Tennessee
A Home for the Aged provides room, board and personal services to four or more unrelated people, mostly older adults (at least 51% of residents). An ACLF accepts mostly older adults for domiciliary care and may also provide medical services as each resident's physician prescribes. The HFC also licenses Level 2 Adult Care Homes. The rules moved from the Department of Health (chapter 1200-08) to the HFC (chapter 0720) effective July 1, 2022 under Public Chapter 1119, and the ACLF rules were revised again in March 2026.
License categories
Assisted-Care Living Facility (ACLF)Home for the Aged (Residential Home for the Aged, RHA)Adult Care Home – Level 2
Key laws
Tenn. Comp. R. & Regs. 0720-26
Standards for Assisted-Care Living Facilities — official text
Tenn. Comp. R. & Regs. 0720-21
Standards for Homes for the Aged — official text
Tenn. Code Ann. Title 68, Ch. 11, Part 2
Health Facilities licensing statute
Key requirements
- An ACLF must have a responsible attendant who is alert and awake at all times, and a licensed nurse available as needed (0720-26-.06)
- The ACLF administrator must hold ACLF administrator certification or a current Tennessee nursing home administrator license (0720-26-.02)
- Direct care staff must be 18 or older, and no one listed on the state Abuse Registry may be employed (0720-26-.06)
- An ACLF must use a qualified dietitian (full-time, part-time or consultant)
Sources
- https://www.tn.gov/hfc/division-of-licensure-and-regulation/hfc-licensure/licensure-applications.html
- https://www.tn.gov/hfc/division-of-licensure-and-regulation.html
- https://www.tn.gov/content/tn/hfc/division-of-licensure-and-regulation/filing-a-complaint.html
- https://www.law.cornell.edu/regulations/tennessee/title-0720
- https://www.law.cornell.edu/regulations/tennessee/title-0720/chapter-0720-26
- https://www.law.cornell.edu/regulations/tennessee/Tenn-Comp-R-Regs-0720-26-.01
- https://www.law.cornell.edu/regulations/tennessee/Tenn-Comp-R-Regs-0720-26-.02
- https://www.law.cornell.edu/regulations/tennessee/Tenn-Comp-R-Regs-0720-26-.06