Tennessee has roughly 304 licensed nursing homes as of the Health Facilities Commission's most recent annual inspection report. They range from top-quality nonprofit homes integrated with major health systems to chronically understaffed facilities with repeat serious deficiencies. For families making a placement decision, usually 24 to 72 hours after a parent has been hospitalized, the difference between those two extremes is enormous.

This guide covers what nursing home care actually costs in Tennessee in 2026, how Medicare and TennCare pay, how to read CMS Five-Star quality ratings, what the Tennessee Health Facilities Commission's inspection reports tell you, and the specific red flags and green flags to look for on a facility tour.

Key Takeaways

  • A semi-private nursing-home room in Tennessee runs about $113,150 a year (roughly $9,429 a month), and a private room about $120,450 a year (roughly $10,038 a month), per the most recent state-level CareScout survey data. TennCare's 2026 average daily reimbursement is approximately $294.87/day, below private-pay rates, which is why private payers effectively subsidize Medicaid residents in mixed-payer facilities.
  • Medicare pays a maximum of 100 days of skilled nursing facility care after a qualifying 3-day hospital admission, and only while skilled need and measurable progress continue. Days 21–100 carry a daily coinsurance ($217/day in 2026); Day 101 onward Medicare pays nothing.
  • TennCare CHOICES Group 1 is the primary long-term funding source for nursing facility residents who meet Nursing Facility Level of Care (at least 9 points on the PAE Acuity Scale on score alone, with a narrow alternate path below 9) and the financial tests: gross income up to $2,982/month, countable resources up to $2,000, with spousal resource and income protections for the at-home spouse.,
  • Federal law (42 CFR §483.15(c)) prohibits a nursing home from discharging a resident solely because they convert from private pay to Medicaid. Any facility that threatens this is in violation, report immediately to the Tennessee Long-Term Care Ombudsman at 877-236-0013 and to the Health Facilities Commission complaint line at 877-287-0010.
  • Use CMS Five-Star ratings and the HFC inspection record before touring. Per the HFC's 2025 Nursing Home Inspection and Enforcement Report, roughly 88 of Tennessee's 304 licensed nursing homes had at least one serious (G-or-above) deficiency of record. Any G-or-above finding within the last year is a red flag; two or more in two years is a serious red flag.
  • The Long-Term Care Ombudsman is independent, free, and confidential. Tennessee's program is administered through the Department of Disability and Aging and advocates for residents; it does not regulate facilities. Statewide line: 877-236-0013. Use it before there's a crisis, not after.

What Tennessee Nursing Homes Cost

Tennessee nursing homes are expensive, but meaningfully less expensive than the national average. Per the most recent state-level figures in the CareScout Cost of Care Survey, a semi-private room runs about $113,150 a year and a private room about $120,450 a year, both below the CareScout 2025 national medians of $114,975 (semi-private) and $129,575 (private).

Cost Measure Tennessee (year) Tennessee (month) National (year)
Nursing home, semi-private room about $113,150 about $9,429 about $114,975
Nursing home, private room about $120,450 about $10,038 about $129,575

TennCare's 2026 average nursing-facility reimbursement is approximately $294.87 a day, or about $107,628 a year, well below the private-pay rate above. That gap is why private-pay residents effectively subsidize Medicaid residents in mixed-payer facilities, and why some facilities limit the share of beds open to Medicaid applicants.

Two caveats on the figures above: they are statewide medians from an industry survey, not government rates and not maximums, and any single facility's price varies by location, room type, and level of care. The number a facility quotes you generally reflects its private-pay rate.

For the full Medicaid eligibility framework (Qualified Income Trust, Personal Needs Allowance, Minimum Monthly Maintenance Needs Allowance, Community Spouse Resource Allowance, the 5-year look-back, and the transfer-penalty divisor), see the Tennessee Medicaid Nursing Home Coverage guide.

