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The Wise Senior

Adult day health care costs in Tennessee

Here is the middle of the price range in Tennessee, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.

The Tennessee median

$80 a day

Works out to, monthly
$1,733
Works out to, yearly
$20,800

Our arithmetic, not the survey's. The survey reports this one by the day, so the monthly and yearly figures assume a schedule: $80 a day × 5 days a week × 52 weeks ÷ 12 months. Fewer hours, smaller bill — the schedule is the biggest lever you have.

That is about 16% lower than the national median of $95 a day. Within Tennessee the spread is usually wider still: a city costs more than a rural county, often by a great deal.

A supervised daytime program in a protective setting, with health and social services, for adults who are functionally or cognitively impaired; it also gives a family caregiver the day back.

What this number is, and what it is not.

It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.

A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.

Where Tennessee sits

$80 a day ranks Tennessee 36th of the 45 states priced for adult day health care: 35 charge more, 8 charge less. Nevada report the same figure.

Virginia is the next state up, at $81; Arkansas the next down, at $76.

The national median is $95, so Tennessee runs $15 below it — 16% less, or $3,900 a year ($15 × 5 days a week × 52 weeks).

The column runs $58 (Alabama) to $267 (Montana). Tennessee sits 11% up it, 1.38× the lowest, with 10 other within a tenth of it.

Of the 6 kinds of care Tennessee was priced for, this is its 5th dearest standing: at best 32nd of 50 for assisted living community, at worst 41st of 50 for in-home care (non-medical caregiver).

What $1,733 a month becomes

Our multiplication, holding the Tennessee median flat — no real bill does — with the same span of the state's least costly priced care beside it:

  • Six months

    $10,400

    $35,070 of assisted living community

  • One year

    $20,800

    $70,140 of assisted living community

  • Two years

    $41,600

    $140,280 of assisted living community

  • Three years

    $62,400

    $210,420 of assisted living community

  • Five years

    $104,000

    $350,700 of assisted living community

Care is bought in years, not months, and $1,733 a month is $20,800 a year.

Five years at the national median would be $123,500: $19,500 more than five years in Tennessee.

Inside Tennessee, five years of assisted living community runs $350,700 and five of skilled nursing at home (private duty nurse) $903,760; this page's $104,000 sits 0% between them. Most families pay for more than one of these in sequence.

Against other care in Tennessee

Converted to a month on our schedule, set beside this page's $1,733:

  • Skilled nursing at home (private duty nurse)

    $15,063 a month

    $13,329 a month more, $159,952 a year, 8.69× this page. Tennessee places 32nd of 46 for it, 4 above its 36th here.

  • Nursing home, private room

    $10,038 a month

    $8,305 a month more, $99,656 a year, 5.79× this page. Tennessee places 35th of 49 for it, 1 above its 36th here.

  • Nursing home, semi-private room

    $9,429 a month

    $7,696 a month more, $92,348 a year, 5.44× this page. Tennessee places 32nd of 50 for it, 4 above its 36th here.

  • In-home care (non-medical caregiver)

    $5,911 a month

    $4,177 a month more, $50,128 a year, 3.41× this page. Tennessee places 41st of 50 for it, 5 below its 36th here.

  • Assisted living community

    $5,845 a month

    $4,112 a month more, $49,340 a year, 3.37× this page. Tennessee places 32nd of 50 for it, 4 above its 36th here.

On the same monthly footing, adult day health care is the 6th costliest of the 6 kinds of care priced in Tennessee, at $1,733. The conversions are ours; the medians are the survey's.

44 hours a week of in-home care in Tennessee is $5,911 a month against $5,845 for assisted living — 1% less. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.

Who actually pays for this

This is the part most cost pages leave out, and it is the part that changes what a family does next.

Medicare does not pay for long-term care

Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.

Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.

Medicaid may pay — after a spend-down

Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits Tennessee sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.

See the Tennessee Medicaid long-term-care limits

Veterans: Aid and Attendance may help

A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.

How Aid and Attendance is worked out

Otherwise: savings, family, and long-term care insurance

Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.

Working out which of these applies to one particular family is exactly what a free Tennessee counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 will connect you to the area agency on aging for your county.

Who to ask in Tennessee

Tennessee's free counseling program is State Health Insurance Assistance Program (SHIP), on 1-877-801-0044. It is grant-funded and sells nothing.

the Division of TennCare decides Medicaid long-term care here — not a facility, and not us. Tennessee runs it as Nursing facility (institutional) Medicaid, CHOICES home and community based services and Regular Medicaid for the aged, blind and disabled, with a 60-month look-back on gifts and transfers.

Beside $1,733 a month — our comparison, its limits — that is what "spend-down" means: a single applicant's monthly income may not top $2,982, which this bill clears 0.6 times over, countable assets may not top $2,000, or about 35 days of adult day health care at this rate and an at-home spouse may keep up to $162,660, or about 7.8 years of it.

Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.

Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.

Verified 2026-08-02 against Division of TennCare, Aged, Blind and Disabled Manual, Policy Manual Number 115.015 — Institutional Medicaid (updated January 5, 2026) (effective 2026-01-01)

Common questions

Does Medicare pay for adult day health care in Tennessee?
No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
Is adult day health care dearer in Tennessee than in other states?
$80 a day places Tennessee 36th of the 45 states the survey priced for it: 35 charge more and 8 charge less. The national median is $95. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
Is this the price I will be quoted in Tennessee?
No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
Who can help me work out how to pay for it?
Tennessee runs its free counseling program as State Health Insurance Assistance Program (SHIP), on 1-877-801-0044. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.

Other kinds of care in Tennessee