respond to service recipients who are unable to pay the required deductibles? Can I waive a program participant’s financial responsibility?
    Many patients seeking alcohol and drug treatment services face financial difficulties, and request or require reductions in program fees, or waiver of their deductibles, copays, or coinsurance before they can afford treatment. Read More
  44. What are the key issues insurers raise to demand recoupment of fees from substance abuse treatment programs?
    Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws. The most common defects in the billing claim that insurers assert are... Read More
  45. Marketing

  46. What marketing practices are prohibited?
    The most widespread prohibited marketing practices in addiction treatment appear to revolve around inappropriate inducements and inaccurate marketing claims. Read More
  47. What are the limits of gift giving to potential referral sources?
    State and federal regulators prohibit the exchange of items of value to induce referrals so the exchange of any item of value, whether it is... Read More
  48. What kind of benefits can I offer existing or new service recipients?
    Facilities must avoid giving gifts to service recipients or referral sources based on anti-kickback statutes which prohibit service recipient brokering. Facilities must... Read More
  49. Recovery Residences


  50. What is a recovery home?
    Recovery Homes are transitional alcohol and drug free housing with rules, peer-led groups, staff activities and/or other structured operations which are directed toward maintenance of sobriety for persons who exhibit treatment resistance... Read More
  51. we need a license to open a recovery home?
    Recovery homes which do not provide any services to residents are currently unlicensed by Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS). Read More
  52. In the absence of licensing, how can recovery homes demonstrate their commitment to meeting minimum quality standards?
    The Tennessee Alliance of Recovery Residences (TN-ARR) is a peer driven not-for-profit organization. Read More
  53. What is the process through which a sober home can be accepted as an affiliate of Tennessee Alliance of Recovery Residences
    To be accepted as a member of Tennessee Alliance of Recovery Residences (TN-ARR) the recovery home must be an alcohol and drug free environment. Read More
  54. What kinds of services can a recovery home offer?
    Recovery Homes provide a structured alcohol and drug free environment for... Read More
  55. Zoning and Land Use

  56. What are the protections afforded by federal law to small group homes used for the purpose of residential drug rehabilitation?
    A facility with six or fewer people is... Read More
  57. Can local governments put special restrictions on recovery homes?
    Recovery homes in some communities have found growing efforts to regulate them by local ordinance, including registration requirements, concentration (spacing) limits, and other requirements. Read More
  58. What other aspects must I consider before choosing a location for our recovery home?
    In siting a recovery home, attention must be paid to potential hostility from neighbors. Read More
  59. Resident’s Rights and Responsibilities

  60. What would our obligations to residents be?
    To enforce that the premises remain safe and free of intoxicant use; to... Read More
  61. What kind of agreement can we ask our residents to sign?
    Any agreement residents sign must comply with landlord and tenant laws of... Read More
  62. Can we insist on drug tests and searches?
    No, recovery homes do not have the right to impose testing or searches without consent. Rules and regulation... Read More
  63. an a recovery home bill insurance for required and/or random drug testing?
    Recovery homes sometimes rely on the drug screening which takes place when the resident attends outpatient services... Read More
  64. Can we make residents’ obligations contractually enforceable?
    If the rules are contained in the tenancy agreement as conditions of residence, and the resident agrees to them upon accepting the tenancy... Read More
  65. Governance and Staffing

  66. What kind of ownership and staffing structures are common with these types of residential arrangements?
    A sober housing facility may be structured as a nonprofit corporation... Read More
  67. Are there any other organizations where we could find more information?
    Substance Abuse and Mental Health Services Administrationhttp://www.samhsa.gov/ Read More


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