Who Pays for a Nursing Home in Tennessee

Five funding sources cover Tennessee nursing facility stays. Most long-stay residents move through more than one over time.

Medicare (Short-Term, Post-Hospital Only)

Medicare Part A covers up to 100 days of skilled nursing facility care after a qualifying 3-day inpatient hospital admission. The structure:

Medicare pays only when the beneficiary has a skilled care need, skilled nursing, physical therapy, occupational therapy, speech therapy, and is showing measurable progress. It is post-acute rehab funding, not long-term custodial care funding. Most residents who need to stay long-term transition from Medicare to private pay or to TennCare.

Two things about the 3-day rule cut in opposite directions. First, time under observation or in the emergency room before admission does not count toward the 3 days, so a parent who spent two nights in a hospital bed under observation status may have zero qualifying days. Ask the hospital case manager whether the parent is admitted as inpatient or held for observation before counting on Medicare SNF coverage. Second, the 3-day minimum is not universal: it may be waived for a beneficiary in an ACO holding a SNF 3-Day Rule Waiver, or in a Medicare Advantage plan that waives it. Medicare Advantage plans may also set their own SNF cost-sharing or require prior authorization, so check the plan's rules.

Private Pay

Direct payment from savings, investments, Social Security, pensions, and home-sale proceeds. Most families who start private-pay eventually spend down to TennCare after a few years; at roughly $9,429–$10,038 a month, even substantial assets deplete quickly.

Long-Term Care Insurance

Policies purchased before a care need arose. Benefits vary: most pay a fixed daily or monthly amount for a defined benefit period, and many impose an elimination period before benefits begin, so read the policy's own terms rather than assuming. Separately, some policies are "partnership-qualified" under the federal-state Long-Term Care Partnership Program, which lets a policyholder shield assets equal to the benefits the policy pays from a later Medicaid spend-down. Ask the insurer whether a specific policy is partnership-qualified, and confirm the treatment with TennCare before relying on it.

TennCare CHOICES Group 1 (the primary long-term funding source)

TennCare's CHOICES Group 1 is the open-entitlement nursing facility benefit. Eligibility requires:

  • Functional eligibility (NF Level of Care): TennCare determines level-of-care eligibility through the Pre-Admission Evaluation (PAE), which applies the TennCare NF LOC Acuity Scale. The scale scores help needed with the ADLs of transfer, mobility, eating, and toileting plus independence in communication, orientation, dementia-related behaviors, and self-administration of medications (maximum 21 points), together with skilled or rehabilitative services such as tube feeding, wound care, therapy, and ventilator care (maximum 5 points), for a maximum total of 26. Dementia is scored by how often the applicant needs intervention for dementia-related behaviors, not by the diagnosis. On score alone, NF level of care takes at least 9 points. A score below 9 is not automatically the end of the road: an applicant may still qualify by meeting the at-risk level-of-care criteria on an ongoing basis and receiving a TennCare Safety Determination that they do not qualify for CHOICES Group 3.
  • Financial eligibility: Gross monthly income up to the Medicaid Income Cap of $2,982 (300% of the 2026 SSI Federal Benefit Rate of $994), countable resources up to TennCare's institutional standard of $2,000, and ineligibility for LTSS payment once home equity exceeds $752,000. Where one spouse stays in the community, the Community Spouse Resource Maintenance Allowance is half the couple's countable resources, but not less than $32,532 and not more than $162,660 as of January 2026 (the floor matters as much as the ceiling for couples with modest savings), and the maximum Minimum Monthly Maintenance Needs Allowance is $4,066.50/month. An applicant whose gross income is over the cap is given the opportunity to establish a Qualified Income Trust (the TN term for a Miller Trust), after which income eligibility is tested again.,
  • Patient liability: A Group 1 nursing facility resident keeps a Personal Needs Allowance (PNA) of $70/month. TennCare then subtracts the other allowable deductions (court-ordered child support and alimony, a Community Spouse Income Maintenance Allowance for a spouse at home, a Dependent Income Maintenance Allowance for a dependent at home, health insurance premiums, coinsurance and deductibles, and incurred medical expenses TennCare does not cover), and what remains is the patient liability owed toward the cost of care. The facility is obligated to collect it, and the MCO's payment to the facility is reduced by that amount.

