What is the main difference between an ACLF and a home for the aged?
An assisted-care living facility may administer medications and arrange nursing, therapy and hospice inside the building, while a home for the aged provides room, board and personal services and transfers residents to a hospital, nursing home or ACLF when they need health care services.
Both licenses come from the Health Facilities Commission, both require residents to be ambulatory, and both serve primarily older adults (51% or more). The ACLF rules (0720-26) include medication administration by licensed or certified staff, secured units and hospice in place; the home for the aged rules (0720-21) are built around supervision and daily living help.
Which is better for a parent who takes many medications?
An ACLF, in most cases, because it can have medications administered by a nurse or certified medication aide, while a home for the aged is built for residents who need personal services but not health care services on site.
If a home for the aged is otherwise a good fit, ask exactly how medications are handled, who sets them up, what happens with a missed dose or a new prescription after a hospital stay, and whether a home health nurse can visit.
Why would a family choose a home for the aged?
For a small, quiet, family-style setting at what is often a lower price, when the parent is ambulatory, mostly stable medically and mainly needs meals, supervision and help with daily activities.
Homes for the aged in the Memphis area are few and small: HFC's October 2026 report lists 4 in the three counties, each with 5 to 12 beds. Small homes can mean more familiar caregivers but fewer staff overall, so ask who is awake overnight and who covers when the owner is away.
What happens when a home for the aged resident's health declines?
Under rule 0720-21, a home for the aged resident will be transferred to a licensed hospital, nursing home or assisted-care living facility when health care services are needed that must be provided in those settings.
Plan for that move from the start. Identify one or two licensed ACLFs nearby that would suit your parent, and check whether they participate in TennCare CHOICES if savings are limited.
How do I check which license a Memphis residence holds?
Search the Health Facilities Commission's facility listings under both “Assisted Care Living Facility” and “Home for the Aged” for Shelby, Fayette or Tipton County; the license type, number, bed count and last survey date appear on the listing.
Small residential homes in Memphis neighborhoods sometimes describe themselves loosely as assisted living or personal care homes. Tennessee's own term for a small, non-medical residence is a home for the aged, and its term for assisted living is an ACLF. If the residence appears under neither, it is not licensed for either.
At a glance
| Assisted-care living facility | Home for the aged | |
|---|---|---|
| Rule | 0720-26 | 0720-21 |
| Medications | May be administered by licensed or certified staff | Personal services; no on-site health care services |
| Memory care | Secured units allowed with extra rules | Rare; report secured beds if any |
| Typical size (Memphis area) | 12 to 160 beds | Under 15 beds |
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.
