How to Open an Assisted Care Living Facility in Tennessee: A Step-by-Step Guide
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Dreaming of opening assisted living in Tennessee? Here's how to get from idea to licensed, without the overwhelm.
In Tennessee, assisted living is called an assisted-care living facility, or ACLF. The rules are detailed, and the building and life safety standards catch many new owners off guard.
I'm Prachi, a Healthcare Compliance Officer and Healthcare Facility Owner with more than 20 years in healthcare, and I've opened care centers myself. Here's the roadmap I'd give you.
⏱ Short on time? Start here.
Browse every Tennessee startup toolkit, built on Tennessee's own rules, and pick the one that fits what you're opening.
Who regulates assisted living in Tennessee?
ACLFs are regulated by the Tennessee Health Facilities Commission under Chapter 0720-26, Standards for Assisted-Care Living Facilities. The rules cover licensing, administration, services, admissions, building standards, life safety, records, resident rights and disaster preparedness.
The 6 steps to getting licensed
1. Know who you can serve
Residents generally must be able to evacuate in an emergency, and a resident who uses a wheelchair must be able to transfer and move it on their own. Secured dementia units need an interdisciplinary team evaluation before admission.
2. Set up your business
Form your entity, get an EIN, check zoning and arrange insurance. Your application must show you can meet the financial demands of running the facility.
3. Meet building and life safety standards
Bring in an architect who knows healthcare codes before you buy, build or renovate. This is where budgets most often blow up.
4. Write your policies
You'll need policies on admissions and discharges, services, medications, resident rights, records, reporting, health care decision-making and disaster preparedness.
5. Hire and train your team
Hire a qualified administrator and enough trained, screened staff to meet residents' needs.
6. Apply for your license
Submit the approved application, fees and documents to the Health Facilities Commission, then prepare for inspection.
4 costly mistakes new owners make
- Admitting residents who can't evacuate on their own
- Opening memory care without the required team evaluations
- Underestimating building and life safety costs
- Generic policies that never mention Tennessee's rules
Skip months of writing policies from scratch
The Tennessee Assisted Care Living Facility Startup & Compliance Kit includes a Tennessee licensing guide, about 100 ready-to-adapt policies, a model admission agreement, 18 fillable forms and inspection-readiness tools. Instant download.
This article is for education only and isn't legal advice. Always confirm current requirements with the Tennessee Health Facilities Commission.