CHOICES Group 1 is the funding mechanism that keeps the lights on for most long-term Tennessee nursing home residents. Most facilities that accept Medicaid have a substantial majority of their residents on TennCare. See the TennCare CHOICES guide for the full eligibility framework, and the TN Medicaid Nursing Home guide for the full LTC mechanics.

VA Benefits (for Eligible Veterans)

Veterans have three nursing-facility pathways: VA Community Living Centers (operated directly by the VA), VA-contracted community nursing homes, and Tennessee State Veterans' Homes (TSVH). TSVH is run by the Tennessee State Veterans Home Board and is independent of the U.S. Department of Veterans Affairs. It operates five homes as of 2026, offering long-term care, skilled nursing care, and rehabilitative care including therapy services:

  • Murfreesboro
  • Knoxville, the Ben Atchley Home
  • Clarksville, the Brigadier General Wendell H. Gilbert Home
  • Humboldt, the W.D. "Bill" Manning Home
  • Cleveland

A sixth home is under construction at Arlington, on 28.5 acres in rural Shelby County (West Tennessee). TSVH still lists it as "Coming Soon," and the anticipated opening posted on its own Arlington page, "late 2025," has already passed, so treat any opening date you're given as provisional. Admission requires an honorable discharge from active service and a need for a skilled level of care, plus at least one Tennessee connection: Tennessee residency at the time of admission, birth in Tennessee, entering the U.S. Armed Forces in Tennessee, a Tennessee address as the official Home of Record, or an immediate family member who is the primary caregiver and a Tennessee resident. Spouses and Gold-Star parents are eligible on a space-available basis.

What it costs depends on VA eligibility, and there are two distinct VA programs. Under the Basic Per Diem, TSVH applies the VA payment toward a privately paying veteran's bill, reducing the out-of-pocket daily room rate. Under the VA Higher Per Diem, the VA covers 100% of the cost of the stay, but only for a veteran with a service-connected disability rated 70% or more, a veteran who needs nursing home care related to a service-connected disability, or a veteran rated totally disabled based on individual unemployability. A veteran who is not eligible for VA assistance may pay through Medicare, a Medicare managed care plan, TennCare, long-term care insurance, or private payment.

How Tennessee Nursing Homes Are Regulated

Tennessee nursing homes are regulated by overlapping state and federal authorities:

  • Tennessee Health Facilities Commission (HFC), the state regulator, replacing the former TN Department of Health Board for Licensing Health Care Facilities (BLHCF) when LTC oversight migrated to HFC in mid-2024. Many third-party guides and even some hospital discharge materials still cite the old regulator. Tennessee's nursing home rules are now codified at Chapter 0720-18, "Standards for Nursing Homes" (renumbered from the former 1200-08-06 series under the Department of Health). Chapter 0720-37 is a different chapter covering adult care homes, not nursing homes.
  • CMS (federal), for Medicare and Medicaid certification, the Five-Star Quality Rating System, and standard surveys at least every 15 months under 42 CFR §488.308. The HFC contracts with CMS as the State Survey Agency.
  • The federal Nursing Home Reform Act of 1987 (42 USC §§1395i-3, 1396r; regulations at 42 CFR Part 483 Subpart B), setting the federal floor on resident rights and minimum standards.
  • The Nursing Home Compassion, Accountability, Respect and Enforcement Reform Act of 2003 (Tenn. Code §68-11-810), which directs the HFC to publish an annual Nursing Home Inspection and Enforcement Activities Report to the Governor and General Assembly.
  • Tenn. Code §68-11-901 et seq., Tennessee's resident-rights statutory umbrella.
  • The Tennessee Adult Protection Act (Tenn. Code §71-6-101 et seq.), making suspected abuse, neglect, or exploitation of an adult mandatorily reportable for healthcare professionals to TN Adult Protective Services at 888-277-8366.

