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How Texas Licenses Assisted Living

Texas tiers assisted living licenses by evacuation ability -- Type A and Type B -- rather than issuing one blanket license, under Health and Safety Code Chapter 247.

HomeState RulesHow Texas Licenses Assisted Living

How Texas licenses assisted living

The Texas Health and Human Services Commission (HHSC) Long Term Care Regulatory division licenses assisted living under Texas Health and Safety Code Chapter 247 and 26 Texas Administrative Code Part 1, Chapter 553. Unlike states that issue one blanket license, Texas splits assisted living into two tiers based on what a resident can do for themselves in an emergency.

Type A facilities serve residents who do not need routine overnight attendance and who are capable of following directions to evacuate on their own -- most private-pay assisted living in the Fort Worth metro is licensed this way.

Type B facilities serve residents who need staff assistance to evacuate, are not capable of following directions in an emergency, or require nighttime staff attendance -- this is the tier most memory care and higher-acuity assisted living falls under.

A single building can hold both a Type A and a Type B license for different wings or floors. Ask which license applies to the specific unit your parent would live in, not just the building as a whole, and ask what happens if their needs eventually exceed what that license allows.

What the Type A/B split changes for families

The admission and retention limits tied to each license type are what actually gate whether a resident can stay as their needs increase, not the building's marketing. A Type A community that cannot legally retain a resident who now needs nighttime attendance will require a transfer, sometimes to a Type B wing on the same campus and sometimes to a different building entirely.

Ask directly: which license type covers the specific unit my parent would live in today, and what happens if their needs exceed it next year?

Questions families ask

What does a nursing home cost in the Fort Worth area?

The 2024 CareScout Cost of Care Survey puts Texas's median private nursing home room at $7,087 a month statewide. No Fort Worth-specific figure is separately published, and semi-private room pricing (often lower, and often Medicaid-weighted) was not broken out in the most recent survey.

How do families in Fort Worth actually pay when private funds run out?

Options generally include transitioning to the STAR+PLUS HCBS waiver if the community holds a provider agreement, moving to Medicaid-covered nursing facility care, or relocating to a different community that accepts STAR+PLUS HCBS -- ask about this before moving in, not after funds run low.

What does the Long-Term Care Ombudsman do in Tarrant County?

The Area Agency on Aging of Tarrant County's Long-Term Care Ombudsman Program, a United Way of Tarrant County program, investigates and helps resolve complaints on behalf of nursing home and assisted living residents and advocates for their rights. It's free, independent of any facility, and acts only with the resident's consent.

Is the Area Agency on Aging different in Tarrant County than the rest of the metro?

Yes. Tarrant County runs its own dedicated Area Agency on Aging through United Way of Tarrant County, separate from the 16-county North Central Texas Council of Governments (NCTCOG) region that covers Parker, Johnson, Denton, Wise and the rest of the outlying metro.

Can the ombudsman help if I disagree with how a Fort Worth facility handled my parent's care?

Yes, that is exactly the kind of situation the ombudsman program exists for. Contact the Area Agency on Aging of Tarrant County's ombudsman program at 817-258-8000, describe the situation, and a trained advocate -- often a volunteer -- will work with your family and the resident.

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