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.

$7072

Tennessee

$7756

The United States

$5080

Missouri

$5931

Arkansas

$6540

Alabama

$6722

Georgia

$7057

Mississippi

$7300

North Carolina

$7330

Kentucky

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.

$6753

Clarksville

$6844

Cleveland

$6844

Morristown

$7148

Chattanooga

$7148

Knoxville

$7300

Memphis

$7368

Johnson City

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.

$7072

Nursing Home Semiprivate Room

$7619

Nursing Home Private Room

$1679

Adult Day Care

$4039

Assisted Living

$3909

Home Care

$4004

Home Health Care

Financial Assistance for Nursing Home Care in Tennessee

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Tennessee.

Tennessee’s Medicaid Program

Tennessee has 316 nursing homes that provide long-term care to medically fragile seniors. Those who qualify for Medicaid can use their benefits to pay for the cost of care. Approximately 65% of the nursing homes in the state are certified to receive Medicaid funding. Tennessee doesn’t have a Medicaid waiver program specific to seniors.

Through the TennCare Medicaid program, many seniors in Tennessee can receive help to pay for nursing home care. As of August 2020, 1,521,998 individuals were enrolled in Medicaid and CHIP in Tennessee, including many seniors who live in nursing homes. Medicaid covers nursing home care costs as long as the applicant meets income and asset requirements and has a medically-necessary need for nursing home care. In a nursing home, a resident receives care around-the-clock from skilled nursing staff. If the person’s physician indicates that around-the-clock nursing care is required, they may be eligible for Medicaid to help pay for nursing home services. If routine nursing care, but not around-the-clock, is all that is needed, they may not qualify.

Medicaid Eligibility in Tennessee

Tennessee has generous income requirements for its TennCare Medicaid program. Individuals who live in a medical institution and have an income below $2,349 a month can receive TennCare coverage to pay for their care. The state also limits the individual’s assets to no more than $2,000. In addition, the state requires that the applicant meet the following criteria:

  • Reside in the state of Tennessee
  • Be a U.S. citizen, legal alien or permanent resident
  • Need health care or insurance assistance, including a medical need for long-term care

Seniors can apply online through the TennCare Connect website.

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Tennessee

Seniors living in Tennessee can receive help with understanding their Medicaid and Medicare options, protection against abuse and neglect and guidance about long-term care needs from a variety of organizations, including private and government-sponsored groups. Many of these groups provide their services at little to no cost. Services are also available to help families of seniors who are living in nursing homes protect their loved ones and understand their rights.

ResourceContactService
Tennessee Health Care Association/Tennessee Center for Assisted Living(615) 834-6520Through THCA/TCAL, families seeking long-term care options in Tennessee can get information about what is available in the state. This organization holds care providers in Tennessee to a high standard of care, works to boost public understanding of options available in the state and serves as a liaison between long-term care providers and customers and the governments that oversee these facilities.
Collaborative Response to Elder and Vulnerable Adult Abuse(615) 253-5757Seniors aged 60 or older or vulnerable adults who are victims of an adult abuse crime can receive help through this organization. Services may include emergency housing, food, clothing, transportation and personal care help. Through these services, seniors in a nursing home who experience abuse can get out of the facility and find a new care option quickly.
Tennessee Long-Term Care Ombudsman(615) 253-5412Nursing home and other long-term care residents in Tennessee can get help protecting their rights from the state’s Long-Term Care Ombudsman. This program serves to help residents in long-term care facilities advocate for their rights and solve problems as they arise. These concerns often relate to the quality of care and resident rights.
State Health Insurance Assistance Program for Medicare Participants(877) 801-0044Tennessee’s SHIP program helps Medicare participants understand their coverage and options. This program also provides counseling to help seniors choose a Medicare Advantage Plan that will cover their medical needs.
Alzheimer’s Association Tennessee Chapter(800) 272-3900The Tennessee Chapter of the Alzheimer’s Association provides assistance to families affected by Alzheimer’s and other forms of dementia. It provides access to local community resources, regular events to connect with others, educational programming to help families and the community understand this disease and its effects, and addresses caregiving concerns.

Nursing Home Laws and Regulations in Tennessee

Licensing RequirementsNursing 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 RequirementsSNFs 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 RequirementsEach 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 RestrictionsNursing 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 RequirementsNursing 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 RequirementsNursing 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 ServicesNursing 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 ServicesMedication 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 RequirementsNursing homes must have daily group activities on a published calendar. They must record resident attendance at these activities.
Infection Control RequirementsTennessee 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 CoverageMany seniors use Medicaid to pay for long-term care. In Tennessee, about 65% of nursing homes accept Medicaid benefits.