Knoxville Senior AdvisorWho licenses nursing homes in Knoxville?
The Tennessee Health Facilities Commission licenses every nursing home in Knox and the surrounding counties under Tenn. Comp. R. & Regs. chapter 0720-18, and most homes are also certified by CMS so they can bill Medicare, TennCare or both.
HFC lists 31 licensed nursing homes in Knox, Blount, Anderson, Loudon, Sevier, Roane and Union counties with 3,791 licensed beds; CMS gives 30 of them an overall rating, and 11 hold four or five stars (Care Compare data of October 1, 2026). The HFC serves as Tennessee's CMS-designated State Survey Agency, so the same state surveyors carry out the federal inspections whose results feed CMS's star ratings. A few homes certify for Medicare only; they take short rehab stays but cannot bill TennCare for a long-term resident, which matters when savings run low.
What do CMS star ratings for Knoxville nursing homes measure?
CMS gives each certified home an overall rating of one to five stars built from three parts: health inspections, staffing from payroll records, and quality measures drawn from resident assessments and claims.
The inspection component weighs the last few years of surveys and complaint visits; staffing reflects nurse hours per resident day adjusted for how sick the residents are; quality measures track outcomes such as falls with injury, pressure ulcers and rehospitalization. Our nursing home pages reproduce all of these exactly as CMS publishes them, alongside the deficiency counts, fines and turnover figures behind them. A star count is a summary; the underlying numbers usually tell you what to ask.
How are nursing home inspections in East Tennessee done?
State surveyors from the Health Facilities Commission make unannounced standard surveys of certified homes and also investigate complaints; deficiencies are recorded on a federal statement of deficiencies that the home must answer with a plan of correction.
CMS posts the results on Care Compare and in its downloadable Provider Information file, which is where our figures come from. Look at both the count and the type of deficiency: a citation for a missed care-plan signature is not the same as one for a fall that caused harm. CMS also flags homes cited for abuse and lists any civil money penalties and payment denials from the last three years.
What extra protections do nursing home residents have?
Residents of certified nursing homes are covered by federal rights rules on admission, transfer and discharge, care planning, freedom from abuse and restraints, and access to the long-term care ombudsman, in addition to Tennessee's 0720-18 standards.
A home generally has to give written notice before an involuntary discharge and cannot discharge someone simply because the payer changed from Medicare to TennCare if the home participates in both. If a Knoxville home tells you a parent must leave, call the East Tennessee District Long-Term Care Ombudsman at ETHRA (865-691-2551 ext. 4223) before agreeing to anything.
Where do I find a nursing home's Tennessee enforcement history?
Use the Health Facilities Commission's facility listing, which counts disciplinary actions for each license, and its monthly Facility Action and Abuse Reports, which summarize penalties; CMS separately lists federal fines and payment denials.
Our nursing home pages pull both sets together. When state and federal records disagree about recent trouble, ask the administrator about each item by date. See how to check a facility record for the step-by-step version.
Side by side
| A CMS star rating is | A CMS star rating is not | |
|---|---|---|
| Basis | Built from inspections, staffing and quality measures | A review from residents or families |
| Scope | Published for Medicare- or Medicaid-certified homes | Available for assisted living |
| Timing | Updated by CMS on its own schedule | A real-time view of today's staffing |
| Use | A starting point for questions | A substitute for visiting at different hours |
Sources: Tenn. Comp. R. & Regs. chapters 0720-26, 0720-21 and 0720-18; Health Facilities Commission, TennCare and Department of Disability and Aging pages; CareScout and VA rate tables, as cited above. See our editorial standards.
