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Miller Trust Guide
TN · Guide

How Much Does a Nursing Home Cost in Tennessee?

Tennessee private-pay nursing home care typically runs $9,429–$10,038/month. If gross monthly income is over Tennessee's Medicaid long-term-care cap of $2,982/month (effective May 1, 2026 (TennCare ABD Trusts Policy 110.055 revision)), a Miller Trust (Qualified Income Trust) is the mechanism that lets someone qualify for Medicaid anyway — diverting the excess income so it isn't counted against the cap. This guide is informational only and is not legal advice.

What usually happens

Tennessee doesn't publish a fill-in form, so the trust has to be drafted to TennCare's requirements, and an elder-law attorney quotes $1,000–$2,500 to research and draft it. Once it's signed, you take it to the bank, where the branch has never opened one of these and says no.

Meanwhile the month is running out. In Tennessee, coverage can't start before the month the trust is funded, so a month that slips is another month of private-pay nursing care at $9,429–$10,038.

This applies when the person who needs care has gross monthly income over Tennessee's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.

Free: the questions to ask a Tennessee bank before your first visit

7 questions for a five-minute phone call, so you find out whether a branch knows how to open this account before you make the drive. Emailed now, then 4 short follow-ups over the next 10 days — then we stop.

Email only — we never ask for income, age, or family details, and never sell your address.

What a nursing home costs in Tennessee

Private-pay nursing home care in Tennessee typically runs $9,429–$10,038 a month — a number that lands hard whether you're seeing it for the first time or you've already been paying it for months.

Why income alone can shut someone out of help paying for it

Tennessee caps countable income for long-term-care Medicaid at $2,982/month (effective May 1, 2026 (TennCare ABD Trusts Policy 110.055 revision)). Social Security plus a modest pension can add up to more than that cap without coming anywhere close to covering the cost of care above — leaving a gap where someone earns "too much" for Medicaid but far too little to pay privately. A Miller Trust (Qualified Income Trust) is the tool Tennessee and every other income-cap state provide for exactly that gap: it diverts the income above the cap into a dedicated account so it isn't counted, without requiring anyone to give that income away.

The number that matters: if gross monthly income is over $2,982, income (not assets) is likely the barrier, and a Miller Trust is the standard Tennessee fix. See how to set one up in Tennessee.

Medicaid doesn't require spending every dollar down to nothing first

A common misconception is that qualifying for Medicaid long-term care means income has to disappear entirely before help kicks in. Once A Tennessee Qualified Income Trust brings countable income under the cap, Medicaid covers the facility cost directly — the resident keeps a personal-needs allowance of $70/month, not zero. The income cap is a qualification threshold, not a requirement to have no income at all.

Once you're ready to act, this is what actually delays people

Not the paperwork — the bank. Free one-pager: the questions to ask before you drive to a branch, emailed now. Then 4 more short emails over the next 10 days — then we stop.

Email only — we never ask for income, age, or family details, and never sell your address.

Common questions

How much does a nursing home cost in Tennessee?
Private-pay nursing home care in Tennessee typically runs $9,429–$10,038 per month. Once someone qualifies for Medicaid long-term care, Medicaid pays the facility directly and the resident keeps a personal-needs allowance of $70/month — the rest of their income goes toward the cost of care.
What if my income is too high to qualify for Medicaid in Tennessee?
Income over Tennessee's $2,982/month cap (effective May 1, 2026 (TennCare ABD Trusts Policy 110.055 revision)) doesn't automatically disqualify someone. A Miller Trust (Qualified Income Trust) diverts the excess income into a dedicated account so it isn't counted against the cap — the standard mechanism Tennessee and every other income-cap state provide for exactly this situation.