The choice between assisted living and memory care in Tennessee comes down to one question about your parent's safety with dementia. Can they safely live in an ordinary residential setting, or has the disease progressed to the point where a secured, dementia-specialized environment is what they need?

Assisted living is for someone who needs help with daily life but can still largely direct their own day. Memory care is a secured, dementia-trained setting for someone with Alzheimer's or another dementia who would wander, get lost, or come to harm without that supervision. Tennessee assisted living runs about $4,200 to $5,300 a month and memory care runs about $5,900 a month, roughly 20 to 30 percent more., This guide walks through both, so you can match the setting to the care your parent actually needs.

In This Guide

Assisted Living vs. Memory Care in Tennessee: The Core Difference

Assisted living in Tennessee is for an older adult who needs help with the rhythms of daily life, bathing, dressing, medications, meals, and getting around, but who can still largely direct their own day. Tennessee licenses these communities as Assisted-Care Living Facilities (ACLFs), regulated by the Tennessee Health Facilities Commission (HFC) under Chapter 0720-26 of the state rules. Standard assisted living is designed for someone who needs daily support, not dementia-specific supervision.

Memory care in Tennessee is specialized dementia care delivered in a secured setting, most commonly within an assisted living community that operates a dedicated dementia-care unit. There is no entirely standalone "memory care" license separate from assisted living in Tennessee. Instead, memory-care units operate within the ACLF framework as a secured special-care unit, with the locked doors, dementia-trained staff, and structured programming required for residents with Alzheimer's or another dementia who can no longer safely manage in a standard setting. The secured environment exists specifically because dementia can make wandering, exit-seeking, and unsafe behaviors life-threatening.

The question is not which setting is better in the abstract. It's which one fits where your parent is right now.

Side by Side

Here is how the two settings compare on care level, the resident they fit, Tennessee's licensing, and cost.,

Assisted living Memory care
Level of care Help with daily living; resident can still largely direct their own day Secured, dementia-specialized care for residents who need continuous supervision
Typical resident An older adult needing daily support but not dementia-specific safety management Someone with Alzheimer's or another dementia who wanders, exits, or cannot safely self-direct
Tennessee setting Licensed Assisted-Care Living Facility (Health Facilities Commission) Secured dementia-care unit within an ACLF
Cost (2026 estimates) About $4,200 to $5,300/month depending on community type About $5,900/month statewide, roughly 20 to 30 percent more
Who pays Largely private-pay; TennCare CHOICES may cover care services Largely private-pay; TennCare CHOICES may cover care services

Who Each Setting Is Right For

If your parent needs help with daily tasks but can still manage their own day, communicate their needs, and move safely through familiar spaces, assisted living is usually the right fit. Tennessee's assisted living communities are built for exactly that: daily-living support without the locked doors and dementia-specific programming of a memory-care unit.

Memory care becomes the right setting when dementia-related safety becomes the central issue. The warning signs are typically: wandering or trying to leave, getting lost in familiar spaces, unsafe behaviors like leaving appliances on, escalating agitation or disorientation, or simply no longer being able to recognize danger and call for help. When those behaviors appear in a standard assisted living setting, a secured memory-care unit is what the care need calls for.

Dementia is progressive, and many Tennessee families start a parent in assisted living and move to memory care as the disease advances. Many communities offer both levels under one roof, making that transition easier when it comes.

Assisted Living vs. Memory Care Cost in Tennessee

In Tennessee, assisted living runs about $4,200 to $5,300 a month, below the national median, depending on the community, floor plan, and location. A Place for Mom's 2026 cost report puts the statewide assisted living median at about $4,928 a month, and the CareScout 2025 Cost of Care Survey (released March 2026) reports a national assisted living median of $6,200 a month for comparison. Memory care in Tennessee runs about $5,900 a month statewide, roughly 20 to 30 percent more than standard assisted living, because dementia care requires higher staffing and the physical infrastructure of a secured unit. The exact premium varies by community and level of care. Note that the recognized national cost survey (CareScout) does not separately measure memory care, so the memory-care median above comes from A Place for Mom's 2026 network data rather than a government source.

Both settings are largely private-pay. TennCare, Tennessee's Medicaid program, does not cover room and board in assisted living or memory care. The TennCare CHOICES program, Tennessee's Medicaid waiver for long-term services and supports, can cover care services for qualifying residents in either setting, but not the housing cost. Long-term care insurance, if purchased before a care need arose, can offset part of the monthly bill.

How to Decide

  1. Is your parent cognitively safe in a standard assisted living setting? If dementia has produced wandering, exit-seeking, or unsafe behaviors, a memory-care unit is the setting built for that. If they need daily support but are not showing those dementia-specific safety risks, standard assisted living is likely right.
  2. How will the cost be covered? Both settings run primarily on private funds; if TennCare CHOICES eligibility is likely, explore it early since care-services coverage can make a meaningful difference in sustainability.

When touring memory-care units, ask specifically about staff dementia-training hours, the physical design of the secured area, and what structured dementia programming looks like day to day, since those details separate a well-run unit from a standard floor with a locked door. Tennessee does not set a mandated resident-to-staff ratio for assisted living, so ask each community for its staffing by shift directly.

To verify a specific community's license, search the Tennessee Health Facilities Commission's facility listings at internet.health.tn.gov/facilitylistings, which returns the license number, bed count, and date of the most recent survey. If you have a concern about care in a licensed community, the Tennessee Long-Term Care Ombudsman, housed within the Tennessee Department of Disability and Aging, advocates for residents of assisted living and memory care and can be reached at 877-236-0013.

Frequently Asked Questions

What is the difference between assisted living and memory care in Tennessee?

Assisted living helps an older adult with daily tasks like bathing, dressing, medications, and meals while the resident can still largely direct their own day. Memory care is a secured, dementia-specialized setting for someone with Alzheimer's or another dementia who can no longer safely self-direct.

How much does memory care cost in Tennessee compared to assisted living?

In Tennessee, assisted living runs about $4,200 to $5,300 a month and memory care runs about $5,900 a month statewide, roughly 20 to 30 percent more, according to A Place for Mom's 2026 cost report., The added cost reflects the higher staffing and secured environment that dementia care requires, and the exact premium varies by facility.

Does TennCare pay for memory care in Tennessee?

TennCare does not pay room and board in memory care or assisted living. The TennCare CHOICES waiver program can help cover care services, including in assisted living and memory-care settings, for qualifying members who meet the clinical and financial eligibility rules. The housing cost remains the resident's responsibility.

When should a parent move from assisted living to memory care?

The trigger is usually a dementia-related safety concern: wandering, exit-seeking, getting lost in familiar spaces, or unsafe behaviors that a standard assisted living setting cannot safely manage. When those signs appear, a secured memory-care unit is what the situation calls for. Discussing the threshold proactively with the existing facility team is almost always worthwhile.

Does Tennessee have a separate memory-care license?

Tennessee does not have a separate standalone memory-care license entirely distinct from assisted living. Memory-care units operate within the Assisted-Care Living Facility (ACLF) framework as a secured special-care unit, with locked environments and dementia-specific programming and staffing added on top of the standard ACLF requirements.

Learn More

Find personalized help comparing assisted living and memory care in Tennessee at brevy.com.


The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.