Texas assisted living facility regulations: licensing, staffing, and compliance

Last updated 2026-07-25

What types of assisted living licenses does Texas issue?

Texas issues three distinct assisted living facility (ALF) licenses under Title 40 of the Texas Administrative Code, Chapter 92 ^[1]. Each license type serves different resident populations and service models. Type A facilities house 16 or more residents and provide a full range of services including housing, personal care, assistance with activities of daily living (ADLs), medication administration, and social or recreational programming. These are the traditional large assisted living communities most people picture. Type B facilities can be any size and provide housing, personal care, and assistance with self-administration of medication. Type B is the most common license for smaller group homes and mid-size facilities that don't provide the full spectrum of Type A services. You can operate a Type B with six residents or 60. Type C facilities serve only persons determined to be "cared-for elderly" under Texas Human Resources Code §102.003(3), meaning they're 65 or older or have Alzheimer's or a related disorder ^[2]. Type C licenses allow for specialized dementia care settings with specific environmental and staffing accommodations. All three license types fall under HHSC's Regulatory Services division. The agency does not use the term "group home" in assisted living statutes; that phrase appears more commonly in licensing for community homes serving individuals with intellectual disabilities or mental health needs, which operate under different Texas Administrative Code chapters.

How does assisted living differ from a nursing home in Texas?

Assisted living facilities provide housing and support with daily activities. Nursing homes (called nursing facilities or skilled nursing facilities in Texas) provide 24-hour licensed nursing care and rehabilitation services ^[3]. The core difference is medical intensity. Assisted living staff help residents with bathing, dressing, medication reminders, and meals. Licensed nurses are not required to be on-site around the clock. Nursing facilities must have licensed nurses on duty 24/7 and provide wound care, IV therapy, ventilator support, and post-hospital rehabilitation. Texas law prohibits assisted living facilities from admitting or retaining residents who require "continuous licensed nursing care" ^[1]. If a resident's condition deteriorates to the point that they need skilled nursing beyond what unlicensed caregivers can provide, the facility must arrange transfer to a nursing home or hospice. Payment models differ sharply. Medicaid pays for nursing home care once a resident meets financial and medical eligibility criteria ^[4]. Medicaid does not pay for room and board in assisted living, though Texas does offer limited assisted living services through the Community Based Alternatives (CBA) and STAR+PLUS waiver programs, which cover personal care and medication assistance but not rent ^[4]. Medicare covers neither assisted living nor long-term nursing home stays; it only pays for post-acute skilled nursing rehabilitation up to 100 days following a qualifying hospital admission ^[3]. Most assisted living residents pay privately. Nursing home residents often start private-pay and transition to Medicaid after spending down assets.

What physical plant standards must a Texas ALF meet?

Every Texas assisted living facility must comply with minimum construction, space, and safety standards detailed in 40 TAC §92.61 through §92.73 ^[1]. These rules apply whether you're converting a single-family home or building a new 100-bed complex. Resident bedrooms must provide at least 80 square feet of usable floor space per resident in a shared room and 100 square feet in a single-occupancy room. Bathrooms must have grab bars, slip-resistant surfaces, and adequate lighting. Each resident needs a closet or wardrobe and access to natural light. Activity and dining spaces must provide at least 15 square feet per licensed resident combined. Common areas must accommodate wheelchairs and walkers, with corridors at least 60 inches wide in new construction (44 inches in older facilities that received a variance). Kitchens must meet local health department food service standards. If you serve three meals daily to residents, you're operating a food establishment under Texas Health and Safety Code Chapter 437 and need a separate permit from your local health authority ^[5]. Fire safety requirements include interconnected smoke detectors in every bedroom and common area, at least two exits on every floor, posted evacuation plans, and quarterly fire drills documented in writing. Facilities with 17 or more residents must install an automatic fire sprinkler system unless they received a variance under older code provisions ^[1]. Accessibility standards follow the Texas Accessibility Standards (TAS), which incorporate and exceed federal ADA requirements. At least one entrance must be accessible without steps, and at least 5% of resident units (minimum one) must meet mobility-accessible design rules. Before you can admit residents, your local fire marshal must issue a certificate of occupancy and HHSC must complete a pre-occupancy inspection verifying compliance with all physical plant standards.

What staffing ratios and qualifications does Texas require?

