Nursing Homes in Tennessee
Tennessee is a state that takes care of its seniors well. Generous income eligibility requirements for Medicaid mean many seniors can get help paying for long-term care options. For seniors with serious medical concerns who need supportive care at all times, nursing homes in Tennessee can provide the right level of care. These facilities have skilled nursing care at all times, which helps seniors who can no longer care for themselves maintain a high quality of life. In 2019, the state had an estimated population of 6,829,174 people, and 16.7% of that population is aged 65 and over. Of those, 26,647 Tennessee seniors reside in nursing homes.
Nursing home care is the most costly type of care for seniors in the state. According to the 2020 Genworth Cost of Care Survey, seniors pay an average of $7,072 a month for care in a semiprivate room and $7,619 a month for care in a private room. Many nursing home residents use Medicaid to help pay for this care.
This guide provides an overview of Medicaid coverage for Tennessee nursing homes, access to resources seniors can use to understand and protect their rights and a summary of nursing home regulations in the state.
The Cost of Nursing Home Care in Tennessee
In the state of Tennessee, the average cost for nursing home care in a semiprivate room is $7,072, based on 2020 figures from the Genworth Cost of Care Survey. This cost is somewhat high compared to neighboring states but lower than the national average of $7,756. To the north in Kentucky, the cost is $7,330. In North Carolina, seniors can expect to pay $7,300 a month for care. Georgia has a slightly lower cost at $6,722, while Alabama is even less at $6,540. The cost in Mississippi is closer at $7,057. Missouri has the lowest cost in the area with an average of $5,080, followed by Arkansas at $5,931.
The cost of care in Tennessee varies from one location within the state to the next. While the state’s average is $7,072, seniors in Clarksville in the northern part of the state pay much less at $6,753. In contrast, on the western edge of the state in Memphis, the cost increases to $7,300. Chattanooga is closer to the state average, coming in at $7,148 per month, which is the same average as Knoxville. In Cleveland, seniors average $6,844 per month for nursing home care, while Johnson City has the highest average cost at $7,368. Morristown is another city that is on the lower end with a cost of $6,844.
While medically fragile seniors may need nursing home care, which averages $7,072 for a semiprivate room and $7,619 for a private room, there are other care options in the state. The most affordable is adult day care, which costs an average of $1,679. Seniors who need some help with activities of daily living may choose assisted living care, which averages $4,039. The services of a home care provider cost approximately $3,909, while seniors who need additional medical care at home can choose home health care at an average of $4,004.
Nursing Home Semiprivate Room
Nursing Home Private Room
Adult Day Care
Home Health Care
Does Medicaid Cover Nursing Home Care in Tennessee?
Medicaid can cover some or all of the costs of Nursing Home Care for eligible adults aged 65 and older in Tennessee. It can also pay for hospital treatments and Home Care for frail seniors who don’t need skilled nursing in a residential facility. The benefit is administered by the Division of TennCare, which divides those in need into three groups within its CHOICES program. Frail seniors who are best supported by care staff within nursing homes are in Group 1.
Figures from July 2021 show 1,637,535 Tennesseans have enrolled in Medicaid and CHIP, which is around 23% of the state’s population. There are 312 nursing homes in Tennessee housing slightly more than 37,000 beds monitored by skilled nurses, therapists and physicians. Residents receive high levels of care in environments more homelike than the sterile surroundings associated with hospitals. The facilities also provide common room-and-board services, such as beds, bedroom furniture, cleaning, diet-specific meals and laundry services. Groups 2 and 3 of the CHOICES program offer alternative forms of care, with the former created for seniors who need skilled nursing but can live at home and the latter for those who need assistance at home but don’t qualify for nursing home care.
Medicaid Eligibility in Tennessee
The Division of TennCare applies strict guidelines to who can and can’t receive Medicaid, so it’s vital families collect all the relevant information they have to support their claim. However, as CHOICES Group 1 is an entitlement program, once an application has been approved, the senior will be eligible for financial support to meet their nursing home care costs. If one person is applying, they’ll need to have a monthly income of no more than $2,523 per month and assets not exceeding $2,000. If both people in the household apply, those figures are doubled.
It becomes a little more complicated when one spouse applies but the other remains at home. In this case, the applicant’s income should be no greater than $2,523 and their assets a maximum of $2,000, with the non-applicant spouse’s assets being no more than $137,400. Assets include cash, investments, savings, bonds, stocks and real estate that isn’t the applicant’s primary address. Some assets don’t count, such as personal belongings, furniture and typically the family home.
