In order to operate in Tennessee, every publicly or privately owned hospital, nursing home, recuperation center, ambulatory surgical treatment center, mental health hospital or home for the aged is required to be licensed by the state Department of Health.  T.C.A. § 68-11-201 et seq.  A county may operate such facilities if they are licensed and maintained according to rules established by the state Department of Health.  T.C.A. §§ 68-11-204, 9-21-105(21)(A).  The state health care licensing board has exclusive jurisdiction to regulate this area so that any conflicting regulations adopted by local governments are inoperative.  The state health care licensing board must approve all new healthcare facilities before construction work may begin.  T.C.A. § 68-11-202.