How Tennessee licenses assisted living in Memphis

Who licenses assisted living facilities in Memphis, Tennessee?

The Tennessee Health Facilities Commission (HFC) licenses every assisted living building in Memphis and the rest of the state, using the legal name Assisted-Care Living Facility (ACLF) and the standards in Tenn. Comp. R. & Regs. chapter 0720-26.

The HFC is newer than many family guides suggest. Public Chapter 1119 of 2022 created it as an independent state agency, combining the former Health Services and Development Agency with the Department of Health's Office of Health Care Facilities. The licensing rules moved from chapter 1200-08-25 to 0720-26 at the same time. Some rule text and older articles still refer to “Department of Health inspectors” or the Board for Licensing Health Care Facilities; the work now sits with the HFC, which is also the agency CMS uses to survey Medicare- and TennCare-certified providers.

Shelby County Government, the City of Memphis and suburbs such as Germantown or Collierville do not license care settings. Local zoning and fire codes apply to the building, but the right to operate comes from the state license, and that is the record to check first.

What counts as an assisted-care living facility in Tennessee?

Tennessee defines an ACLF as a building, complex or distinct part of one that accepts primarily aged persons for domiciliary care and services, and “primarily aged” means at least 51% of residents are 62 or older (0720-26-.02(7) and (34)).

An ACLF provides room and board, protective care, daily awareness of each resident's whereabouts, readiness to intervene in a crisis, and non-medical help with activities of daily living (0720-26-.07(7)). It may also administer typically self-administered medications and arrange any medical service a person could receive in a private home. Unlike some states, Tennessee does not split assisted living into several license tiers: there is one ACLF license, and a building that runs a locked memory care area reports those beds as “secured beds” within that license.

Smaller, non-medical residences are a separate license, the Home for the Aged (often called a residential home for the aged, or RHA). See how homes for the aged differ.

How often does Tennessee inspect assisted living in Memphis?

Rule 0720-26-.05(1) requires an unannounced inspection of every licensed ACLF within 15 months of its last inspection, and more often when needed to protect residents; the facility must allow entry at any hour and produce all required records.

When inspectors find a violation, the facility receives a statement of deficiencies and has ten days to return a plan of correction that explains how and when each problem will be fixed, what systemic changes will prevent a repeat, and how the fix will be monitored (0720-26-.05(2)). A late or unacceptable plan can itself lead to discipline. HFC's public facility listing shows a “date of last survey” for each license; on our directory pages that date is reproduced exactly, and some listed dates are older than 15 months, which is a reason to ask the facility for its most recent survey report rather than a sign of anything by itself.

What does an ACLF license cost, and why does that matter to families?

Tennessee's annual ACLF license fee is set by bed count, from $1,040 for fewer than 25 beds to $2,860 for 175 to 199 beds, plus $200 for each 25 beds above 199 (0720-26-.04(1)).

The fee schedule is the reason the state's bed report is a reliable size measure: a facility pays on its licensed beds, and admitting more residents than the licensed bed capacity is prohibited (0720-26-.03(7)). Licenses expire every year on the anniversary of original issuance, and a facility that misses renewal by more than 60 days must reapply and be inspected again (0720-26-.03(4)). A license belongs to one licensee at one location; moving or changing ownership requires a new application, which is why HFC orders sometimes refer to a “contingent change of ownership.”

Who runs an ACLF, and what must the administrator have?

Every Tennessee ACLF must have an administrator certified by the state board, or a Tennessee-licensed nursing home administrator; certification requires being at least 21, a high school diploma or GED, a criminal background check, no conviction for abusing or neglecting a vulnerable person, and 24 classroom hours of continuing education every two years (0720-26-.03(9)).

The licensee must also name a capable person to act on administrative matters in its absence, keep an awake responsible attendant on duty at all times, have a licensed nurse available as needed, and employ or contract with a qualified dietitian (0720-26-.06(1)). An ACLF may not employ anyone on the state's abuse registry. When a family asks “who is in charge,” the answer should include the certified administrator's name and the name of the management company, which HFC's listing often shows.