Assisted Living in Tennessee

Tennessee is a tax-friendly state since it doesn’t impose any income tax and has a cost of living that is 9.6% lower than the national average. Additionally, Tennessee offers easy access to affordable healthcare facilities. Scenic towns like Winchester, Loudon, and Crossville are popular among senior citizens with a fairly large percentage of older adults.

Directory of Assisted Living Facilities in Tennessee

There are many aspects to consider when selecting an assisted living facility, including the amenities available, the care that is offered, and financial assistance. Our directory on assisted living facilities in Tennessee combines many of these features into one database that will help you make the right choice for yourself or a loved one.

Paying For Assisted Living in Tennessee

The Cost of Assisted Living in Tennessee

The monthly median cost of an assisted living facility is $3,920, which is about the same as the national average of $4,000. According to Genworth’s 2018 Cost of Care Survey, the monthly cost of assisted living in Tennessee is the highest amongst all of its neighboring states except Virginia.

 

The average monthly cost of assisted living in Tennessee ranges from $3,018 to $4,500, varying across the state. The average monthly cost in the Nashville area is the highest in the state, while Chattanooga averages the cheapest.

 

The average monthly cost of nursing home care and memory care is significantly higher than assisted living. While not providing as much care as assisted living, independent living in Tennessee is the cheapest senior living option followed by homemaker services.

Financial Assistance for Assisted Living in Tennessee

CHOICES Waiver

The Medicaid program in Tennessee is called TennCare, which is jointly funded by the state and federal health care program for low-income seniors. TennCare offers Home Based Community Services for assisted living through the TennCare CHOICES in Long-Term Service and Support program. CHOICES is not an entitlement program for individuals who apply for assisted living support. The waiting list is prioritized based on the intensity of care needed.

CHOICES provides monthly financial support of up to $1,100 for some services eligible residents receive at an assisted living facility. These include personal care services like assistance with activities of daily living, medical oversight, transportation assistance, and homemaker services like meals and laundry. However, TennCare members are expected to pay for room and board themselves.

Who Is Eligible

Applicants eligible for TennCare CHOICES program for an assisted living must be 65 years or older who are at the risk of moving to a nursing home if they don’t receive proper care. The monthly income limit of applicants is $2,250, and the asset limit is $2,000.

How To Apply

Applicants must first apply for TennCare to receive benefits of the CHOICES program by contacting local Area Agency on Aging and Disability at 1-866-836-6678 or visiting the TennCare website.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.

• Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov

• Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.

• Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in Tennessee

Long-Term Care Ombudsman Program

As a government supported program for the elderly, the Long-Term Care Ombudsman is responsible to protect the rights of all long-term care residents including residents of assisted living facilities. The ombudsman addresses and resolves issues involving finances, services at the facility, medications, and staff communication.

Since the District Ombudsman works with many state and federal agencies that serve the elderly, it is able to resolve concerns that include:

• Quality of care
• Financial information
• Resident rights
• Admissions, transfer, and discharge
• Choosing the right long-term care facility

The Office of the State Long-Term Care Ombudsman appoints volunteers to visit long-term care facilities and trains them to:

• Assess the facility’s condition and quality of care
• Provide information about resident rights
• Communicate with the residents and the staff
• Handle simple complaints

The State Long-Term Care Ombudsman can be reached at:

Phone: (615) 741-2056
Toll-Free: (877) 236-0013
Website: tn.gov/aging/our-programs/long-term-care-ombudsman

Area Agencies on Aging

Area Agencies on Aging (AAA) offers different programs to assist the elderly when they seek long-term care. Area agencies help seniors assess their physical and financial status and find suitable service providers. The agencies advocate the rights of the elderly to live with dignity in long-term care facilities.

Veterans Affairs

The Tennessee Department of Veteran Affairs plans and executes programs designed to benefit veterans and their families. The department’s resources and services aim to provide a high quality of life, financial assistance, and advocacy for long-term care residents.

Social Security Offices

Senior citizens who are in long-term care can access social security benefits. Social security offices provide information regarding benefits and eligibility and assist the elderly to solve any issues related to social security.

Assisted Living Laws and Regulations in Tennessee

Assisted Living Service Plans

The Tennessee Health Care Association requires all assisted living facilities in the state to develop a service plan or a plan of care for each resident at the time of admission. The resident or a legal representative and the treating physician or a licensed medical professional should participate in developing the plan of care.

A service plan should explain:

• The type of assistance the resident needs like activities of daily living and medication management
• The extent and frequency of assistance needed and the caregivers involved
• The visiting arrangements for or to physicians and other health providers
• The healthcare power-of-attorney or advance care directive as applicable
• The recreational and social activities desired by the resident
• The dietary needs and preferences of the residents

Assisted Living Admission Requirements

Assisted living facilities in Tennessee should screen applicants based on the eligibility criteria set by the Tennessee Health Care Association.

According to state laws, assisted living facilities can admit or retain residents who:

• Can care for themselves independently in some conditions
• Do not qualify for a nursing care facility
• Receive a Health and Community Based Services waiver from the board
• Require skilled nursing care for a brief period

Facilities are restricted from admitting or retaining individuals who:

• Demonstrate aggressive behavior and can be a serious threat to themselves or others
• Suffer an advanced stage of Alzheimer’s or related memory loss disorders
• Suffer exfoliative dermatitis or ulcers at stage III or IV
• Have an infectious or communicable disease
• Require continuous nursing care
• Cannot evacuate within 13 minutes in case of an emergency
• Are not able to communicate their needs

Assisted Living Scope of Care

Assisted living facilities offer services that range from personal care to limited medical services. Since an assisted living facility is not an intensive nursing facility, medical assistance is provided to patients who usually self-administer medication. As per state regulations, an assisted living facility should have a licensed nurse to provide certain medical services like therapies, hospice care, and intravenous injections. The extent of medication management should be specified in the resident’s service plan.

