Knoxville Senior AdvisorWhich laws govern senior care facilities around Knoxville?
Tennessee law governs them: the Health Facilities and Resources Act (T.C.A. 68-11-201 and following) and the Health Facilities Commission's rule chapters 0720-26 for assisted-care living facilities, 0720-21 for homes for the aged and 0720-18 for nursing homes, with federal CMS requirements added for certified nursing homes.
Last verified: October 2026One commission licenses, inspects and disciplines all three. Knox County, the City of Knoxville and the towns around it apply building and zoning codes but do not license care settings.
What sets Tennessee's approach apart?
Tennessee keeps a single assisted living license (the ACLF) rather than tiers, records memory care as secured beds within that license, lets residents at nursing-home level of care remain in assisted living with physician certification, and pays for assisted living care, but not room and board, through TennCare CHOICES.
Across Knox, Blount, Anderson, Loudon, Sevier, Roane and Union counties, that means 57 licensed ACLFs on HFC's October 2026 report, 37 with secured units, and 5 homes for the aged.
Where do Knoxville-area families report a problem?
Licensing complaints go to the Health Facilities Commission at 1-877-287-0010; suspected abuse, neglect or exploitation goes to Adult Protective Services at 1-888-277-8366, any hour; and residents can get free advocacy from the East Tennessee District Long-Term Care Ombudsman at ETHRA, 865-691-2551 ext. 4223.
Each guide below explains one part of the system in detail.
Tennessee Rules: every guide
How assisted living is licensed in Knoxville and East Tennessee
Knoxville assisted living is licensed by the Tennessee Health Facilities Commission as Assisted-Care Living Facilities under rule 0720-26: definition, annual license fees, administrator certification and inspection timing.
Read the guide →How Tennessee regulates locked memory care units
Knoxville memory care operates as ACLF secured units under rule 0720-26-.08(9): pre-admission evaluation, quarterly reviews, an awake attendant around the clock and yearly dementia training.
Read the guide →Who a Tennessee ACLF may admit, and who it may keep
Tennessee's ACLF admission and retention rules: the ambulatory standard, conditions that bar admission, the nursing-facility-level exception, the 21-day rule for tube feeding and IV therapy, and the 13-minute evacuation rule.
Read the guide →Homes for the aged: Tennessee's small residential license
Tennessee licenses homes for the aged (residential homes for the aged, RHA) under rule 0720-21. What they provide, who qualifies, how they differ from ACLFs, and the licensed homes near Knoxville.
Read the guide →Who oversees nursing homes in Knoxville and East Tennessee
Knoxville-area nursing homes hold a Tennessee HFC license under rule 0720-18; most are also certified by CMS, which publishes star ratings, inspections and staffing on Care Compare. How the layers fit together.
Read the guide →How to check a facility's license and record in Tennessee
Step-by-step: verify a Knoxville assisted living or nursing home license in the HFC listing, read survey dates and disciplinary actions, check the Facility Action and Abuse Reports and CMS Care Compare.
Read the guide →How to complain or report abuse in East Tennessee senior care
Where Knoxville-area families report problems: HFC complaint intake (1-877-287-0010), Adult Protective Services (1-888-277-8366), and the ETHRA District Long-Term Care Ombudsman. What each one does.
Read the guide →Side by side
| Tennessee's rules do | Tennessee's rules do not | |
|---|---|---|
| Assisted living | Require an HFC license and a certified administrator | Set a staff-to-resident ratio for the building |
| Memory care | Require an awake attendant on every secured unit around the clock | Create a separate memory care license |
| Inspections | Call for unannounced ACLF surveys within 15 months | Post ACLF survey reports online in bulk |
| Payment | Let TennCare CHOICES pay ACLF care services | Pay ACLF room and board |