The HFC inspects every Tennessee nursing facility at least annually for state license purposes. Federal Medicare-certified facilities receive standard surveys at least every 15 months. Complaint-driven surveys may occur at any time. Inspection results are public.

Reading CMS Five-Star Ratings

CMS publishes Nursing Home Compare at medicare.gov/care-compare. Every Medicare-certified nursing home is rated on a 1-to-5-star scale across four domains plus an overall rating:

  • Health Inspections. Based on the three most recent state inspections, weighted by recency and severity of deficiencies.
  • Staffing. Nurse and aide hours per resident day, adjusted for resident acuity.
  • Quality Measures. Outcomes such as pressure ulcers, falls, hospitalizations, and resident-reported metrics.
  • Overall Rating. A weighted combination of the three.

Read the rating carefully. A 5-star Overall with a 2-star Health Inspection means quality measures look good but recent inspections found problems. A 2-star Overall facility usually means look elsewhere unless you know something the rating doesn't.

What Inspection Deficiencies Mean

CMS and HFC inspection reports categorize deficiencies by scope and severity on an A-through-L grid. Severity rises from no actual harm to immediate jeopardy; scope rises from isolated to widespread.

  • A–C: The least severe band: no actual harm, with potential for minimal harm.
  • D–F: No actual harm found, but potential for more than minimal harm.
  • G–I: Actual harm, or substandard quality of care.
  • J–L: Immediate jeopardy to resident health or safety.

The line that matters for a family reading a report is G: below it, the surveyor found risk; at G and above, the surveyor found harm. Any G-or-above finding in the last year is a red flag, and two or more in two years is a serious red flag. Per the HFC's 2025 inspection and enforcement report, of Tennessee's roughly 304 licensed nursing homes, approximately 88 had at least one G-or-above deficiency and 241 had at least one infection-prevention-related deficiency. Read those counts with the caveat that they reflect any-year-of-record findings rather than every facility's current status, which is exactly why you pull the individual facility's report instead of stopping at the statewide number.

You can pull the official Statement of Deficiencies (CMS-2567) from Nursing Home Compare for any Medicare-certified facility. The HFC facility lookup at internet.health.tn.gov/facilitylistings returns license number, bed count, and date of most recent survey for every TN-licensed facility; the full state survey reports can be requested from the facility or the HFC under public records.

Choosing a Facility: The Tour

Tours are the strongest signal of facility quality. Schedule tours at multiple facilities, visit at different times of day (mid-morning is common; visit at 4 PM and on a weekend if you can), and bring a family member or trusted friend. The right tour is roughly two hours and includes both a structured walk-through and quiet observation.

Before the Tour

  • Pull the CMS Five-Star rating from medicare.gov/care-compare.
  • Pull the most recent CMS Statement of Deficiencies (CMS-2567).
  • Look up the facility on the HFC database at internet.health.tn.gov/facilitylistings for license, bed count, and most-recent-survey date.
  • Read online reviews skeptically, they tend to overrepresent both highly satisfied and highly aggrieved families. Treat them as anecdote, not evidence.
  • Call the Tennessee Long-Term Care Ombudsman at 877-236-0013 and ask whether the facility has had recent complaint patterns.

During the Tour

Sensory checks.

  • Is there a consistent odor of urine in resident hallways? One bad day happens; a pervasive smell signals understaffing and hygiene gaps.
  • Is the lighting adequate, and are common areas welcoming and clean?
  • Are call lights visible and being answered promptly (within roughly 5 minutes)?

Staff interaction.

