From application to approval, we handle your HFC licensing — then hand you the platform to run your agency from day one. Most consultancies disappear when your license arrives. We keep going.
Want to open a non-medical home care agency in Tennessee? You need a Personal Support Services Agency (PSSA) License from the Tennessee Health Facilities Commission. Plan on 90–150 days for provisional approval plus an on-site survey. State filing fees total $1,404 and are paid directly to HFC.
A Certificate of Need is required for non-medical home care in Tennessee.
Medicaid Program
CHOICES (Long-Term Services & Supports)
Plus the TennCare (Managed Care) for qualifying providers.
Home Care License Type in Tennessee
Tennessee regulates home-based care under several license categories. Most new founders start with a PSSA License for non-medical care, then add skilled services later if they choose.
NON-MEDICAL
Personal Support Services Agency (PSSA) License
Tennessee requires a Home Care Organization license for non-medical home care agencies providing services like homemaking, errands, and personal care.
Personal care and daily living assistance
Companionship and homemaker services
Medication reminders (not administration)
Transportation and errand assistance
Respite care for family caregivers
State fee:
$1,404 $1,404 Annual License Fee
Timeline:
3-5 months for provisional approval
Regulator:
Tennessee Health Facilities Commission
How to Get Licensed in Tennessee
Tennessee licensing follows a structured 6-step process through HFC. Our specialists handle all 6 steps in the Launch and Signature packages; in the Licensing Kit, you handle the submission yourself with our expert guidance.
90–150 days from start to provisional approval
1
FOUNDATION
2
APPLICATION
3
POLICIES
4
SURVEY
1
Define your agency type & register your business
FOUNDATION
Decide if you are providing non-medical "Home Care Organization" services or medical "Home Health" (requires RN oversight). Register your LLC or corporation with the Tennessee Secretary of State. Get your EIN from the IRS.
2
Apply for Certificate of Need (if required)
APPLICATION
Check with the Health Services and Development Agency to see if a CON is needed for your service type and area. If required, submit your CON application. This step can add time to the process.
3
Develop policies, procedures & hire administrator
POLICIES
Create a comprehensive policy manual covering care delivery, hiring, training, emergency protocols, patient rights, infection control, and abuse reporting (TCA 71-6-103). Designate a qualified administrator who meets state requirements.
4
Submit license application & fees
APPLICATION
Submit your notarized application to the Tennessee Department of Health, Office of Health Care Facilities, along with the $1,404 annual license fee and all required documentation.
5
Recruit staff & complete background checks
SURVEY
Recruit caregivers and admin staff. All staff must pass TBI background checks and TB tests. Ensure caregivers receive required training before providing care.
6
Request & pass survey/inspection
SURVEY
Request a survey from the Regional Office 30-45 days before your planned opening date. A surveyor will visit to verify compliance with Tennessee regulations. Upon passing, you receive your license to operate.
Why Tennessee Founders Choose HomeCareAtlas
The biggest difference between us and traditional consultancies isn't the license — it's what happens after the license arrives.
Traditional Consultant
HomeCareAtlas
Pricing
A mystery sales process and hard upsells
Clear packages built for your goals
Policies & Procedures
Generic templates
Built around your state and your service model
Application Filing
You assemble the packet
Done-for-you in Launch and Signature
Survey Day
You're on your own
On-call phone support during your state visit
After License Arrives
Relationship ends
Platform, dashboard, and directory listing go live
Caregiver Onboarding
Not included
Digital onboarding ready for hire #1
Compliance Tracking
You build a spreadsheet
Live compliance dashboard included
Directory Presence
None
Listed on Carezano the day you open
Three Ways to Get Your Tennessee Agency Licensed
Pick the level of support that matches how hands-on you want to be. Tennessee state fees ($1,404 to HFC) are passed through at cost.
Tennessee charges a state application fee, paid directly to the state licensing body. We don't mark it up.
Want to see pricing? We share it on your free 15-minute call. Pick a time →
The Platform That Comes With Your License
Every tier includes free time on Home Care Atlas — the operating system for your new agency. This is the part other Tennessee consultancies don't offer.
Tennessee Licensing Workspace
Track your application, documents, and deadlines in one dashboard. Your Atlas specialist works in the same view you do.
Custom Tennessee P&P Manual
Written around your state's rules, your service model, and your agency — not a generic national template. Survey-ready before you file.
Business Formation
LLC, EIN, NPI, surety bond, and insurance — all tracked and handled in Launch and Signature packages.
Compliance Dashboard
From caregiver #1 onward, every certification, background check, and required document is tracked with automatic expiration alerts.
