TENNESSEE SENIOR HOUSING

    Tennessee Senior Housing Feasibility Study

    Senior housing demand in Tennessee is driven by an aging population and strong retiree in-migration to the Nashville suburbs, the Knoxville and Blount County area, and the Smokies foothills, with the over-65 cohort the fastest-growing age group in the state. The defining regulatory feature is the active but narrowing Certificate of Need program: nursing-home beds remain gated, while assisted living and memory care are licensed instead and fall outside the Certificate of Need process. The feasibility study has to be built around the right product, the approval and licensure path, and the local demand. We prepare lender-grade studies for SBA, USDA, HUD, and conventional financing, calibrated to the product and the market.

    Key Tennessee market indicators

    7,315,076

    Tennessee residents as of July 1, 2025

    Source: U.S. Census Bureau Vintage 2025 (2025)

    $549,709 million

    Tennessee nominal GDP

    Source: U.S. Bureau of Economic Analysis (2024)

    2.4%

    Tennessee real GDP growth

    Source: U.S. Bureau of Economic Analysis (2024)

    3.6%

    Tennessee unemployment rate, seasonally adjusted

    Source: U.S. Bureau of Labor Statistics (May 2026)

    Why a Tennessee senior housing study is different

    Several state-specific items shape a Tennessee senior-housing study. The Certificate of Need program is the first and the most important: Tennessee runs an active Certificate of Need program through the Health Facilities Commission that still gates nursing-home beds and several other services, though it has been narrowing through recent reforms, so a project that involves nursing-home beds has to demonstrate need. Assisted-care living facilities and homes for the aged are licensed instead through the Department of Health and fall outside the Certificate of Need process, which makes the licensed assisted-living and memory-care path the practical greenfield route for a developer. A meaningful detail from the recent reforms is that a set of distressed counties without an actively licensed acute-care hospital are now exempt from many Certificate of Need requirements, which opens specific rural markets. Demand is driven by an aging population, strong retiree in-migration, the metro corridors, and the Smokies foothills. The statewide commercial building code and the relevant occupancy classification apply, and there is no state income tax, which helps the operating model. Every figure has to be sourced to the product, the market, and the regulatory overlay the project actually faces.

    Financing a Tennessee senior housing project

    The financing path depends on the product. For assisted living and memory care, which are not Certificate-of-Need gated, SBA 7(a) and SBA 504 are common for private-pay and owner-operated projects. Under SOP 50 10 8, effective June 1, 2025, the SBA may request a feasibility study based on enumerated risk factors, and a study is normally expected for a special-purpose property like senior housing. HUD Section 232 financing is a common path for assisted living, memory care, and skilled nursing where the Certificate of Need is in hand. Larger and stabilized projects also run through conventional and agency channels.

    USDA Community Facilities financing is a frequent fit for senior housing in the rural and nonprofit context under the OneRD framework, available outside the cities and towns over 50,000 and their contiguous urbanized areas, which covers East Tennessee Appalachia, the Cumberland Plateau, the Middle Tennessee farm counties, and the West Tennessee Delta, where the need is often highest and where the distressed-county Certificate of Need exemptions apply. For a new business, the over-one-million-dollar independent feasibility requirement at 7 CFR 5001.306 applies on the Business and Industry side, and we prepare to that standard. We confirm rural eligibility parcel by parcel through the USDA Rural Development Tennessee office in Nashville at the start of every engagement.

    The Tennessee regulatory layer for senior housing

    The binding items are the Certificate of Need process through the Health Facilities Commission for nursing-home beds, the separate licensure of assisted-care living facilities and homes for the aged through the Department of Health, the distressed-county Certificate of Need exemptions that open certain rural markets, the statewide commercial building code and the relevant occupancy classification, and local zoning. The product distinction between the nursing-bed path and the licensed assisted-living and memory-care path drives the entire approval process. We map the binding approvals and the licensure path for the specific product before a single revenue assumption is made.

    What a Tennessee senior housing feasibility study includes

    We document the demographic demand and the age-and-income-qualified population, the competitive set of existing and pipeline communities, the projected unit mix and absorption, the product type and the Certificate of Need or licensure path, the payor mix and operating model, the site and regulatory characteristics, and the financial projections, all to a standard built to satisfy the party that approves the loan. For a Certificate of Need project that means demonstrating need to the Health Facilities Commission; for an SBA file it means an SBA reviewer and the credit committee; for a USDA file it means the USDA state office; for a HUD file it means that review. The analysis is calibrated to the product and the market, and the conclusions are defensible.

    Built to the lender's standard

    Every study is prepared as an independent, third-party document. We document the market, the demand, the competitive supply, the regulatory path, and the financial projections to a standard that holds up under lender scrutiny, and the conclusions are defensible.

    Frequently asked questions

    Under SOP 50 10 8, effective June 1, 2025, the SBA may request a feasibility study based on enumerated risk factors, and a study is normally expected for a special-purpose property like assisted living or memory care. Because it is special-purpose collateral, the equity injection runs higher, and a lender-grade study supports the credit decision.

    It depends on the product. Tennessee runs an active Certificate of Need program through the Health Facilities Commission that still gates nursing-home beds and several other services, though it has been narrowing through recent reforms. Assisted-care living facilities and homes for the aged are licensed instead through the Department of Health and fall outside the Certificate of Need process, which makes the licensed assisted-living and memory-care path the practical greenfield route. A set of distressed counties without an actively licensed acute-care hospital are now exempt from many requirements. We calibrate each study to the correct approval and licensure path and confirm the current requirements before relying on study conclusions.

    The licensed path through the Department of Health. Because nursing-home beds remain Certificate-of-Need gated, assisted living and memory care, which are licensed rather than CON-gated, are the practical greenfield route for new development, and we calibrate the study to that path where it fits the project.

    If the site is not within a city or town over 50,000 and not in its contiguous urbanized area, it is likely USDA-eligible, which covers East Tennessee Appalachia, the Cumberland Plateau, the Middle Tennessee farm counties, and the West Tennessee Delta, where the need is often highest. USDA Community Facilities is a frequent fit for rural and nonprofit senior housing. We confirm eligibility parcel by parcel through the USDA Rural Development Tennessee office in Nashville at the start of every engagement.

    Yes. We prepare studies across the senior-housing spectrum, including independent living, assisted living, memory care, and skilled nursing, calibrated to the product, the Certificate of Need or licensure path, the payor mix, and the financing path. The skilled-nursing path in particular requires navigating the Certificate of Need process.

    Timelines depend on the product, the market, and how much regulatory diligence the project requires. We scope each engagement individually and give a clear delivery schedule at the start. Reach out through our contact page to discuss your project and timing.

    Ready to move forward?

    Discuss your Tennessee senior housing project with our team.