---
type: "Bill"
title: "Economic and Community Development, Dept. of - As enacted, enacts the \"Tennessee Rural Hospital Transformation Act of 2018.\" - Amends TCA Title 4; Title 68 and Title 71."
description: "Economic and Community Development, Dept. of - As enacted, enacts the \"Tennessee Rural Hospital Transformation Act of 2018.\" - Amends TCA Title 4; Title 68 and Title 71."
jurisdiction: "us/states/tn"
legislature: "Tennessee General Assembly"
session: "110"
identifier: "SB 2646"
citation: "Tennessee SB 2646 (110)"
classification: ["bill"]
subjects: ["Economic and Community Development", "Dept. of"]
status: "enacted"
primary_sponsors: ["Keisling", "Watson"]
version_count: 1
action_count: 65
vote_count: 2
first_action: "2018-01-31"
last_action: "2018-05-23"
source: "openstates"
source_identifier: "ocd-bill/af645a3f-115e-4987-8afa-fb7650de99a7"
source_url: "http://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=SB2646&GA=110"
source_hash: "e4974e45f3ae14aa6c1599b3079e363494d897f81870dd703d8f457432ed3c63"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-tn"]
---

# Tennessee SB 2646 (110) — Economic and Community Development, Dept. of - As enacted, enacts the "Tennessee Rural Hospital Transformation Act of 2018." - Amends TCA Title 4; Title 68 and Title 71.

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Current Version** (committee substitute) — [source](http://www.capitol.tn.gov/Bills/110/Bill/SB2646.pdf)

## Votes

- SENATE HEALTH AND WELFARE COMMITTEE: Recommended for passage with amendment/s, refer to Senate Finance, Ways, and Means Committee Ayes 8, Nays 0 PNV 0 3/14/2018 Passed (2) — **8–0** (pass) · upper
- SENATE FINANCE, WAYS, AND MEANS COMMITTEE: Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0 4/23/2018 Passed (1) — **9–0** (pass) · upper

## Sponsors

- Keisling — primary (person)
- Watson — primary (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2018-01-31** Filed for intro. `introduction, reading-1`
- **2018-02-01** Introduced, Passed on First Consideration `introduction`
- **2018-02-01** Filed for introduction `introduction, reading-1`
- **2018-02-01** Intro. `introduction`
- **2018-02-05** Passed on Second Consideration, refer to Senate Health and Welfare Committee
- **2018-02-05** P1C.
- **2018-02-07** Assigned to s/c Health Subcommittee `referral-committee`
- **2018-02-07** P2C, ref. to Health Committee `referral-committee`
- **2018-02-20** Sponsor(s) Added.
- **2018-02-21** Placed on Senate Health and Welfare Committee calendar for 2/28/2018
- **2018-02-21** Placed on s/c cal Health Subcommittee for 2/28/2018
- **2018-02-28** Placed on Senate Health and Welfare Committee calendar for 3/7/2018
- **2018-02-28** Action deferred in Senate Health and Welfare Committee to 3/7/2018
- **2018-02-28** Placed on s/c cal Health Subcommittee for 3/7/2018
- **2018-02-28** Action Def. in s/c Health Subcommittee to 3/7/2018
- **2018-03-07** Placed on Senate Health and Welfare Committee calendar for 3/14/2018
- **2018-03-07** Action deferred in Senate Health and Welfare Committee to 3/14/2018
- **2018-03-07** Placed on s/c cal Health Subcommittee for 3/14/2018
- **2018-03-07** Action Def. in s/c Health Subcommittee to 3/14/2018
- **2018-03-14** Recommended for passage with amendment/s, refer to Senate Finance, Ways, and Means Committee Ayes 8, Nays 0 PNV 0
- **2018-03-14** Placed on cal. Health Committee for 3/20/2018
- **2018-03-14** Rec for pass if am by s/c ref. to Health Committee `referral-committee`
- **2018-03-16** Sponsor(s) Added.
- **2018-03-19** Sponsor(s) Added.
- **2018-03-20** Rec. for pass. if am., ref. to Finance, Ways & Means Committee `committee-passage-favorable`
- **2018-03-21** Sponsor(s) Added.
- **2018-03-21** Placed on s/c cal Finance, Ways & Means Subcommittee for 3/28/2018
- **2018-03-21** Assigned to s/c Finance, Ways & Means Subcommittee `referral-committee`
- **2018-03-28** Placed behind the budget
- **2018-04-04** Placed on s/c cal Finance, Ways & Means Subcommittee for 4/13/2018
- **2018-04-11** Placed on s/c cal Finance, Ways & Means Subcommittee for 4/18/18
- **2018-04-13** Placed on Senate Finance, Ways, and Means Committee calendar for 4/17/2018
- **2018-04-17** Action deferred in Senate Finance, Ways, and Means Committee to 4/18/2018
- **2018-04-18** Action deferred in Senate Finance, Ways, and Means Committee to 4/23/2018
- **2018-04-18** Placed on Senate Finance, Ways, and Means Committee calendar for 4/18/2018
- **2018-04-18** H. Placed on Regular Calendar for 4/23/2018
- **2018-04-18** Placed on cal. Calendar & Rules Committee for 4/18/2018
- **2018-04-18** Rec. for pass. if am., ref. to Calendar & Rules Committee `committee-passage-favorable`
- **2018-04-18** Placed on cal. Finance, Ways & Means Committee for 4/18/2018
- **2018-04-18** Sponsor(s) Added.
- **2018-04-18** Rec for pass if am by s/c ref. to Finance, Ways & Means Committee `referral-committee`
- **2018-04-19** Placed on Senate Finance, Ways, and Means Committee calendar for 4/23/2018
- **2018-04-23** Sponsor(s) Added.
- **2018-04-23** Placed on Senate Regular Calendar calendar for 4/24/2018
- **2018-04-23** Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0
- **2018-04-24** Companion House Bill substituted
- **2018-04-24** Passed Senate, Ayes 32, Nays 0 `passage`
- **2018-04-24** Amendment withdrawn. (Amendment 2 - SA1175)
- **2018-04-24** Amendment withdrawn. (Amendment 1 - SA0815)
- **2018-04-24** Senate substituted House Bill for companion Senate Bill.
- **2018-04-24** Received from House, Passed on First Consideration `introduction`
- **2018-04-24** Engrossed; ready for transmission to Sen.
- **2018-04-24** Passed H., as am., Ayes 95, Nays 1, PNV 0 `passage`
- **2018-04-24** Sponsor(s) Added.
- **2018-04-24** H. adopted am. (Amendment 2 - HA1260) `amendment-passage`
- **2018-04-24** H. adopted am. (Amendment 1 - HA0932) `amendment-passage`
- **2018-04-25** Sponsor(s) Added.
- **2018-04-27** Enrolled; ready for sig. of H. Speaker.
- **2018-05-02** Signed by H. Speaker
- **2018-05-09** Signed by Senate Speaker
- **2018-05-10** Transmitted to Governor for his action. `executive-receipt`
- **2018-05-21** Signed by Governor. `executive-signature`
- **2018-05-23** Comp. became Pub. Ch. 1055
- **2018-05-23** Pub. Ch. 1055
- **2018-05-23** Effective date(s) 07/01/2018

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/af645a3f-115e-4987-8afa-fb7650de99a7`. Confidence: reported (aggregated from official Tennessee legislature records).