MEAL & NUTRITION SERVICES PROVIDER IN TENNESSEE

Fatumata Kaba
3 days ago
3 min read

PROMOTING HEALTH AND INDEPENDENCE THROUGH HOME-DELIVERED AND SPECIALIZED MEAL SUPPORT FOR INDIVIDUALS WITH DISABILITIES, THE ELDERLY, AND MEDICALLY COMPLEX POPULATIONS

Meal and Nutrition Services in Tennessee are essential supports offered under various Medicaid programs, including the Employment and Community First (ECF) CHOICES, 1915(c) Waivers, and the Tennessee Commission on Aging and Disability (TCAD). These services ensure that individuals with limited ability to shop for or prepare meals can maintain their health, meet dietary requirements, and continue living independently at home or in the community.

1. GOVERNING AGENCIES

Agency: TennCare (Tennessee Medicaid)

Role: Oversees Medicaid waiver programs including ECF CHOICES and reimburses for meal and nutrition supports when authorized in the participant's service plan.

Agency: Tennessee Department of Intellectual and Developmental Disabilities (DIDD)

Role: Certifies waiver providers who deliver meal services to individuals with I/DD under Medicaid waivers.

Agency: Tennessee Commission on Aging and Disability (TCAD)

Role: Provides State-funded home-delivered meals and nutrition education for older adults.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Approves waiver-based nutritional services under federal HCBS regulations.

2. MEAL & NUTRITION SERVICES OVERVIEW

Meal services are individualized and may be provided in a participant’s home or a congregate setting, depending on the participant’s needs and service plan. Services can include:

Home-Delivered Meals – Frozen, shelf-stable, or hot meals delivered to the participant’s home
Congregate Meals – Meals served at adult day programs or community centers
Specialized Diets – Diabetic, renal, gluten-free, mechanically altered, or culturally preferred meals
Feeding Assistance – Physical help with eating, drinking, or mealtime positioning
Nutrition Counseling (optional) – By licensed dietitians for health condition-specific meal plans
Grocery Support Services (when part of the waiver plan)
Documentation of Meal Delivery and Participant Feedback

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Tennessee Secretary of State
Obtain EIN and Type 2 NPI
Apply through TennCare/DIDD or TCAD depending on the program
If preparing food, obtain an appropriate Food Establishment Permit from the Tennessee Department of Health
Maintain food safety certifications and staff training
Develop a Meal & Nutrition Services Policy & Procedure Manual

4. TENNESSEE PROVIDER ENROLLMENT PROCESS

Step 1: Register as a legal entity and acquire an EIN/NPI

Step 2: Apply through TennCare or DIDD to become a waiver-approved nutrition services provider

Step 3: Submit menus, dietary protocols, and meal delivery plan

Step 4: Obtain a food safety license if preparing meals

Step 5: Receive participant referrals and begin meal service per ISP or care plan

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI
Proof of insurance (liability, workers' comp)
Food handling certifications and DOH permit (if applicable)
Meal & Nutrition Services Policy & Procedure Manual including:
- Nutrition standards and meal prep guidelines
- Delivery scheduling and confirmation logs
- Client feedback and complaint response protocols
- Meal modification procedures for special diets
- Feeding assistance and choking prevention procedures
- HIPAA compliance, emergency contact forms, and billing documentation

6. STAFFING REQUIREMENTS

Role: Meal Prep/Delivery Staff

Requirements: Food handler certification, background check, CPR/First Aid recommended

Role: Nutrition Coordinator / Licensed Dietitian (if offering nutrition education or special meal planning)

Requirements: TN license, knowledge of waiver nutrition needs, diet formulation experience

All staff must complete:

HIPAA and participant confidentiality training
Infection control and food safety training
Participant rights and non-discrimination education
Documentation and incident reporting procedures

7. MEDICAID WAIVER PROGRAMS

Meal and Nutrition Services are available under:

ECF CHOICES – As part of a person-centered plan to support individuals with I/DD
1915(c) Waivers – When needed for health or support goals (e.g., elderly or medically fragile adults)
EPSDT (under 21) – Meals may be covered for children with medical necessity
State Aging Services via TCAD – For seniors age 60+ in partnership with local Area Agencies on Aging

8. TIMELINE TO LAUNCH

Phase: Business Formation & Menu Planning

Timeline: 1–2 months

Phase: TennCare or DIDD Enrollment & Safety Compliance

Timeline: 2–3 months

Phase: Staff Hiring, Training & Meal Prep Readiness

Timeline: 1–2 months

Phase: Launch of Meal Services

Timeline: After participant plan approval and referrals

9. CONTACT INFORMATION

TennCare (Tennessee Medicaid Program)

Website: https://www.tn.gov/tenncare