This study focused on the identification of entry-level competencies needed by bachelor of science in nursing (BSN) graduates who will begin working in acute health care agencies in Tennessee within 10 years. The purpose of this study was to increase awareness of the competencies needed by graduates of BSN programs in Tennessee to meet the demands of acute health care agencies, considering current and anticipated changes in the health care delivery system. The opinions of nurse educators, nurse administrators, recent BSN graduates, and experienced BSN graduates were solicited to assess congruency of perceptions. This study found there was a statistically significant difference in the perceptions of nurses in acute health care agencies and faculty in BSN programs about the importance of entry-level competencies needed by BSN graduates.