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Selling a skilled nursing facility in Tennessee

What moves the price of a Tennessee nursing home, how a sale runs from first call to change of ownership, and where to see the record for every Tennessee building.

By Stan Klos III · Updated October 2026
Each point is one of Tennessee's 303 certified skilled nursing facilities. See every one on SNFRadar ↗

Tennessee at a glance

Tennessee has 303 Medicare- and Medicaid-certified skilled nursing facilities with 34,613 certified beds, and on average 73.6% of those beds are occupied, below the national average of 80.3%.

303certified facilities
34,613certified beds
73.6%of beds occupied

Source: CMS Provider Information file, August 2026. The full Tennessee picture, rates and every building are on SNFRadar, the market record we built and publish free.

What a buyer reads first in Tennessee

The numbers a buyer pulls before the first call, for the typical Tennessee building against the nation. Your own building's are on its SNFRadar page.

Tennessee by the numbers
73.6%of beds occupiedU.S. 80.3%
63%Medicaid share of days, medianU.S. 66%
$353revenue per patient day, medianU.S. $373
1.4%net margin, medianU.S. 3.6%
3.80nurse hours per resident dayU.S. 3.86
0.60RN hours per resident dayU.S. 0.69
48.9%nurse turnover in a yearU.S. 45.8%
39%rated 4 or 5 starsU.S. 40%
38%rated 1 or 2 starsU.S. 41%

Sources: CMS Provider Information file, August 2026 (occupancy, staffing, turnover, star ratings: averages across certified buildings); Medicare cost reports (full-year filings), as SNFRadar compares them (medians, the same figures each building's SNFRadar page is compared against).

What moves value in Tennessee

Occupancy. 73.6% of Tennessee's certified beds are occupied, below the national 80.3%. With empty beds common, buyers pay for a building that fills its own and discount one that cannot say why it does not.

Payer mix and the Medicaid rate. Medicaid pays for 63% of resident days in the median Tennessee building, close to the national 66%. Small shifts between Medicaid and Medicare census move value, which is why buyers ask for census by payer, month by month. Tennessee's Medicaid rate files are on SNFRadar.

Revenue and margin. Net patient revenue runs $353 per patient day in the median Tennessee filing, below the national $373, and the median net margin is 1.4% against 3.6%. With thin margins common, buyers price on what they can fix, so a seller who can show where the costs sit gets paid for it.

Staffing. Tennessee's buildings average 3.80 nurse staffing hours per resident per day, close to the national 3.86, and nurse turnover runs 48.9% a year against 45.8%. Buyers treat agency use and turnover as a cost they will inherit, so a stable staff is worth showing early.

Inspection record. 39% of Tennessee buildings are rated four or five stars by Medicare and 38% one or two, against 40% and 41% nationally. Every buyer reads the last three inspections before pricing; each building's are on its SNFRadar page.

Size and ownership type. The average Tennessee building has 114 certified beds, against 107 nationally. 82% are for-profit, 14% non-profit and 5% government, and 74% are part of a chain.

Where the beds are

Tennessee's largest counties by certified beds. Each opens that county's buildings on SNFRadar.

CountyFacilitiesCertified beds
Shelby253,269
Davidson202,396
Hamilton111,735
Knox131,732
Sullivan7995
All 95 Tennessee counties

How a sale works

  1. A first call. What you want from the sale, and when. No listing, no blast.
  2. A value from the record. Your building's own numbers and the trades around it. How valuation works
  3. Vetted buyers under confidentiality, bidding against each other, not against you.
  4. Letter of intent, then the purchase agreement and the operations transfer agreement. The full process
  5. Change of ownership. Tennessee's licensure filings plus Medicare and Medicaid, timed so billing does not stop. CHOW and Medicaid

Our recent closings

One shot deal · Seven states · November 2025

One shot deal: $545 million.

A 5,000-bed skilled nursing portfolio across seven states in the Midwest and Southeast, sold for approximately $545 million.

Read the deal sheet

All five closings, with the press coverage they drew.

Questions owners ask

How many nursing homes are in Tennessee?

Tennessee has 303 Medicare- and Medicaid-certified skilled nursing facilities with 34,613 certified beds, according to the CMS Provider Information file (August 2026).

What is the average occupancy of Tennessee nursing homes?

On average 73.6% of certified beds in Tennessee are occupied, below the national average of 80.3% (CMS Provider Information, August 2026).

Do you work with sellers in Tennessee?

Yes. We advise skilled nursing sellers nationwide; our published closings so far are in Ohio, Mississippi, North Carolina and a seven-state portfolio across the Midwest and Southeast.

How much of Tennessee's nursing home care does Medicaid pay for?

In the median Tennessee building, Medicaid pays for 63% of resident days, against 66% nationally (Medicare cost reports (full-year filings), as SNFRadar compares them). That share is why Tennessee's Medicaid rate method decides so much of a building's value.

Are Tennessee nursing homes profitable?

The median Tennessee building that filed a full-year Medicare cost report shows a net margin of 1.4%, against 3.6% nationally. Margins vary widely from building to building; each building's own filing is on its SNFRadar page.

Is the first conversation confidential?

Yes. Nothing about you or your building goes to a buyer without your say.

Do you represent buyers?

No. We represent sellers. Buyers can share their acquisition criteria with us so we know who to call when a building fits; that does not make us their broker.