A step-by-step guide for Nashville families who want to check a facility's safety record before making a decision.
📋 Updated May 2026 🏛️ Official TN SourcesBefore trusting a senior living community with your loved one's care, you should know what state inspectors found during their most recent visit. Tennessee makes this information publicly available — but finding and interpreting the records isn't always straightforward. This guide walks you through exactly how to do it.
Every licensed senior living facility in Tennessee is subject to regular inspections by the Tennessee Department of Health (TDH) and, for nursing homes, the Centers for Medicare & Medicaid Services (CMS). These inspections evaluate everything from medication management and infection control to staffing levels, resident safety, and building maintenance.
Inspection records — sometimes called "survey results" — give you an unfiltered look at how a facility actually operates, not just how it markets itself. A single five-star Google review doesn't tell you whether a facility was cited for medication errors. The state inspection report does.
💡 Key Insight
Almost every family skips this step. Checking inspection records takes 15 minutes and can save you from choosing a facility with a pattern of safety violations. It's one of the most important things you can do during your search.
Not all senior living communities are inspected by the same agency or held to the same standards. Understanding which type of facility you're researching determines where to look:
| Facility Type | Licensed By | Where to Find Records |
|---|---|---|
| Nursing Homes (Skilled Nursing Facilities) | TN Dept. of Health + CMS | Medicare.gov Care Compare |
| Assisted Living / Residential Care | TN Dept. of Health — Health Care Facilities Division | TN Health Facilities Commission |
| Memory Care (usually within assisted living) | TN Dept. of Health | TN Health Facilities Commission |
| Assisted Care Living Facilities (ACLF) | TN Dept. of Health | TN Health Facilities Commission |
| Independent Living | Typically not state-licensed | No state inspection records |
⚠️ Important Distinction
Independent living communities are generally not licensed or inspected by the state because they don't provide hands-on care. If you're looking at an independent living community, inspection records won't exist — but you should still ask about fire marshal inspections and local code compliance.
Visit medicare.gov/care-compare and select "Nursing Homes." Enter the facility name or Nashville, TN as the location. This is the most comprehensive and user-friendly tool for nursing home inspections.
CMS assigns each nursing home a 1-to-5 star overall rating based on three components: health inspections, staffing, and quality measures. Pay the most attention to the health inspection rating — it reflects what surveyors actually found on-site.
Click into a facility's profile and navigate to the "Inspections" tab. You'll see a list of deficiencies cited during each survey, their severity level (from minor to immediate jeopardy), and the date they were found. Facilities with a pattern of serious deficiencies should raise a red flag.
💡 Pro Tip
Look at the complaint investigations section — not just the standard annual survey. Complaint inspections happen when someone (a family member, staff, or ombudsman) reports a concern. These often reveal issues the standard survey missed.
Go to tn.gov/health and search for the Health Facilities Commission (formerly Board for Licensing Health Care Facilities). You can search their facility database by name, city, or license type.
Enter the name of the assisted living community or filter by Davidson County (Nashville) to see all licensed facilities. The listing will show the facility's license status, license type, and any enforcement actions.
Tennessee doesn't always post detailed assisted living survey reports online the way CMS does for nursing homes. If you can't find the report online, call the Health Facilities Commission at (615) 741-7221 and request it. You're entitled to this information under Tennessee public records law.
⚠️ Don't Be Discouraged
Tennessee's online system for assisted living records is less polished than the federal Medicare system for nursing homes. You may need to make a phone call. This is normal — and it's worth the effort. Don't skip this step just because the website is confusing.
Once you have the inspection report, here's how to read it effectively:
Deficiencies are categorized by scope (how many residents were affected) and severity (how serious the harm or potential harm was). The scale ranges from:
💡 Context Matters
Almost every facility will have some deficiencies — that's normal. What you're looking for is patterns: the same type of violation appearing across multiple inspections, Level 3 or Level 4 findings, or a facility that takes months to correct cited problems.
🚩 Watch for These Warning Signs
✅ Positive Signs in Reports
State inspection records are the most important source, but they're not the only one. Here are additional resources Nashville families should check:
The Ombudsman program advocates for residents in long-term care facilities. They investigate complaints and can tell you about issues at specific facilities that may not appear in formal inspection reports. Contact the Tennessee Long-Term Care Ombudsman at (877) 236-0013.
While not a regulatory body, the BBB tracks complaints filed against businesses. Search for the facility at bbb.org to see if families have filed formal complaints.
For an extra layer of due diligence, search Tennessee court records for any lawsuits filed against the facility. Negligence or wrongful death lawsuits can indicate systemic problems. Search at tncourts.gov.
A reputable facility should be willing to show you their most recent inspection report and discuss any deficiencies openly. If a facility is defensive, dismissive, or refuses to share this information, treat that as a red flag.
💡 The Transparency Test
During your tour, ask: "Can I see your most recent state inspection report and your plan of correction?" How the facility responds tells you a lot about their culture. Good communities are proud of their records and will walk you through the findings.
Nashville has a large and competitive senior living market, which means families have options — and leverage. Here are some local tips:
In Tennessee, the inspection schedule varies by facility type:
⚠️ Inspection Gaps
During COVID-19, routine inspections were significantly delayed. Some assisted living facilities went 2+ years without a standard survey. If the most recent inspection report is from 2022 or earlier, it may not reflect the current state of the facility. Weigh this accordingly.
📋 Inspection Records Due Diligence Checklist
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Browse Assisted Living Browse Memory CareLast updated: May 2026. This guide is for informational purposes only and does not constitute legal or medical advice. Inspection records and regulatory processes may change — always verify current information with the Tennessee Department of Health.