  • Do staff greet residents by name?
  • Are residents being attended to, or left alone in hallways?
  • Is the activities program active, actual people participating, not just a calendar on the wall?
  • Ask the tour guide directly: "What is the ratio of nursing assistants to residents on the day shift, evening shift, and overnight?"

Resident signals.

  • Do residents look clean, well-groomed, appropriately dressed?
  • Do residents seem engaged with each other and with staff?
  • Are residents positioned properly in wheelchairs (not slumped, not restrained)?

Facility questions to ask the administrator and director of nursing.

  • How long has the director of nursing been in this role? How long has the administrator?
  • What is the annual staff turnover rate? (Lower nurse-aide turnover is better; nursing-home aide turnover runs high nationally, so a facility reporting notably low, stable turnover is a good sign.)
  • How does the facility handle a resident's decline, hospital transfers, hospice integration, end-of-life conversations?
  • What happens when a resident runs out of funds and converts to Medicaid? The correct answer is "nothing changes." Federal law (42 CFR §483.15(c)) prohibits discharging a resident for converting from private pay to Medicaid. Any equivocation is a serious red flag.
  • May I see the most recent resident and family satisfaction survey results?
  • May I see the most recent CMS Statement of Deficiencies and the facility's plan of correction?

Red Flags

  • Frequent ownership changes in the last 5 years.
  • New administrator or director of nursing in the last 6 months.
  • History of G-or-above deficiencies, especially in the last 12 months.
  • High annual staff turnover.
  • Heavy use of agency / temporary staff.
  • Pressure to sign move-in paperwork before reading it.
  • Insistence that you private-pay for a fixed period before applying for Medicaid.
  • Dismissiveness about specific dietary, religious, or care preferences.
  • Refusal to share the most recent CMS-2567.

Green Flags

  • Long-tenured staff, especially at the DON and administrator levels.
  • Low nurse-aide turnover.
  • Recent inspection with minimal or no serious deficiencies.
  • Active, visible, engaged activities program (residents in groups, not parked).
  • Ombudsman has a good working relationship with facility leadership.
  • Residents who greet visitors or interact in common areas.
  • Staff who knock before entering resident rooms.
  • Transparent willingness to walk through the deficiency report with you.

Facing a Tennessee nursing home placement decision? Chat with Brevy on brevy.com to read the CMS Five-Star ratings, interpret the HFC inspection report, and build a targeted tour checklist for your family's situation.

The Tennessee Long-Term Care Ombudsman

Every state has a Long-Term Care Ombudsman program required under the federal Older Americans Act. Tennessee's Office of the State Long-Term Care Ombudsman is administered through the Tennessee Department of Disability and Aging (DDA) and is an advocacy program for long-term care residents. It does not regulate facilities, which is exactly why it can take the resident's side without a licensing interest of its own. Its statewide complaint line is 877-236-0013, and it is independent of the facilities it covers.

The ombudsman is independent, free, and confidential. They are an advocate for the resident's wishes, not the family's wishes, not the facility's policies. They can help with:

  • Disputes about care, services, or billing
  • Complaints about staff conduct
  • Concerns about quality or safety
  • Involuntary discharge situations
  • Resident-rights violations

The program covers residents of nursing homes, assisted-care living facilities, homes for the aged, and adult care homes. Call early, while a concern is still a staffing or scheduling complaint rather than a discharge notice; that is when an ombudsman has the most room to work. Most Tennessee families don't know the ombudsman exists. They should. Call before there is a crisis.

Memory Care Within Nursing Homes

Some Tennessee nursing homes operate secured Alzheimer's care units under historic standards at Tenn. Comp. R. & Regs. 0720-18-.07 (carried forward under the HFC). Features typically include:

  • Annual reporting to HFC covering interdisciplinary team review, deaths, hospitalizations, incidents, staffing patterns, training, and group activities
  • A required interdisciplinary team: a physician with dementia experience, a social worker, a registered nurse, and a family member or patient advocate

A secured memory care unit is a special-services unit within a nursing facility license, not a separate license, so ask the facility what its secured unit does differently in staffing, training, and environment rather than assuming the label guarantees it. For dementia care outside a nursing facility setting (memory care within an assisted living building, for example), see the Tennessee Memory Care guide and the Tennessee Assisted Living guide.