2022 Medicaid Income Limits for Seniors in Tennessee
|Income Limits Per Year||Asset Limits|
|Married (One Spouse Applying)||$30,276||$2,000 for applicant, $137,400 for non-applicant|
|Married (Both Spouses Applying)||$60,552 ($30,276 per person)||$4,000 ($2,000 per person)|
*All income is counted, minus a $50 per month personal needs allowance, Medicare premiums and an income allowance for a non-applicant spouse.
Other qualification requirements include:
- Being an American citizen or legal resident
- Living in Tennessee
It can take up to an hour to complete an application form, so seniors are advised to set aside enough time for the process.
How To Apply for Medicaid in Tennessee
The fastest way to apply for Medicaid in Tennessee is to create an online TennCare Connect account. This is also where seniors can check the current status of their applications and make amendments if circumstances change during the review period. Alternatively, families can call (855) 259-0701 to speak to an adviser who can guide them through the application journey. The third option is to print an application form and mail it to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240. The application can also be faxed to (855) 315-0669.
Information You Will Need
- Citizenship or legal residency documentation
- Social Security number and birth certificate
- Evidence of all income, including jobs if applicable
- Current contact details (mailing address, phone number, email address)
- Current value of cars and property
Additional Medicaid Support & Resources in Tennessee
Navigating the Medicaid application process can be confusing for some. The following links may help those unsure if they qualify for Medicaid and provide alternative sources of information should families need more support.
|American Council on Aging||Online Only||The Medicaid Eligibility Test is a free online resource for families that may be worried their loved ones don't qualify for Medicaid. Users answer a series of simple questions and receive general information specific to their state. The information is for guidance only and shouldn't be seen as a guarantee of acceptance. The site also has a useful Spend Down Calculator for those who may not qualify for Medicaid and need to know how much of their assets they need to spend down to fall within the benefit's restrictions.|
|Benefits.gov||(573) 751-3425||Benefits.gov is a federal website with extensive information about Medicaid in general. It provides up-to-date content regarding annual household income restrictions and links to Tennessee TennCare and other benefit providers.|
|Tennessee Justice Center||(877) 608-1009||The Tennessee Justice Center is a nonprofit organization with a wide area of responsibility related to social rights. It can help families determine if they qualify for Medicaid that contributes to nursing home care costs. Additionally, its advisers can guide clients on related matters, such as understanding the content of letters sent by TennCare and challenging the authority's decisions.|
Does Medicare Cover Nursing Home Care in Tennessee?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- A semiprivate room
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support and Resources in Tennessee
Although Medicaid is the most common method of support for seniors who need nursing home care, it’s possible that Medicare may be able to help in the short term. The following list includes resources in Tennessee that provide free and customized information, advice and support on Medicare matters.
|Medicare.gov||(800) 633-4227||Medicare.gov is the federal website for the state health insurance program. It's a comprehensive resource of everything Medicare, providing users with detailed content about the different plans and the scope of the coverage they provide. It also takes visitors through the sign-up process step by step and provides a list of useful tools that show how to get the most from each plan.|
|State Health Insurance Assistance Program||(877) 801-0044||The State Health Insurance Assistance Program (SHIP) is a free resource funded by the federal government for seniors using or considering Medicare. Trained counselors help seniors understand the different Medicare plans, including their likely costs and how they may fit into the person's long-term care goals. They can also advise on Medicare Advantage and private health care policies, and seniors don't need to be concerned about being sold a plan because the counselors are entirely impartial. Additionally, if a senior is denied Medicare, the counselor can help them draft and submit their appeal.|
|Medicare Cost Sharing Programs||(855) 259-0701||Some low-income seniors are eligible for financial assistance to cover the costs of their Medicare premiums. Some may fall under the qualified Medicare beneficiaries (QMB) umbrella. QMB will pay the premiums for the successful applicant's Medicare Part B, as well as deductibles and copayments for Parts A and B. To be eligible, the senior's monthly income must be no more than 100% of the Federal Poverty Limit and their resources can't exceed $8,400 for a single applicant or $12,600 for a couple.|
Other Financial Assistance Options for Nursing Home Care in Tennessee
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
|Name||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 skilled nursing care.|
|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 nursing care. 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 skilled nursing care. 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 skilled nursing care will not typically be eligible to sign up for a LTC insurance policy.|
Free and Low-Cost Resources for Seniors in Tennessee
Older Tennesseans can access a wide range of free and subsidized resources to help them age more comfortably. The following organizations and agencies provide comprehensive support for seniors to help them overcome various obstacles, such as challenging poor quality care, dealing with cognitive decline and finding the most appropriate nursing home community within their location and budget.
