Renewal Application for License for Nursing Home - the Tennessee - health state tn 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of your facility and its license number in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the location details, including street address, city, county, state, zip code, and contact numbers. This section helps establish your facility's official records.
4. Indicate whether your facility has secured units, Alzheimer’s units, or ventilator units by checking 'Yes' or 'No' and providing the number of beds where applicable.
5. Complete the ownership section by selecting the type of legal entity and providing relevant details about owners or partners. If additional space is needed, utilize a separate sheet.
6. Review all entries for accuracy before signing at the bottom of the form. The signature verifies compliance with Tennessee regulations.

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