Transitioning Out: Money Follows the Person

Placement in a nursing facility is not always permanent. Tennessee runs the federal Money Follows the Person (MFP) program, which helps people move from an institution back into the community. Federal MFP funding was extended through September 30, 2027 by the Consolidated Appropriations Act, 2023. TennCare integrates MFP with CHOICES: a person who transitions under MFP does so into CHOICES (or ECF CHOICES, or other waiver HCBS), so MFP supports the move itself while CHOICES provides the ongoing home and community based services afterward.

To qualify, the resident must:

  1. Be enrolled in Medicaid.
  2. Be 18 or older.
  3. Have resided in a qualified institution (an ICF/IID, a Regional Mental Health Institute, or a nursing home) for 60 days.
  4. Have care needs that can be adequately met in a community setting.

The MCO Care Coordinator is the person to ask about starting an MFP transition; ask them directly what the transition plan would cover and what supports would be in place at home before the move. Separately, in July 2025 TennCare Long-Term Services & Supports launched an initiative to invest $50 million in its HCBS provider network over five years to expand community-based capacity.

If your loved one was placed in a nursing facility under crisis conditions and now wants to come home, ask the MCO Care Coordinator about MFP and CHOICES. The path exists; it is materially underused.

Avoiding Placement in the First Place

For families trying to avoid nursing facility placement entirely, Tennessee has several community alternatives that can make staying at home viable:

  • CHOICES Group 2, TennCare's HCBS at home for adults 21+ with a physical disability and seniors 65+ who meet nursing facility level of care but choose community services instead, provided their needs can be safely met at home within their Individual Cost Neutrality Cap. Group 2 carries an Enrollment Target (the maximum enrollable at any one time) of 12,500, and applicants who cannot be enrolled go on a waiting list. The cap is not absolute: Reserve Capacity and the rule's specified exceptions can allow enrollment even at target, so ask rather than assume the door is closed. "At Risk" Group 3, for people who do not meet NF level of care but need services to delay it, is the lower-acuity preventive bridge; its enrollment target is 1,750 for non-SSI recipients, with an annual HCBS expenditure cap of $18,000.
  • Paid family caregivers via the agency route, under Public Chapter 182 (the Freedom for Family Caregiving Act of 2025, fully effective July 1, 2025), TennCare-contracted home care agencies can hire a relative, including spouses and parents of minor children, as a W-2 Direct Support Worker. The act prohibits TennCare and DDA from blocking the hire based solely on factors such as the family relationship, a shared residence, the age of the recipient, parental or spousal status, or which TennCare program the recipient is enrolled in. Two limits: court-appointed conservators and legal guardians stay excluded unless a court order explicitly permits employment, and Consumer Direction rules are unchanged, so spouses, conservators, and powers of attorney remain ineligible under that route. No agency is required to hire any particular family member, so access still depends on finding a willing one. See the Tennessee paid family caregiver guide for the full framework.
  • Assisted living with VA Aid & Attendance, a wartime veteran or surviving spouse may receive an Aid & Attendance pension that helps fund AL services. See the Tennessee Assisted Living guide.
  • Private-duty home care paid from LTC insurance or savings.
  • PACE (Programs of All-inclusive Care for the Elderly), offered in Tennessee as a Medicaid State Plan benefit. Federal rules require a participant to be 55 or older, to be determined by the state to need nursing facility level of care, to live in the PACE organization's service area, and to be able to live in the community at enrollment without jeopardizing their health or safety. TennCare lists "You must live in Hamilton County" among its published PACE eligibility criteria and directs applicants to Ascension Living Alexian PACE, 425 Cumberland Street, Chattanooga, TN 37404, or 423-698-0802. Most PACE participants are dually eligible for Medicare and Medicaid. If you live outside Hamilton County, this is not a route currently open to you.

