How to Open an Adult Day Care Center in Tennessee: A Step-by-Step Guide
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Tennessee caregivers are stretched thin. An adult day center gives them a lifeline, and gives you a meaningful business.
Adult day services help older adults stay social, active and safe during the day. In Tennessee, they're licensed by the Department of Human Services, not the health department, which surprises many new owners.
I'm Prachi, a Healthcare Compliance Officer and Healthcare Facility Owner with more than 20 years in healthcare. I've opened and run an adult day center with integrated therapy, and here's the roadmap I'd give you.
⏱ Short on time? Start here.
Browse every Tennessee startup toolkit and bundle.
Who regulates adult day care in Tennessee?
Adult day services centers are licensed by the Tennessee Department of Human Services once they serve a set minimum number of participants. If you want to serve TennCare members, you'll also work with the TennCare CHOICES program. Check the current rules before you start.
The 6 steps to opening your center
1. Choose your model and payers
Private pay, TennCare CHOICES, veterans or a mix? Your payers shape your services and paperwork.
2. Set up your business
Form your entity, get an EIN, confirm zoning and arrange insurance.
3. Get your approvals lined up
Tennessee expects certain approvals, like fire safety and health inspections, before your licensing inspection. Build them into your timeline.
Safety tip: walk the space as a participant with a walker or wheelchair would before you sign a lease.
4. Write your policies
Cover admissions, participant rights, care plans, medications, emergencies, transportation, incidents and training.
5. Hire and train your team
Tennessee sets staff ratios, director qualifications and training hours. Plan your schedule around them.
6. Apply and get inspection-ready
Submit your DHS application, then prepare for your inspection.
4 costly mistakes new owners make
- Applying to the wrong state agency
- Scheduling the licensing inspection before other approvals are done
- Missing the required staff ratio
- Generic policies that never mention Tennessee's rules
Built by someone who's actually done it
The Tennessee Adult Day Center Startup & Compliance Toolkit includes a Tennessee licensing guide, about 140 ready-to-adapt policies, 32 fillable forms and a 90-day opening plan. Instant download.
This article is for education only and isn't legal advice. Always confirm current requirements with the Tennessee Department of Human Services.