Caregiver Onboarding
I-9, W-4, direct deposit, and required background-check verifications — all collected digitally.
Carezano Directory Listing
Listed on our public directory the day you open. Local families find you, referral partners find you, you're visible from day one.
Common Questions Before You Book
Do I need a license to start a home care agency in Tennessee?
Yes. Tennessee requires a Home Care Organization license for all non-medical home care agencies, including basic companion care. Operating without a license is illegal. You apply through the Tennessee Department of Health, Office of Health Care Facilities.
Do I need a Certificate of Need (CON) in Tennessee?
A CON may be required depending on your service type and area. You must check with the Health Services and Development Agency before applying for licensure. If required, the CON process adds time to your startup timeline.
How much does it cost to start a home care agency in Tennessee?
The annual license fee is $1,404. Total startup costs typically range from $40,000 to $75,000, including insurance, surety bond, office setup, training, marketing, and working capital.
How long does licensing take in Tennessee?
The full process takes about 3-5 months. This includes CON application (if required), license application review, staff hiring and background checks, and the on-site survey/inspection. Request your survey 30-45 days before your planned opening.
What insurance is required in Tennessee?
Tennessee requires general liability insurance ($1,000,000 per occurrence) and workers' compensation for all employees. A $25,000 surety bond may also be required depending on your service type.
Is Tennessee a good market for home care agencies?
Tennessee has about 1.2 million adults aged 65 and older (17.0% of the population). The market opportunity rating is 4/5 stars. Nashville is booming with affluent retirees, Knoxville and Chattanooga have less competition, and the state has no income tax -- a big advantage for agency owners.
What are the biggest mistakes new agencies make in Tennessee?
The two most common mistakes are underestimating Nashville market competition (there are many established agencies) and not building a healthcare referral network early enough. Start building relationships with hospitals, discharge planners, and senior centers before you even open.
Tennessee Home Care Licensing: What You Need to Know
Tennessee requires a Home Care Organization license for non-medical home care agencies providing services like homemaking, errands, and personal care. You must apply through the Tennessee Department of Health, Office of Health Care Facilities. A Certificate of Need (CON) may be required before applying for licensure. The process includes a notarized application, policy review, and a survey/inspection from the Regional Office before you can open. Tennessee also has no state income tax, which is a big advantage for agency owners.
The Personal Support Services Agency (PSSA) License
Tennessee requires licensure for all agencies providing non-medical home care services, including basic companion care. Operating without a license is illegal. Apply through the Office of Health Care Facilities with the $1,404 annual fee. You must designate a qualified administrator for your agency. The administrator must meet state requirements for education, experience, and background clearance. All staff must pass Tennessee Bureau of Investigation (TBI) background checks and TB tests before providing care. This is a mandatory part of the hiring process. Carry general liability insurance ($1,000,000 per occurrence) and workers' compensation for all employees. A $25,000 surety bond may be required depending on your service type.
Certificate of Need (CON) in Tennessee
Certificate of Need (CON) May Be Required. You must apply for a CON from the Health Services and Development Agency before applying for licensure, unless your agency strictly serves specific federal programs. Check CON requirements for your specific service type and area.
Tennessee's primary Medicaid waiver program for long-term care. CHOICES provides home and community-based services to seniors and adults with disabilities, helping them stay in their homes.
Common Reasons Tennessee Applications Are Rejected or Delayed
Generic P&P manuals that don't reflect state-specific regulations
Incomplete administrator documentation
Insurance or surety bond policies that don't meet state minimums
Missing or inadequate quality assurance program documentation
Physical office that doesn't meet site-review standards
Caregiver background checks that miss required state databases
Every one of these is preventable with proper preparation. It's the biggest reason founders choose done-for-you packages over DIY — the cost of a rejection in lost time is almost always higher than the cost of doing it right the first time.
Book a Free Tennessee Strategy Call
15 minutes with a home care specialist. We'll map out Tennessee licensing for you, your timeline, and your best next step — even if you don't hire us.
Which Tennessee license type fits your business model (Personal Support Services Agency)
Your realistic timeline and budget
Whether CHOICES (Long-Term Services & Supports) enrollment makes sense for your plan
No pressure. No obligation. Tennessee-specific guidance either way.
Your Future Tennessee Clients Are Already Looking for Care.
Every week you spend piecing this together alone is a week you're not serving your first Tennessee client. Let's get your agency licensed, launched, and visible — with people on your side who know HFC.
Built exclusively for non-medical home care|Tennessee-specific guidance under TCA 68-11 / Rule 1200-08-26|Platform & HomeCareAtlas directory on day one
Tennessee licensing details verified by HomeCareAtlas on March 1, 2026.