For the full set of community-based alternatives, see the Tennessee caregiver programs hub.

Common Misconceptions

"Medicare will pay for my mom's nursing home indefinitely." It will not. Medicare's SNF benefit caps at 100 days, normally requires a qualifying 3-day inpatient hospital admission (waivable for some ACO and Medicare Advantage enrollees), and stops the moment skilled need or measurable progress ends. Long-term nursing home care is funded by TennCare, private pay, LTC insurance, or VA benefits, not Medicare.

"All Tennessee nursing homes are basically the same." They are not. The CMS Five-Star ratings, HFC inspection reports, and ombudsman complaint patterns document significant variation. The gap between a top-tier and a bottom-tier Tennessee nursing home is real, measurable, and worth driving an extra 30 minutes to access.

"Once on Medicaid, the facility can evict us." Federal law (42 CFR §483.15(c)) prohibits a nursing home from discharging a resident solely because they convert from private pay to Medicaid. Any facility that threatens this is in violation of federal law; report immediately to the Tennessee Long-Term Care Ombudsman at 877-236-0013 and to the HFC complaint line at 877-287-0010.

"The facility will tell me what I need to know." Facilities are sales organizations during the move-in process, and online reviews skew toward the delighted and the aggrieved. The CMS Five-Star rating, the HFC inspection report, the ombudsman conversation, and your own observation of residents are all stronger signals.

"The estate will lose the home to TennCare." Not necessarily, but the protections are narrower than they are usually reported. TennCare seeks recovery only after death, only from a member who received CHOICES Group 1, 2, or 3 long-term services and supports at age 55 or older, and only where no waiver or hardship applies. Claims of $10,000 and below are treated as not cost effective, and where the claim is below $10,000 the state releases it. Three cautions. Tennessee's State Plan answers the TEFRA-lien question "Not applicable. Tennessee does not apply TEFRA liens," but that disclaims one species of lien, not every lien: federal law still permits a pre-death lien imposed by court judgment on account of benefits incorrectly paid. The survivor protections are a timing bar, not permanent forgiveness: federal law allows recovery only after the surviving spouse's death and only when there is no surviving child under 21 or blind or permanently and totally disabled, so protection can lapse when a spouse dies or a child turns 21. And "estate" means all property owned immediately before death as Tennessee's Titles 30, 31, and 32 and its courts limit or expand it, which is not the same as a flat probate-only rule. The full mechanics are in the Tennessee Medicaid Nursing Home guide.

Frequently Asked Questions

How much does a nursing home cost in Tennessee in 2026?

Per the most recent state-level CareScout survey figures, Tennessee's median runs about $113,150 a year (roughly $9,429 a month) for a semi-private room and about $120,450 a year (roughly $10,038 a month) for a private room, both below the CareScout 2025 national medians of $114,975 and $129,575. TennCare's 2026 average daily reimbursement is approximately $294.87/day, below private pay, which is why private payers effectively subsidize Medicaid residents in mixed-payer facilities.

Does Medicare pay for nursing home care in Tennessee?

Only short-term. Medicare Part A pays up to 100 days of skilled nursing facility care after a qualifying 3-day inpatient hospital admission: Days 1–20 at 100%, Days 21–100 with a daily coinsurance ($217/day in 2026), and nothing from Day 101 onward. Medicare requires ongoing skilled need and measurable progress. Long-term custodial nursing home care is paid through TennCare CHOICES Group 1, private pay, LTC insurance, or VA benefits, not Medicare.

Who qualifies for TennCare nursing home coverage?

