Licensed Provider Frequently Asked Questions
The Office of Licensure is here to help our licensed providers in any way that we can. This list of FAQs is a good place to start if you are a provider who has a question about your license.
Need to Make a Change to Your Current License or Add a New Location or Category?
A Fact Sheet form is used for the following:
- to establish a new site/location
- to add a new category to an existing license
- to relocate a currently licensed facility/service to another location*
- to request approval for a major renovation, expansion, or change in use or occupancy of a currently licensed facility.
A Change of Status form is used for the following:
- Change in Chief Executive Officer or Executive Director (A Background Information form and Non-criminal Justice Privacy Rights statement must also be submitted.)
- Change in licensee name (Used for change in name only. This is not a transfer of ownership.)
- Change in site name
- Change in licensed bed capacity
- Change affecting current life safety occupancy classification such as adding or deleting safety occupancy classification to serve mobile non-ambulatory, hearing impaired, blind, or individuals incapable of self-preservation or imposing security measures upon persons which are beyond their control (e.g., exit doors or windows locked against egress, restraints, seclusion, etc.
- Closure of license
- Closure of category(ies) only
- Closure of license due to relocation*
*Licenses are address-specific requiring a new license before a relocation may occur. For relocation of a facility or service, submit a Fact Sheet form for the new location AND a Change of Status form to close out the old location.
Need to Review Your Applicable Rules?
See the TDMHSAS Office of Licensure Administrative Rules
Need to Report an Incident?
- To inform TDMHSAS of an incident, use this form: Reportable Incident Form
- Incident Reporting Requirements
- For additional documentation and information around reporting, please see the following links:
Personal Support Service Agency license category
Residential and all other non-residential license categories
Contact Information
TDMHSAS Office of Licensure
Complaint Line: 866-797-9470
Fax: 615-401-7644
Email: LicensureInv.Fax@tn.gov