Tennessee is a popular location for retirees thanks to its mild climate and affordable cost of living. Assisted living costs $4,105 per month, which is $395 lower than the national average. Although the Volunteer State ranks in the lowest quartile for its senior-friendly amenities, it receives more favorable ratings for its health care and affordability, and it’s the 18th-best state for senior living and housing according to our 2022 Senior Living Report

Tennessee is home to some excellent hospitals, including the Vanderbilt University Medical Center, a member of U.S. News and World Report’s honor roll. Memphis, Knoxville and Chattanooga also have top-rated medical facilities. Given these world-class amenities, it’s not surprising that seniors represent 16.7% of the state’s 6.6 million residents. Additionally, the cost of living is about 12% lower than the national average, which benefits retirees who depend on a fixed income.

This guide takes a look at average long-term care costs in Tennessee plus government-sponsored financial assistance programs, such as TennCare CHOICES. It also provides a detailed look at assisted living regulations and free and low-cost resources that can help with long-term care planning and decision-making.

The Cost of Assisted Living in Tennessee

The Genworth 2021 Cost of Care Survey lists the average cost of a private one-bedroom unit in an assisted living community in Tennessee as $4,105. Assisted living prices are approximately 10% lower than the national average of $4,500. However, they’re higher than other parts of the Southeast. Seniors in North Carolina pay $95 less per month or about $1,140 less per year. Prices in Mississippi, Alabama and Georgia range from $3,500 to $3,535 per month, which saves residents about $600 a month. Average prices in Kentucky are $657 lower based on an average of $3,448.

$4105

Tennessee

$4500

The United States

$3448

Kentucky

$3500

Mississippi

$3503

Alabama

$4010

North Carolina

$3535

Georgia

Assisted living prices in Tennessee’s major cities are close to the state median with minor price fluctuations in some smaller communities. For example, prices in Clarksville are $890 lower than the state average based on average rates of $3,215 per month. Seniors in Memphis, Chattanooga and Jackson pay about $1,000 more per month with average rates between $4,200 and $4,240.

Assisted living prices in Johnson City and the Nashville metropolitan area, which includes Davidson County, Franklin and Murfreesboro, are within $5 of the state median, and with a local average of $3,823, Knoxville residents save about $282 per month compared to seniors in other parts of the Volunteer State.

$4100

Nashville

$3823

Knoxville

$4200

Memphis

$4240

Jackson

$4220

Chattanooga

$3215

Clarksville

$4100

Johnson City

In most cases, long-term care costs in Tennessee are similar to or slightly lower than the national average. Assisted living costs less than in-home care, which averages $4,576 per month, and the rates are more comprehensive. Seniors who require minimal support may be comfortable with a daytime health care program offered in a community-based setting. This type of care runs $1,733 per month. Seniors who require more advanced care than an assisted living facility can provide will pay a median rate of $7,148 per month to transition to a nursing home.

$4105

Assisted Living

$4576

Home Care

$4576

Home Health Care

$1733

Adult Day Health Care

$7148

Nursing Home Care (semiprivate)

Does Medicaid Cover Assisted Living in Tennessee?

TennCare covers assisted living through its home- and community-based CHOICES waiver. This program is available to individuals who meet financial requirements and require a nursing home level of care but choose lower-cost alternatives, such as self-directed in-home care or assisted living. The Program of All-Inclusive Care for the Elderly may cover similar services. However, it’s only available in certain geographic areas.

What Assisted Living Services Are Covered by Medicaid in Tennessee? 

Tennessee’s Medicaid program will cover assisted living when these services are medically necessary. Waiver eligibility is based on need and medical criteria. There may be a waiting list. CHOICES includes provisions for self-directed care, so seniors have the freedom to hire their own caregivers and select the services and supports that best fit their needs. Here are a few of the long-term care services that Medicaid covers.

  • Personal care
  • Attendant care
  • Adult day health care
  • Companionship
  • Adult care homes
  • Assisted living
  • Skilled nursing
  • Community living supports
  • Residential or institutional respite care
  • Emergency response systems
  • Assistive technology
  • Home modifications
  • Meal deliveries
  • Pest control 

Assisted Living Waiver Programs in Tennessee 

TennCare CHOICES

TennCare CHOICES supports seniors who want to remain at home, but it will also cover assisted living for individuals who are unable to live safely on their own. The program pays for personal care, one-on-one assistance, homemaker services or housekeeping and medication assistance. Beneficiaries are still responsible for the cost of room and board at their assisted living facility. Applicants must have limited income and assets and require a nursing home level of care as determined by a personal needs assessment. Seniors and disabled adults can contact their Area Aging on Aging and Disability to begin the application process.

