Frequently Asked Questions (FAQ)

We have put together a list of commonly asked questions asked regarding assisted living in Texas. We add to these as questions arise so please check back.

What is the definition of an Assisted Living Facility?2020-04-02T13:42:25-05:00

Under Texas law, an assisted living facility is an establishment that:

  • furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to theproprietor of the establishment;
  • provides:
    • personal care services; or
    • administration of medication by a person licensed or otherwise authorized in this state to administer themedication;
  • may provide assistance with or supervision of the administration of medication; and
  • may provide skilled nursing services for the following limited purposes:
    • coordination of resident care with outside home and community support services agencies and otherhealth care professionals;
    • provision or delegation of personal care services and medication administration as described by Health andSafety Code, Chapter 247;
    • assessment of residents to determine the care required; and
    • for periods of time as established by department rule, delivery of temporary skilled nursing treatment for a minor illness, injury, or emergency.

What are the laws and regulations?2020-04-02T14:31:12-05:00

The state laws pertaining to assisted living facilities are contained, for the most part, in Health and Safety Code, Chapter247. The state regulations/standards that govern ALFs are contained in the Texas Administration Code, Title 26, Part I,Chapter 553.

The following links will direct you to the licensing standards and statues for ALFs

What are the different types of assisted living facilities?2020-04-02T13:44:02-05:00

Assisted living facilities (ALFs) must be licensed to operate in Texas. The Texas Health and Human Services(HHSC) licenses assisted living facilities based on residents' physical and mental ability to evacuate the facility inan emergency and whether nighttime attendance is necessary.

  • A Type A facility cares for residents who do not require routine attendance during sleeping hours and arecapable of following directions in an
  • A Type B facility is for residents who require staff assistance to evacuate, are not capable of followingdirections in an emergency and require nighttime

Additionally, HHSC classifies facilities based on size - a large ALF is 17 residents or more and a small ALF is 16 residentsor fewer.

What about Alzheimer’s Disease and related disorders certification?2020-04-02T13:52:58-05:00

A Type B assisted living facility can have a memory care unit / be Alzheimer certified. Additional requirements need to be met to achieve certification and there are additional fees.

Note, a facility that advertises, markets, or otherwise promotes that the facility or a distinct unit of the facility provides specialized care for persons with Alzheimer's disease or related disorders must be certified or have the unit certified.

What should I know about the licensing process?2020-04-02T14:30:43-05:00

HHSC licenses and certifies ALFs based upon compliance with state regulations. To become licensed, a location must:

  • Complete the pre-survey computer-based
  • Properly complete and submit the electronic license
  • Upload all required
  • Pay the required license
  • Electronically submit appropriate ownership
  • Pass on-site Life Safety Code and Health
  • Be approved by the Licensure and Certification

Licensure Fees

  • The license fee is $300, plus $15 for each bed for which a license is sought, with a maximum of

$2,250 for a three-year license. The license fee for a two-year license issued in accordance with

  • 553.15(b)(1) or (c)(1) of this chapter is $200, plus $10 for each bed for which a license is sought, with amaximum of $1,500. The fee must be paid with an initial application, change of ownership application, or renewal application.
  • Increase capacity fee: $15.00 per
  • Late fee of one half the basic fee will be assessed if the renewal application is submitted less than 45 daysbefore the license expiration

Time Frames

License application for an initial, renewal, CHOW and or relocation:

  • Upon receipt of a license application in the HHSC Licensing and Credentialing Unit has up 30 days to reviewthe
  • If HHSC receives an incomplete application, the HHSC Licensing and Credentialing Unit will notify theapplicant in writing of any deficient items in the The applicant must respond with complete and correct information within 30 days from the date of notification. If the application is no completed timelythe application will be denied.
  • The applicant must provide written notice the building is in compliance with the Subchapter D of the LicensingStandards for Assisted Living Facilities and ready for a LSC (Initial and Relocation applications.)
  • When the LSC survey is passed one resident but no more than three may be admitted to the Theapplicant must submit a written notification that at least one resident has been admitted and the location isready for the health survey. (Initial and relocation applications)
  • Upon receipt of a complete application and LSC and Health survey approvals, the Licensing andCredentialing Unit will issue the license within 45
  • If a location does not complete the application or pass LSC or health surveys the application will be denied.

Types of Applications

  • Initial - An initial application, is a application that has never been issued a license to operate in
  • Change of Ownership - A Change of Ownerships (CHOW) occurs when the facility changes its Tax Identification
  • Renewal- A renewal application for a current license holder must be submitted at least 45 days prior tolicensure expiration Late fee may apply. Any application submitted after the licensure expiration datewill not be accepted.
  • Relocation - A license may not be transferred from one location to another without prior notice to 26 TAC§553.17


Changes of Information

  • Change in the facility name (legal entity or doing business as)- If license holder intends to change itsname (legal entity or doing business as) but does not undergo a change of ownership, the change must reportthe name Another license will be issued to reflect thischange.
  • Changes in telephone number - Changes in telephone number or operating hours must be submitted inwriting as soon as
  • Fax number and email address- report as soon as
  • Changes in management - report as soon as
  • Changes in Controlling Person (Stock Transfers)- Changes in controlling person, as defined in 26 TAC553.2(b)(16), report as soon as possible.
  • Closures- A license holder must notify HHSC in writing about the closure and return


TULIP – The online licensing portal

Are there available checklists for assisted living facilities?2020-04-02T13:59:59-05:00

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