Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Do I need a license to run a non-medical home care agency in Tennessee?
Usually yes, a PSSA license.
Agencies that give personal support services (help with self-care, household tasks or community activities at a person's home) need a Personal Support Services Agency license. It comes from DMHSAS if 50% or more of your clients are aged or have a mental illness or substance use diagnosis, or from DDA if 50% or more have an intellectual or developmental disability. Homemaker service alone does not need an HFC home care organization license, but DDA's rules count household help as a personal support service and exempt only an individual who does housekeeping alone. We don't hold DMHSAS's rules, so check with DMHSAS before relying on a homemaker-only exemption.
Written and checked September 22, 2026
Do I need a license if I serve only one patient?
Yes, for home care organization services.
Public Chapter 858 (effective July 1, 2024) rewrote the definition of a home care organization. HFC's staff determination of April 29, 2025 says that providing in-home care for even a single patient needs a home care organization license. Being able to bill the federal EEOICPA (Energy Employees Occupational Illness Compensation Program Act) program does not replace a state license.
Written and checked September 22, 2026
Do I need a Certificate of Need to open a home health agency?
Yes, in most cases.
HFC's application says you must first get a Certificate of Need (CON) from the Commission before you apply for a home health license. Agencies that will serve only children, or only the federal EEOICPA program, don't need a CON first but must be accredited within two years of starting services. The license costs $1,404 a year.
Written and checked September 22, 2026
Which EVV system do I use in Tennessee?
The member's health plan's system, or a linked vendor.
Agencies either use the EVV system of the member's health plan or make sure their own vendor sends data to that plan's aggregator. TennCare's home health memos name Sandata for BlueCare (833-540-0093) and CareBridge for Wellpoint and UnitedHealthcare (844-482-0256), and TennCare expects home health agencies with members in both groups of plans to work with both systems.
Written and checked September 22, 2026
What background checks do CHOICES and waiver workers need?
A criminal check plus six registries.
Workers with direct contact need a criminal background check through TBI or a state-licensed private investigation company, with a nationwide check if they have lived in Tennessee one year or less. You also check six registries, including the abuse registry, the national sex offender registry and the OIG exclusion list. A name on any of the first five registries disqualifies the worker. Other criminal history calls for an individualized assessment, not a blanket ban.
Written and checked September 22, 2026
How fast must I report abuse or neglect?
Within 4 hours for Tier 1 events in TennCare home and community based programs.
In CHOICES, ECF CHOICES, Katie Beckett and 1915(c) waiver services, call the DDA Abuse Hotline (1-888-633-1313) as soon as possible and no later than 4 hours after a Tier 1 event happens or is discovered, then submit a Reportable Event Form within 1 business day. Tier 2 events need a Reportable Event Form within 1 business day. Also report to Adult Protective Services, Child Protective Services or law enforcement as the law requires.
Written and checked September 22, 2026
How long do I have to file a TennCare claim?
120 days for health plans.
Claims to a TennCare health plan must be filed within 120 calendar days. Claims TennCare pays directly, such as 1915(c) waiver services for people with intellectual disabilities, have one year. Retroactive eligibility and other insurance can change when the clock starts.
Written and checked September 22, 2026
Which Medicaid health plans operate in Tennessee?
Three: BlueCare, UnitedHealthcare, Wellpoint.
TennCare's Enabling Technology protocol (Feb. 1, 2026) lists BlueCare, UnitedHealthcare and Wellpoint as contacts. CHOICES and ECF CHOICES home care is paid through these plans. TennCare Select is a separate statewide plan backed by the state, set up as a backup and for certain groups, such as children in state custody and children on SSI.
Written and checked September 22, 2026
What does CHOICES pay for personal care?
$6.59 per 15 minutes (July 1, 2025 rate sheet).
TennCare's rate sheet effective July 1, 2025 (the newest we hold) lists Personal Care Visits (T1019) at $6.59 per 15 minutes. Visits can last up to 4 hours, twice a day at least 4 hours apart, up to 2,580 hours a year. Personal care visits can't include companion or sitter services.
Written and checked September 22, 2026
Can my aides give medicines if a member asks?
Only under self-direction, if you opt in.
From July 1, 2026, members can choose to direct and supervise a paid aide doing certain health care tasks, such as giving medicines. The member or caregiver directs the aide; your Director of Nursing is not delegating. Your agency must confirm the aide is trained and keep the attestation on file. An aide trained only for that member may give medicine only to that member; aides who complete DDA's medication administration course may do it for any member who self-directs.
Written and checked September 22, 2026