How To Know If You’re Eligible for Medicaid in Tennessee 

Medicaid is a state-funded and federally funded health insurance program available to residents who need help paying for health care. To qualify for long-term care benefits, you must meet financial eligibility requirements. Medicaid benefits for the aged, blind and disabled consider medical criteria, so they have higher income limits than traditional Medicaid. Income is capped at 300% of the monthly Social Security Income benefit rate. For 2022, this is $2,523 per month, per applicant. Although assets are limited to $2,000 per applicant, a house, car and some valuables can be excluded if only one spouse requires long-term care.

2022 Medicaid Income Limits for Seniors in Tennessee

 

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household
(One Spouse Applying)

$60,552

$2,000 for applicant
$137,400 for non applicant

Two-Person Household
(Both Spouses Applying)

$60,552

$4,000

Medicaid is available to state residents who are financially needy or require a high level of ongoing care, such as:

  • Individuals who receive Supplemental Security Income
  • Adults with breast cancer or cervical cancer
  • Adults who are at risk for nursing home placement

The services TennCare CHOICES covers depend on the applicant’s eligibility category. Learn more about these standards below.

  • Group 1 includes individuals who receive care in a skilled nursing facility.
  • Group 2 includes adults and seniors who require skilled nursing but receive alternative services at home or in assisted living.
  • Group 3 includes adults and seniors who have moderate personal needs and receive SSI.

How to Apply for Medicaid in Tennessee 

The easiest way to apply for TennCare is by contacting your local Area Agency on Aging and Disability. Staff members can make referrals and schedule a personalized needs assessment, which is required to participate in the program. The government offers an online application portal at TennCareConnect.TN.gov, and there are options for seniors who would prefer to submit a paper application. To reach TennCare, seniors can call (855) 259-0701 or dial (866) 836-6678 to speak with a staff member at their AAAD. Those who already have TennCare should call their managed care organization for more information.

Information You Will Need

Applicants should be prepared to provide the following documentation before applying.

  • Current address and phone
  • Social Security number
  • Date of birth
  • Information about income and assets
  • Proof of citizenship or legal immigration
  • Health insurance details 

How to Get Help Applying for Medicaid

If you need help applying for TennCare or if you aren’t sure whether you’re eligible for benefits, you can contact the government directly. Free assistance is also available through health insurance assistance hotlines and nonprofit consumer advocates.

Resource

Contact

Description

(877) 224-0219

The Division of Long-Term Services & Supports administers Medicaid programs available to seniors and disabled adults with ongoing medical needs. This agency manages the CHOICES waiver and the Program of All-Inclusive Care for the Elderly. These benefits are available to residents who require assistance with daily activities and meet medical and financial eligibility requirements.

(877) 801-0044

SHIP is a federally funded program available to Medicare-eligible seniors statewide. Specially trained counselors provide free information to help residents compare available plans. They can also answer questions about long-term care insurance, prescription drug coverage and financial assistance, including TennCare.

(615) 255-0331

The Nashville-based Tennessee Justice Center provides information and advocacy for residents who need help applying for TennCare or accessing covered benefits. It can assist with denials, appeals and notices. Staff may also screen residents for other government benefits that can help reduce the cost of long-term care and minimize out-of-pocket expenses.

Does Medicare Cover Assisted Living in Tennessee?

The short answer is that no, Medicare does not cover the cost of assisted living in Tennessee. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Tennessee.

Other Financial Assistance Options for Assisted Living in Tennessee

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Tennessee

Seniors in Tennessee can take advantage of numerous resources to help with long-term care planning. Free and low-cost programs are available through government agencies and nonprofit groups at the state and local level. Learn more about some of the agencies that can help those who are considering assisted living.

Resource

Contact

Description

(866) 836-6678

Tennessee operates nine Aging and Disability Resource Centers that serve seniors, disabled adults and caregivers in designated geographic areas. Staff members provide free information to help residents access accessible transportation, delivered meals, recreational activities and in-home care. Tennessee's Area Agencies on Aging and Disability are also responsible for screening residents for CHOICES.

