Tenn. Code Ann. § 68-57-104

A hospital, ambulatory surgical treatment center, or other such entity may petition the director of health care facilities of the department for a waiver from this chapter if such entity is unable to employ a sufficient number of surgical technologists who meet the requirements of this chapter. The hospital, ambulatory surgical treatment center, or other such entity must demonstrate to the director that a diligent and thorough effort has been made to employ surgical technologists who meet the requirements of this chapter. The director shall refuse to grant a waiver upon finding that a diligent and thorough effort has not been made. A waiver shall exempt a facility from this chapter for not more than six (6) months. Additional waivers may be granted, but all exemptions greater than twelve (12) consecutive months must be approved by the board.