|Long-Term Care Ombudsman||(877) 236-0013)||The Long-Term Care Ombudsman is a state-sponsored advocate for the rights of seniors residing in care communities. Ombudsmen are trained volunteers who visit nursing homes to speak directly and confidentially to the residents. They can investigate complaints made by seniors, their families and others. Additionally, the ombudsman can supply copies of inspection reports, which may help families make more informed decisions about the best facilities for their loved ones.|
|Tennessee Health Care Association/Tennesse Center for Assisted Living||(615) 834-6520||Tennessee Health Care Association/Tennessee Center for Assisted Living has a wealth of information about the residential care facilities operating throughout the state. It holds them accountable for standards of care and liaises among them, their customers and government agencies responsible for care standards. It can provide additional information not necessarily covered in the inspection reports compiled by the Long-Term Care Ombudsman.|
|Collaborative Response to Elder and Vulnerable Adult Abuse (CREVAA)||(615) 253-5757||CREVVA is a program that pulls in various agencies to help seniors aged 60 and older who may be victims of abuse. It utilizes the resources of organizations such as Area Agencies on Aging and Disability and Human Resource Agencies to provide vulnerable adults with all-around support regardless of where they reside in the state. For example, the program has the authority to immediately remove a nursing home resident experiencing abuse and find them safe, suitable accommodations for their health care needs. As required, the program will also supply a personal attendant, clothing, food and transportation.|
|Information and Assistance||(866) 836-6678||Information and Assistance is a program administered by the Commission on Aging & Disability as a means of helping families and seniors find the most appropriate health care and human services resources offered by the state government. It can be a good place to start for people who think nursing home care may be needed for a loved one. The program's advisers can help them recognize the full scope of what's potentially available.|
|Alzheimer's Association - Tennessee Chapter||(800) 272-3900||The Alzheimer's Association is the primary resource for families in the United States whose loved ones are in the early and mid-stages of cognitive decline. It advocates for people with Alzheimer's at a national level and provides more hands-on support through its local chapters. The Tennessee chapter hosts a wealth of resources for seniors and their families, including one-on-one and group therapy sessions that can prepare them for a life with the condition. It also operates face-to-face and virtual educational programs to help people recognize warning signs and develop safe practices.|
Nursing Home Laws and Regulations in Tennessee
|Nursing Home Laws and Regulations in Tennessee|
|Licensing Requirements||Nursing homes are licensed through the Tennessee Board for Licensing Health Care Facilities, which is part of the Department of Health. After receiving an initial license, nursing homes must submit to regular inspections by Department surveyors to ensure they remain compliant with licensure rules. The Board can revoke the license at any time for violations of the rules of licensure.|
|Staffing Requirements||SNFs in Tennessee must have a full-time administrator licensed by the state. Staff ratios must be such that there's an awake staff member at all times. Nursing homes must have registered nurses to supervise nursing services, with at least an LPN on duty at all times and two nursing personnel on duty for each shift.|
|Staff Training Requirements||Each year, staff must receive annual in-service training in Alzheimer’s disease, dysfunctional behavior, safety risks, assistance with daily living and family communications. Certified Nursing Aides must complete at least 75 hours of state-accredited training.|
|Admission Restrictions||Nursing homes cannot admit people who pose documented dangers to themselves or other residents. They also must be able to provide the level of care required by the resident’s physician before admitting them. All residents must have their diagnoses recorded on the admission records. Any resident admitted for care must be under the supervision of a state-licensed physician.|
|Care Planning Requirements||Nursing homes are required to provide a care plan for each resident. This plan is created at a meeting that includes the resident or the resident’s family or legal representative. It must contain measurable objectives to meet the needs of the resident based on a resident assessment.|
|Dietary and Nutritional Services Requirement||Nursing homes must provide meals for residents that are overseen by a dietician, either employed by the facility or a consultant. Residents must receive at least three meals each day, and a supplemental night meal or snack is required if there are 14 hours between scheduled dinner and breakfasts. Nursing homes must have a three-day supply of food on hand at all times.|
|Specialized Rehabilitative Services||Nursing homes must provide physical, occupational and speech therapy services either directly at the facility or on contract with a qualified service provider and as required by each individual care plan. The facility must have sufficient staff on hand to provide this care or make this care available.|
|Medication and Pharmaceutical Services||Medication must be provided in accordance with the Tennessee Board of Pharmacy statutes and rules. It must be stored in secure, locked cabinets or drug rooms. Orders for drugs and medical devices must be made in writing and signed by a practitioner. Only licensed medical or licensed nursing personnel can administer medications.|
|Activities Requirements||Nursing homes must have daily group activities on a published calendar. They must record resident attendance at these activities.|
|Infection Control Requirements||Tennessee nursing homes must provide sanitary environments for residents. They must have precautions and standards in place based on CDC recommendations to prevent transmission of infections and communicable diseases.|
|Medicaid Coverages||Many seniors use Medicaid to pay for long-term care. In Tennessee, about 65% of nursing homes accept Medicaid benefits.|