In January 1889 the Frank Cheatham Bivouac of the Association of Confederate Soldiers forwarded a bill to the Tennessee General Assembly to establish a home for indigent and disabled Confederate veterans on the grounds of the Hermitage. The general assembly approved the measure, but excluded the Hermitage Mansion, the tomb of Andrew and Rachel Jackson, and twenty-five acres surrounding the house, which it entrusted to The Ladies' Hermitage Association. The legislature also appointed a nine-member board of trustees to oversee construction and management of the veterans' home. Funding came from the state and Confederate veterans organizations, especially the United Daughters of the Confederacy.
The new building opened on May 12, 1892, and could house 125 inmates in its two dormitory wings that adjoined a center section used for dining and relaxation. The Tennessee Confederate Soldiers' Home provided shelter, comfort, and medical attention to nearly 700 veterans during its forty-one years of service. Most men who entered the home were poor farmers before the Civil War, and their financial situation further deteriorated after it. Many were physically and mentally disabled, not only from wounds but by the harsh conditions some had experienced as prisoners of war. Most veterans living at the home fought in Tennessee units, but some were veterans of units from other states. Normally, men who died at the home were buried in the Tennessee Confederate Soldiers' Home Cemetery. The cemetery, adjacent to the Hermitage Presbyterian Church, contains the remains of 487 veterans.
The Tennessee Confederate Soldiers' Home closed on November 22, 1933, and the six veterans still living at the home moved to the Girls Infirmary at the Tennessee Industrial School. The home's last inmate died in 1941.