Senior care in Tennessee costs less than it does in much of the country, but the gap between settings is still wide. Assisted living runs roughly $4,200 to $5,300 a month, well below the national median, while a nursing home runs closer to $9,700 a month for a semi-private room. Which setting a family chooses can swing the yearly bill by tens of thousands of dollars.
This guide lays out what every senior-care setting in Tennessee costs side by side, what pushes the price up or down, and how families actually pay, from private funds to TennCare for those who qualify.
In This Guide
- Key Takeaways
- What Each Setting Costs in Tennessee
- What Drives the Price
- How Families Pay
- How to Plan and Budget
- Frequently Asked Questions
What Each Setting Costs in Tennessee
The figures below come from industry cost surveys, not government rates and not maximums, so the cost at any one provider can land higher or lower depending on location, room type, and how much care a person needs. For assisted living, the national benchmark is the CareScout 2025 Cost of Care Survey, which reports a national median of about $6,200 a month ($74,400 a year). For nursing homes, SeniorLiving.org reports Tennessee statewide medians as of early 2026.
Read across the settings and Tennessee's pattern is consistent: costs sit below the national line, but the distance between assisted living and a nursing home is still large. Assisted living runs roughly $4,200 to $5,300 a month statewide, while a semi-private nursing-home room runs about $9,681 a month, close to double.
| Care setting | Tennessee (month) | Tennessee (year) | National (month) |
|---|---|---|---|
| Assisted living | about $4,200 to $5,300 | about $50,000 to $60,000 | about $6,200 |
| Nursing home, semi-private room | about $9,681 | about $116,170 | n/a |
| Nursing home, private room | about $10,456 | about $125,470 | n/a |
Assisted-living costs in Tennessee vary by metro as well. Nashville runs at the high end, closest to the national average, while Knoxville and other markets generally sit lower. Nursing-home rates follow a similar pattern, with Nashville the most expensive private-room market in the state.
What Drives the Price
The single biggest driver of cost is the level of care a person needs, which is why a nursing home runs close to double the price of assisted living in Tennessee. A nursing home provides 24-hour licensed nursing care, with a staff of nurses and aides on every shift plus the building, equipment, and oversight that skilled care requires. Assisted living is built for people who need help with daily tasks but not constant skilled nursing, so it carries a lighter staffing load and a lower price.
Within any single setting, the advertised rate is rarely the whole bill. An assisted-living facility usually quotes a base rate that covers room, meals, housekeeping, laundry, basic activities, 24-hour staffing, medication assistance, and help with daily living. It then adds charges as care needs grow: tiered level-of-care fees based on assessed needs, a one-time community or move-in fee, incontinence supplies, a second-occupant fee for couples, and transportation beyond the included scope. Annual rate increases in Tennessee typically run 5 to 10 percent. A resident who enters needing little help and later needs much more can see the monthly cost climb well past the opening figure.
When you compare quotes, ask what the base rate includes and what triggers an add-on, because two facilities with similar headline prices can bill very differently once care needs rise.
How Families Pay
Almost no one pays for years of senior care out of a single source. Most families start with private funds and shift to other payers as the bills mount. Here's how the main options work in Tennessee.
Private pay is savings, income, the proceeds of a home sale, and long-term care insurance if a person bought it. It's the most flexible option, since it covers any setting, but it's also the one that runs out, and at about $9,681 a month for a semi-private nursing-home room, it can run out faster than families expect. Long-term care insurance, where it exists, can offset a share of the cost, though policies vary widely in what they pay and for how long.
TennCare, Tennessee's Medicaid program, pays for long-term care through TennCare CHOICES, its long-term services and supports program, for people who meet both a level-of-care test and the financial rules. The monthly income limit for an applicant is $2,982, which is 300 percent of the 2026 federal SSI benefit rate of $994 a month. An applicant whose income sits above that limit can establish a Qualified Income Trust, the functional equivalent of what other states call a Miller Trust, to redirect the excess income and still qualify. The countable-asset limit is $2,000 for an individual and $3,000 for a married couple where both spouses apply. When one spouse needs care, the at-home spouse may keep one-half of countable assets up to a maximum of $162,660, with a minimum protected standard of $32,532, so the couple isn't held to the single-person asset figure.
One gap trips up many families: CHOICES does not pay the room-and-board cost of assisted living. CHOICES covers the assisted-living services component only; room and board remain the member's responsibility. A family choosing assisted living should plan to cover room and board privately, even where CHOICES helps pay for the care services themselves.
Two more rules shape long-term-care planning in Tennessee. The state enforces a 60-month look-back on assets transferred for less than fair value before an application, which can trigger a penalty period. Up to $752,000 of equity in a primary residence is excluded from countable assets.
A note on Medicare, because the assumption is common: Medicare covers only short-term skilled rehab after a hospital stay, not the long-term custodial care, the ongoing help with daily living, that most families are budgeting for. That long-term care is what private pay and TennCare cover.
How to Plan and Budget
Start by matching the setting to the actual need, not the other way around. Because a nursing home in Tennessee costs close to double what assisted living does, a candid assessment of how much help a person truly needs is worth more than a default assumption. Many people who need help with daily tasks but not skilled nursing are well served by assisted living, while someone needing continuous skilled care belongs in a nursing facility, where the higher price buys 24-hour licensed nursing.
Then build a realistic timeline. Estimate the monthly cost of the right setting, list the resources available to pay for it, and work out how long private funds will last before TennCare would come into play. If TennCare is likely to be part of the plan, the look-back rule rewards starting early and getting advice, because last-minute moves to qualify often trigger penalties. Two Brevy guides go deeper here: Medicaid Planning Strategies walks through how to position assets and income within the rules, and Medicaid Personal Needs Allowance, Explained covers the small monthly amount a resident keeps.
Finally, budget for the add-ons, not just the base rate. Care needs tend to rise over time, and Tennessee assisted-living rates typically climb 5 to 10 percent a year, so the figure you start with is rarely the figure you finish with. A plan that assumes some increase is more likely to hold up than one built on today's lowest quote.
Frequently Asked Questions
It depends heavily on the setting. Assisted living runs roughly $4,200 to $5,300 a month statewide, below the national median of about $6,200 a month. A semi-private nursing-home room runs about $9,681 a month and a private room about $10,456, or roughly $301 and $319 a day by another measure. These are statewide medians from industry surveys, not maximums, so an individual provider can cost more or less.
A nursing home runs close to double the price of assisted living because it provides 24-hour licensed nursing care, with nurses and aides on every shift plus the equipment and oversight that skilled care requires. Assisted living is built for people who need help with daily tasks but not constant skilled nursing, so it carries a lighter staffing load and a lower price.
For people who meet a level-of-care test and the financial rules, yes, through TennCare CHOICES, the state's long-term services and supports program. The monthly income limit for an applicant is $2,982, equal to 300 percent of the 2026 federal SSI benefit rate, and the asset limit is $2,000 for an individual. An applicant over the income limit can use a Qualified Income Trust, the equivalent of a Miller Trust, to qualify.
Not the room-and-board cost. TennCare CHOICES covers the assisted-living services component only; the rent-and-meals portion remains the member's responsibility. A family choosing assisted living should plan to pay room and board privately.
Most start with private pay, savings, income, home-sale proceeds, and long-term care insurance if they have it, then turn to TennCare CHOICES once a person meets the level-of-care and financial rules. Because Tennessee has a 60-month look-back on transferred assets, planning early and getting professional advice usually pays off.
Learn More
Find personalized help building a realistic senior-care budget for Tennessee at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.