By Memphis Senior Advisor Care Team · September 30, 2026
Fayette County's population is the oldest of the three Tennessee counties in the Memphis metro (25.4% aged 65+, median age 48.5), but the Health Facilities Commission lists only 2 assisted-care living facilities and 2 nursing homes there, and no hospital. Most families combine local options with Collierville, Covington or care at home.
An older county with thin local capacity
Fayette County sits just east of Shelby along U.S. 64 and State Route 57, with Somerville as its county seat and Oakland, Gallaway, Rossville, Piperton and Moscow among its towns. Census Bureau estimates for July 1, 2025 show a striking age profile compared with its neighbors.
| County | Population | Age 65+ | Share 65+ | Median age | Licensed ACLFs | Nursing homes |
|---|---|---|---|---|---|---|
| Shelby County | 910,226 | 151,180 | 16.6% | 36.9 | 31 | 25 |
| Fayette County | 45,071 | 11,446 | 25.4% | 48.5 | 2 | 2 |
| Tipton County | 62,287 | 11,253 | 18.1% | 39.9 | 2 | 2 |
At the same time, the county is changing. Oakland grew from 8,985 residents in the 2020 estimates base to 10,835 in 2025, much of it commuter growth from Shelby County. Newer residents often have parents who move in later, which is part of why the county's care needs are rising faster than its licensed capacity.
What is licensed in Fayette County
The Health Facilities Commission's records list these licensed facilities with Fayette County addresses:
| Facility | Type | City | Licensed beds | Secured beds | Last state survey |
|---|---|---|---|---|---|
| NHC HealthCare, Somerville | Assisted-care living facility (ACLF) | Somerville | 12 | 0 | 04/15/2026 |
| Someroak Senior Living, LLC | Assisted-care living facility (ACLF) | Somerville | 40 | 0 | 12/07/2022 |
| Gallaway Health and Rehab | Nursing home | Gallaway | 104 | 27 | 06/09/2022 |
| NHC HealthCare Somerville | Nursing home | Somerville | 72 | 0 | 04/07/2026 |
There is no hospital in Fayette County on the commission's hospital report. Hospital care means a drive to Collierville, Germantown, Memphis or Covington, which matters for both emergencies and post-hospital rehab planning.
How Fayette families usually piece together care
Because local beds are few, Fayette families tend to follow one of three paths. Some keep a parent at home with help: OPTIONS for Community Living (homemaker, personal care and home-delivered meals on a sliding fee with no income limit) and TennCare CHOICES (personal care visits, adult day care and respite for eligible members) both run through the Aging Commission of the Mid-South, which serves Fayette County at (901) 222-4111.
Others choose one of the Somerville facilities to stay close to home and church. And many look west to Collierville, which has one of the larger groups of licensed assisted living buildings outside Memphis, most with secured memory care units, or north to Covington in Tipton County.
Whichever path fits, check each facility's record. Every licensed facility in the county has an entry on our Fayette County page, with beds, secured beds, last survey date and any disciplinary actions.
The questions to settle early
How far is the nearest hospital from the house, and who would drive? Can the parent still evacuate unaided, which Tennessee's assisted living rules require? Is there a family member nearby who can visit weekly? Distance shapes every other decision in a rural county, so settle it before comparing amenities.
Getting to appointments without a hospital in the county
Transportation is the hidden cost of rural senior care. Without a hospital in Fayette County, specialist visits, imaging and emergency care mean a drive to Collierville, Germantown, Memphis or Covington. For a parent who no longer drives, every appointment becomes a family errand or a paid ride. Ask the Aging Commission of the Mid-South about transportation assistance when you call, and ask any facility you consider whether it provides or arranges rides to medical appointments.
Distance also shapes post-hospital planning. A parent discharged from a Memphis hospital may be referred to a rehab bed near the hospital rather than near home, which changes who can visit. Ask early whether the Gallaway or Somerville nursing homes can take the referral.
Staying home in a rural county
Many Fayette County parents live on larger lots or farms where the nearest neighbor is not close, which makes a fall more dangerous. A personal emergency response button, a phone schedule with a family member, and home safety changes such as grab bars and better lighting are inexpensive first steps. Home-delivered meals can be harder to arrange outside town limits; ask what reaches your road.
If help at home is not enough, look at the licensed facilities in Somerville first, then widen the circle to Collierville and Covington. For memory care, check the secured bed counts on the state's bed report, because secured beds are scarce in the county.
Memory care for Fayette County families
Secured beds are scarce inside the county. The state's bed report shows a secured unit at the Gallaway nursing home, and the nearest assisted living secured units are in Collierville, Cordova and Covington. Families caring for a parent with dementia at home should plan the likely next step early, because waiting lists for secured units can form, and a crisis move to a distant unit is harder on everyone.
In the meantime, adult day care can provide supervision and activity during the day, and TennCare CHOICES Groups 2 and 3 cover adult day care and respite for eligible members. Caregivers should also ask the Aging Commission of the Mid-South about caregiver services; the strain of dementia care at home falls hardest where help is farthest away.
Frequently asked questions
Is there a hospital in Fayette County?
No hospital in Fayette County appears on the Tennessee Health Facilities Commission's hospital report; residents travel to Shelby or Tipton County.
Who is the Area Agency on Aging for Fayette County?
The Aging Commission of the Mid-South, which serves Shelby, Fayette, Tipton and Lauderdale counties, at (901) 222-4111.
Is PACE available in Fayette County?
Not as of October 2026; no PACE organization serves the county.
Who is the long-term care ombudsman for Fayette County?
The Memphis Delta District program at MIFA, 901-529-4565.
