Tennessee · TDMHSAS, Office of Licensure Licensing
Start a Home Care Agency in Tennessee
From application to approval, we handle your TDMHSAS, Office of Licensure 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 Department of Mental Health and Substance Abuse Services. Our estimate: 90–150 days for provisional approval plus an on-site survey. State filing fees total $810 and are paid directly to TDMHSAS, Office of Licensure.
Tennessee Department of Mental Health and Substance Abuse Services
License Types
1 Categories
Personal Support Services Agency
Certificate of Need
Not Required
Non-medical home care agencies do not require a CON 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 calls a non-medical home care agency a Personal Support Services Agency (PSSA).
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:
$810 Annual License Fee (per office)
Timeline:
3-5 months for provisional approval
Regulator:
Tennessee Department of Mental Health and Substance Abuse Services
How to Get Licensed in Tennessee
Tennessee licensing follows a structured 6-step process through TDMHSAS, Office of Licensure. 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
POLICIES
3
APPLICATION
4
SURVEY
5
OPERATIONS
1
Pick your agency type & register your business
FOUNDATION
Non-medical care means a PSSA license. Skilled care means a home health license from the Health Facilities Commission, and that needs a CON. Register your LLC or corporation with the Tennessee Secretary of State. Get your EIN from the IRS.
2
Read the rules & write your policies
POLICIES
Read rules 0940-05-38 and 0940-05-06. Write policies on staff training, abuse reporting (TCA 71-6-103), client rights, infection control, emergencies, and records. Decide who will run the agency day to day.
3
Send your forms to the regional office
POLICIES
Send the Initial Application, Fact Sheet, Background Check and Privacy Statement Form, and Financial Statement to your TDMHSAS regional office (West, Middle, or East). List the counties you will serve and where you keep records. Most senior-care agencies apply to TDMHSAS. If half or more of your clients have intellectual or developmental disabilities, you apply to the Department of Disability and Aging (DDA) instead (rule 0940-05-38-.04(3)).
4
Pay the license fee
APPLICATION
TDMHSAS sends you an invoice after it gets your forms. A PSSA-only office pays $810. Fees are not refundable. No license is issued until the fee is paid.
5
Recruit staff & run checks
SURVEY
Hire caregivers who are 18 or older. Get criminal background check results back before any client contact. Check the abuse registry and sex offender registry before any client contact. Finish pre-service training before the first shift.
6
Pass the desk audit & get your license
OPERATIONS
A licensure surveyor reviews your policies and records by electronic desk audit. Fix any problems they find. Then you get an initial license good for up to one year. Renew it every year.
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 ($810 to TDMHSAS, Office of Licensure) 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 calls it a Personal Support Services Agency (PSSA) license. It covers non-medical help like bathing, meals, chores, and errands. You apply to the Department of Mental Health and Substance Abuse Services (TDMHSAS) Office of Licensure. Working without a license is against the law.
Do I need a Certificate of Need (CON) in Tennessee?
No. PSSAs do not need a CON. A CON is only for skilled home health agencies licensed by the Health Facilities Commission.
How much does it cost to start a home care agency in Tennessee?
The license fee is set by rule 0940-05-02-.05. A PSSA-only office pays $810 a year. The fee is not refunded. Our estimate for total startup costs is $40,000 to $75,000. That covers insurance, office setup, training, marketing, and cash to run.
How long does licensing take in Tennessee?
Our estimate is about 3-5 months. That covers writing policies, sending your forms, paying the fee, hiring staff, running checks, and the desk audit. There is no on-site visit or fire inspection for a PSSA.
What insurance is required in Tennessee?
The PSSA rules require proof of liability insurance but set no amount (0940-05-38-.07(3)). Many agencies carry $1,000,000 per occurrence. TN Labor says workers' comp is required once you have five or more employees. The PSSA rules do not list a surety bond.
Is Tennessee a good market for home care agencies?
Tennessee has about 1.36 million adults 65 and older, or 19% of the state (Census, July 2025). Nashville is growing fast but has many agencies. Knoxville and Chattanooga are good places to look too. There is no income tax on wages. TN Revenue says LLCs and corporations pay franchise and excise taxes.
What are the biggest mistakes new agencies make in Tennessee?
Two big ones. First, underestimating Nashville competition. Second, waiting too long to build referral ties. Start meeting hospitals, discharge planners, and senior centers before you open.
Tennessee Home Care Licensing: What You Need to Know
Tennessee calls a non-medical home care agency a Personal Support Services Agency (PSSA). You need a PSSA license to help people with bathing, dressing, meals, chores, and errands. The license comes from the TDMHSAS Office of Licensure, not the Health Facilities Commission. The rules are in Tenn. Comp. R. & Regs. 0940-05-38 under Tenn. Code Ann. Title 33. You do not need a Certificate of Need. There is no fire inspection or on-site visit for a PSSA. The state does an electronic desk audit instead. The license is good for up to one year. You renew it every year. Tennessee has no income tax on wages. But TN Revenue says LLCs and corporations doing business here must pay franchise and excise taxes.
The Personal Support Services Agency (PSSA) License
Any agency that helps people with personal care or chores at home needs a PSSA license. You apply to the TDMHSAS regional office for your area. Fees are set by rule 0940-05-02-.05. A PSSA-only office pays $810 a year. If you add a second license type at the same office, it costs $1,010. Every worker needs a criminal background check. TDMHSAS says the results must be back before the worker has contact with a client (T.C.A. 33-2-1202; rule 0940-05-38-.07). You must also check the abuse registry and the sex offender registry before the worker sees a client, and every year after that (rule 0940-05-38-.07). The PSSA rules say you must have proof of liability insurance for the agency and its workers (0940-05-38-.07(3)). They set no dollar amount. TN Labor says workers' comp is required once you have five or more employees, counting part-time workers. Check with TN Labor for your case. The PSSA rules do not list a surety bond.
Certificate of Need (CON) in Tennessee
No Certificate of Need. PSSAs do not need a Certificate of Need. CON only applies to skilled home health agencies. This saves you months compared to starting a home health agency.
TennCare's main program for long-term care at home. CHOICES pays for home and community-based services for seniors and adults with disabilities so they can stay at home.
The TDMHSAS, Office of Licensure On-Site Survey
Desk Audit, Not a Site Visit. TDMHSAS reviews PSSAs with an electronic desk audit. You do not need a fire safety inspection. You still need written policies that follow rule 0940-05-38-.06.
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 TDMHSAS, Office of Licensure.
Built exclusively for non-medical home care|Tennessee-specific guidance under Tenn. Code Ann. Title 33; Tenn. Comp. R. & Regs. 0940-05-38 (Personal Support Services Agencies)|Platform & HomeCareAtlas directory on day one
Tennessee licensing details verified by HomeCareAtlas on November 1, 2026.
Tennessee Home Care License — Done-for-You Licensing