(800) 698-2411

The U.S. Department of Veterans Affairs operates a number of facilities that serve the state's veterans, including medical centers, community-based outpatient clinics and outreach offices. Senior veterans and their spouses may qualify for health care, medical transportation, pensions and supplemental benefits that can help with the cost of long-term care.

(615) 741-2345

Veterans who need help accessing VA benefits and other government-sponsored services can contact their local Veterans Services office for assistance. The state operates 14 regional outposts that provide benefit screenings, application assistance and other services, including placement in one of the state's three veterans homes.

(800) 772-1213

Tennessee has more than two dozen Social Security offices that can help seniors claim retirement and disability benefits. The agency also handles Medicare eligibility and Supplemental Security Income benefits that can help with the cost of room and board provided in an assisted living facility.

(877) 236-0013

Tennessee's long-term care ombudsman is available to handle questions or concerns about assisted living communities and other licensed health care facilities. They advise long-term care residents, accept confidential complaints against providers and advocate for seniors' personal rights.

(844) 435-7486

The Tennessee Senior Law Alliance uses funding from the Commission on Aging and Disability to provide free legal assistance to seniors aged 60 and older in all 95 counties. Attorneys help with questions about health care, estate planning, housing and government benefits. Services are provided by five regional legal aid societies.

COVID-19 Rules for Assisted Living in Tennessee

The following information is based on research done on several government websites, including The Tennessee Department of Health and Centers For Medicare and Medicaid Services. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 03/14/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Tennessee Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Tennessee Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Rules for Tennessee Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Tennessee

The Tennessee Department of Health, Board for Licensing Health Care Facilities is responsible for regulating the state’s assisted living facilities. State laws require long-term care providers to meet specific standards for resident care and staff training, including the following.

TENNESSEE LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

Assisted living communities must perform a comprehensive needs assessment within three days of admission and prepare a detailed plan of care within five days of admission. All assessments must be performed by a qualified direct-care staff member. Assessments are designed to determine the level of assistance and types of services that each resident requires.

Assisted Living Admission Requirements

Residential care facilities may only admit residents who are able to live safely in the community. Seniors who have complex medical needs, require continuous medical monitoring or have been diagnosed with late-stage dementia may be ineligible for admission. In most cases, residents must be able to safely evacuate the building and take their own medications with some assistance.

Assisted Living Scope of Care

Assisted living facilities and residential homes for the aged must provide a comprehensive range of services to meet residents’ day-to-day personal and medical needs. Facilities typically offer room, board, medication assistance, intermittent nursing, rehabilitative care, physical therapy and help with the activities of daily living.

Assisted Living Medicaid Policy

TennCare CHOICES is a Medicaid waiver program that covers the cost of assisted living and personal care provided in licensed health care facilities and community-based settings. Seniors and disabled adults must meet medical and financial eligibility requirements to qualify.

Assisted Living Facility Requirements

Assisted living facilities may provide private or shared bedrooms for up to two adults per unit. Residents must be able to unlock their own doors, and the facility must provide curtains or privacy screens upon request. Bathrooms may be private or shared by up to six residents.

Medication Management Regulations

Long-term care facilities may assist residents with the self-administration of prescription medications. Qualified health care professionals, including nurses and certified medication aides, can provide reminders and help residents read labels, open containers and determine dosing.

Staffing Requirements

Assisted living facilities in Tennessee must employ a certified administrator and a sufficient number of support staff to meet residents’ needs. There’s no minimum staffing ratio, however, the facility must employ 24-hour awake caregivers, on-call nurses and a dietitian or nutritional consultant.

Staff Training Requirements

Assisted living administrators must meet licensing requirements and complete at least 24 hours of continuing education every two years. Certified nursing assistants in Tennessee must complete at least 75 hours of training, including 35 hours of clinical work experience. Additionally, staff must be trained in facility protocols for health, safety and emergency management. Specialized training is required for anyone who works in a memory care unit.

Background Checks for Assisted Living Staff

Tennessee requires background checks for all workers who provide patient care. Assisted living facilities and other staff members must not have any convictions for criminal offenses related to abuse or neglect. Facilities are prohibited from hiring anyone who has been listed on the state’s abuse registry.

Requirements for Reporting Abuse

Tennessee requires health care workers and members of the public to report all instances of suspected abuse or neglect. Reports can be made to the Tennessee Department of Adult Protective Services by calling (888) 277-8366. Concerns related to assisted living communities and other licensed facilities can also be reported to the Long-Term Care Ombudsman by calling (877) 236-0013.