Applicants must meet Nursing Facility Level of Care and the financial tests. On score alone, level of care takes at least 9 points on the TennCare PAE Acuity Scale (out of a possible 26); an applicant who scores below 9 may still qualify by meeting the at-risk criteria on an ongoing basis and receiving a TennCare Safety Determination that they do not qualify for CHOICES Group 3. Financially: gross monthly income up to $2,982 (300% of the 2026 SSI Federal Benefit Rate), countable resources up to $2,000, ineligibility for LTSS payment above $752,000 in home equity, and a Community Spouse Resource Maintenance Allowance of $32,532 to $162,660 plus a maximum MMMNA of $4,066.50/month for a spouse at home. Applicants over the income cap are given the opportunity to use a Qualified Income Trust. See the Tennessee Medicaid Nursing Home Coverage guide for the full eligibility framework.,

Can a Tennessee nursing home evict me when I convert to TennCare?

No. Federal law (42 CFR §483.15(c)) prohibits a nursing home from discharging a resident solely because they convert from private pay to Medicaid. Any facility that threatens this is in violation of federal law. Report immediately to the Tennessee Long-Term Care Ombudsman at 877-236-0013 and to the Health Facilities Commission complaint line at 877-287-0010. Any equivocation from a facility during the move-in tour about what happens when funds run out is a serious red flag.

How do I check the quality of a Tennessee nursing home before I tour?

Start with the CMS Five-Star rating at medicare.gov/care-compare (Health Inspections, Staffing, Quality Measures, Overall). Pull the most recent CMS Statement of Deficiencies (CMS-2567). Look up the facility on the HFC database at internet.health.tn.gov/facilitylistings. Then call the Tennessee Long-Term Care Ombudsman at 877-236-0013 and ask whether the facility has had recent complaint patterns. Tour the facility at different times of day, ideally including a 4 PM and a weekend visit, before signing anything.

  • Nursing Facility Level of Care (NFLOC): The clinical eligibility test for TennCare nursing home coverage; assessed via the TN PAE Acuity Scale, where at least 9 of a possible 26 points meets the standard on score alone.
  • Activities of Daily Living (ADLs): The functional measures (bathing, dressing, toileting, transferring, eating, continence) that drive much of the PAE score.
  • HCBS Waiver: TennCare CHOICES Groups 2 and 3 are the primary HCBS alternatives to nursing facility placement.

Learn More

Care TypesNursing Homes by State: Costs, Medicaid Coverage, and How to ChooseWhat a nursing home costs, how Medicaid pays for it, and how facilities are rated all share a federal floor but vary by state. See yours, with a 50-state guide. Care TypesTennessee Assisted LivingTennessee assisted living runs about $5,595/mo in 2026, just below the $6,200 national median. How HFC licensure, costs, and TennCare CHOICES work. Care TypesTennessee Memory CareWhat Tennessee memory care costs in 2026, how TennCare CHOICES and VA Aid and Attendance help pay, the legal package to sign early, and how to tour well. Care TypesTennessee Home Care vs. Home HealthHome care vs home health in Tennessee 2026: different licenses, different scopes, different payers. Medicare, TennCare CHOICES, and TN cost benchmarks. MedicaidTennessee Medicaid Nursing Home CoverageTennessee Medicaid nursing home coverage runs through TennCare CHOICES Group 1. 2026 eligibility, patient liability, estate recovery, and how to apply. MedicaidTennCare CHOICESTennCare CHOICES is Tennessee's Medicaid program for adults needing nursing-home-level care. Three groups, a Group 2 waitlist, 2026 eligibility inside. CaregiverTennessee Caregiver ProgramsEvery caregiver program in Tennessee: paid family caregiver pathways, respite vouchers, NFCSP grants, AAAD intake, dementia resources, VA benefits. Care TypesMemory Care vs. Nursing Home in TennesseeMemory care vs. a nursing home in Tennessee: skilled-nursing need and who pays. Memory care about $5,900/mo; a nursing home $9,429/mo, TennCare-covered.

Find personalized help choosing a Tennessee nursing home 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.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.