What is the difference between assisted living and memory care in Tennessee?
In Tennessee, memory care is a secured unit inside a licensed assisted-care living facility (or nursing home), where residents are intentionally prevented from leaving except for life safety; ordinary assisted living is the same license without the locked unit.
The secured unit brings extra duties: a physician, a registered nurse and a family member or advocate must evaluate each resident before admission, the team reviews the placement every quarter, at least one attendant must be awake and physically on the unit around the clock, and every unit worker gets annual dementia training (0720-26-.08(9)). A regular ACLF must only keep one awake responsible attendant somewhere in the building.
When does a parent with dementia need a secured unit instead of assisted living?
Usually when exit-seeking or wandering makes an unlocked building unsafe, or when the parent can no longer evacuate on their own; mild memory loss alone does not require a secured unit if the person can still recognize danger and leave in an emergency.
Watch for getting lost on familiar routes, trying to leave at night, or not recognizing alarms. Tennessee's ambulatory definition requires that a resident be capable of self-preservation in an emergency, so cognitive decline can trigger a move even when walking is fine. Ask the ACLF how it assesses that, and whether it has a secured unit on the same campus so a later move is down the hall rather than across town.
Does memory care cost more than assisted living in Memphis?
Almost always, but no published median exists: CareScout's 2025 Tennessee assisted living median is about $5,595 a month, and it does not survey memory care at all, so each secured unit's price must come from a written quote.
The extra cost reflects higher staffing on the unit and more hands-on care. TennCare CHOICES Assisted Care Living Facility services can apply in a secured unit as in the rest of the building, with room and board still paid by the member, if the facility participates.
How do I find licensed memory care units in the Memphis area?
Use the Health Facilities Commission's quarterly bed report, which lists secured beds for every licensed ACLF and secured and Alzheimer's beds for nursing homes; in Shelby, Fayette and Tipton counties the October 2026 reports show 24 ACLFs and 7 nursing homes with secured or Alzheimer's beds.
Our memory care directory lists every one with its bed counts, last state survey date and disciplinary record. If a building markets memory care but reports no secured beds, ask what that means in practice: it may offer dementia programming in an unlocked setting, which suits some residents and not others.
At a glance
| Assisted living (ACLF) | Memory care (secured unit) | |
|---|---|---|
| License | ACLF license | Same ACLF license, reported as secured beds |
| Doors | Residents come and go | Egress denied except for life safety |
| Staffing floor | One awake responsible attendant in the building | One awake attendant physically on the unit 24/7 |
| Admission | Facility assessment | Physician + RN + family/advocate evaluation, quarterly review |
Sources include Tenn. Comp. R. & Regs. chapters 0720-26, 0720-21 and 0720-18, Health Facilities Commission and TennCare pages, CareScout and VA rate tables as cited above; see our editorial standards.