Some assisted living facilities in Tennessee provide special care services including care for residents who are in the early stages of Alzheimer’s disease or other memory loss disorders. These facilities are staffed with qualified and licensed care providers.

Assisted Living Medicaid Policy

According to the Tennessee Health Care Association, the TennCare CHOICES in Long-Term Care Program pays up to $1,100 per month for personal care services and medication management offered at an assisted living facility. Since this is a waiver program, not everyone who qualifies is entitled to receiving benefits. TennCare does not cover the room or board expenses and not all assisted living facilities in the state accept Medicaid benefits.

Assisted Living Facility Requirements

All assisted living facilities must comply with the International Building Code, the National Fire Protection Code, National Electrical Code, the U.S Public Health Service Food Code, and the Americans with Disabilities Act.

An assisted living facility must provide:

• A bedroom of 80 square feet or more with a maximum of 2 beds and privacy screens or curtains for each resident
• A storage space for each resident for their personal belongings and medications
• A dining area that accommodates all residents with a minimum of 15 square feet per resident
• Toilets and bath or shower areas that will be used by a maximum of 6 residents
• A living area furnished with a calendar, a television set, a radio, and a clock
• A telephone accessible to all residents 24 hours a day
• A kitchen with all types of cooking equipment
• A storage area for soiled linens
• An emergency keyed lock box next to each functioning elevator and fire extinguishers in the kitchen, laundry areas, and at all exits
• A storage area for janitorial supplies that is away from all common areas and is inaccessible to the residents

Medication Management Regulations

All medication management services at an assisted living facility must be provided only by licensed or qualified staff. Medication assistance must be specified in the resident’s plan of care.

An assisted living facility is allowed to:

• Administer medications to residents who usually self-administer
• Provide occasional nursing care, therapies, podiatry care, and hospice service as prescribed by the resident’s physician
• Administer intravenous injections only if the resident needs it occasionally or receives hospice service

Staffing Requirements

Assisted living facilities should employ a qualified administrator as required by the Tennessee Department of Health Board. The administrator will manage the facility and ensure proper functioning.

The staff of an assisted living facility must include:

• An administrator who is at least 18 years old, is certified by the Board or licensed in Tennessee as a nursing home administrator, is a high school graduate or a diploma holder, and has not been convicted of any criminal offense related to an elderly or vulnerable person
• An attendant who is alert and awake at all times to attend to the personal and medical needs of the residents
• A licensed nurse as needed
• A qualified dietitian to manage the daily dietary needs and train staff in dietary services

Staff Training Requirements

An assisted living facility has to provide documentation to the Department of Health specifying the in-service training its staff members receive annually.

The in-service training must include a 24-hour Board-approved continuing education for the administrator which covers subjects like state laws, health care management, nutrition and food service, financial management, and healthy lifestyle. Additionally, annual in-service training for all staff members must be completed. Topics include:

• Basic facts about Alzheimer’s disease and related disorders
• Dealing with a resident’s dysfunctional behavior or catastrophic reactions
• Identifying and alleviating safety risks
• Assisting residents in daily living activities
• Communicating with families

Background Checks for Assisted Living

Assisted living facilities should perform a criminal background check before employing individuals or accepting volunteers. The Tennessee Department of Health maintains The Abuse Registry for the State of Tennessee which lists individuals who have been accused or convicted of a criminal offense related to abuse, neglect, or exploitation involving an elderly or a vulnerable individual. An assisted living facility must provide the Board with proof that all its employees and volunteers have not been convicted of such crimes.

Requirements for Reporting Abuse

Any suspicion regarding elder abuse in long-term facilities should be reported to the State Long-Term Care Ombudsman. The ombudsman investigates cases of elder abuse including deprivation of health, medical, and welfare services, neglect, financial exploitation, and physical, emotional, psychological, and sexual abuse. A report can also be filed with the Adult Protective Services at reportadultabuse.dhs.tn.gov or by calling the 24/7 hotline at 1-888-277-8366.

In case an assisted living facility is suspected of violating the state’s statutes or regulations regarding staff members, facility structure, licenses, and services must be reported to the Division of Health Care Facilities by calling at 1-877-287-0010. Alternatively, a complaint form can be reported online.

Tennessee COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/15/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in Tennessee
Are loved ones allowed to visit residents in their assisted living community?	Yes (Conditions Apply)
Are residents required to quarantine after their loved ones visit?	No
Are loved ones required to wear masks when visiting residents?	Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities?	Yes
Are visitors screened for elevated temperatures before entering the assisted living community?	Yes
Are residents allowed to leave the assisted living community for non-medical reasons?	Yes
Are residents who leave required to quarantine when they get back to the assisted living community?	No (Conditions Apply)
Are assisted living communities required to cancel all group outings?	No
Are assisted living communities allowed to host group activities within the community?	Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures?	Yes
Are staff members regularly tested for COVID-19?	Yes (Conditions Apply)
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)

 

Sources: www.tn.gov www.cms.gov