Texas does not mandate a specific caregiver-to-resident ratio in statute ^[1]. Instead, the rule requires "sufficient staff to meet the needs of the residents at all times" based on each resident's service plan. HHSC surveyors evaluate staffing adequacy during inspections by reviewing service plans, incident reports, and time-stamped care logs. Realistically, most Type B facilities maintain one awake caregiver for every 8 to 12 residents during the day and one for every 15 to 20 at night, but those numbers shift based on acuity. A building full of independent residents who only need medication reminders requires less staffing than a memory care unit with elopement risk. Every facility must designate an administrator who holds an assisted living facility administrator license issued by the Texas Department of Aging and Disability Services (now part of HHSC) ^[6]. To qualify, the administrator must complete a 500-hour administrator-in-training program at an approved training center, pass a state exam, and complete 24 hours of continuing education every two years. The administrator does not need to be on-site 24/7 but must be available by phone and visit the facility regularly. Direct care staff must complete at least 12 hours of orientation before working unsupervised with residents, covering topics like residents' rights, emergency procedures, infection control, and recognizing signs of abuse or neglect ^[1]. An additional 12 hours of in-service training is required annually. Medication aides who assist residents with self-administration of medications must complete a medication management training program approved by HHSC, which includes competency testing ^[1]. Facilities that employ licensed nurses (RNs or LVNs) gain flexibility to provide more complex medication assistance and health monitoring, but nursing licenses are not required unless the facility markets skilled nursing services. All staff and volunteers who have unsupervised contact with residents must pass a federal and state criminal background check before starting work ^[1]. Convictions for violent crimes, exploitation, or abuse result in automatic disqualification.

How do you apply for a Texas assisted living license?

Texas uses a single-stage license application process managed by the Health and Human Services Commission's Regulatory Services division ^[7]. There is no provisional or conditional license period. You apply, HHSC evaluates, and if you meet all standards they issue a license. Start by submitting Form 3504, the Assisted Living Facility License Application, available on the HHSC website ^[7]. The application requires detailed information about the applicant entity (LLC, nonprofit corporation, etc.), the facility administrator, the physical address and layout, ownership structure, and the proposed scope of services. You'll attach several supporting documents: proof of legal occupancy (deed or lease), floor plans showing room dimensions and exits, your admission and service policies, the administrator's current license certificate, proof of liability insurance with minimum coverage of $100,000 per occurrence and $300,000 aggregate ^[1], and the nonrefundable application fee. The application fee is $500 for facilities with 1-16 residents, $750 for 17-100 residents, and $1,000 for facilities with more than 100 residents ^[7]. Annual renewal fees follow the same structure. Once HHSC receives your complete application, they assign a licensing specialist who reviews the documentation and schedules a pre-licensing inspection. The inspector examines the physical plant, verifies that staff have completed required training and background checks, and reviews your resident contract templates and policy manual. Common deficiencies that delay licensure: incomplete floor plans, inadequate fire safety equipment, missing grab bars in bathrooms, staff members who haven't completed the 12-hour orientation, and administrator licenses that expired. Correct deficiencies and HHSC re-inspects. Processing time from complete application to license issuance typically runs 60 to 90 days, assuming you pass the initial inspection or quickly correct any cited issues. HHSC does not guarantee approval timelines and warns applicants not to sign resident contracts or market the facility until the license is physically in hand. Texas licenses are renewed annually. You'll receive a renewal notice 60 days before expiration; submit the renewal application and fee on time to avoid late penalties or lapse. If you're launching a new operation and want structured step-by-step support through the application paperwork, policy manuals, and staff training requirements, the GroupHomePath Texas licensing kit provides state-specific templates and checklists for $299. But you can also download the forms and statutes directly from HHSC and work through the process independently.

What resident rights and contract rules must facilities follow?

Texas law grants assisted living residents a detailed bill of rights codified in 40 TAC §92.21 ^[1]. Facilities must provide every resident and their legal representative a written copy of these rights in the resident's primary language at or before move-in. Residents have the right to participate in developing their service plan, to refuse services or treatments, to receive visitors at reasonable hours, to retain and use personal property, and to manage their own finances unless a court has appointed a guardian or the resident has voluntarily delegated financial management. Facilities cannot require residents to waive any of these rights as a condition of admission. The resident contract must be in writing and include specific elements: the base monthly rate, a detailed list of services included in that rate, an itemized list of any additional services and their charges, the facility's refund policy, the conditions under which the facility may terminate the contract, and the facility's grievance procedure ^[1]. The contract must be signed by the resident or legal representative and the facility before move-in. Texas prohibits facilities from requiring third-party guarantees or co-signers as a condition of admission ^[1]. The contract is between the facility and the resident. You can't demand that a resident's adult child personally guarantee rent, though family members may voluntarily agree to be notified if bills go unpaid. Facilities must give residents or their representatives at least 30 days' written notice before increasing the monthly rate, unless the contract specifies a different notice period ^[1]. Rate increases can't be retroactive. If a resident wants to move out, most facilities require 30 days' written notice. The facility must refund any prepaid fees or deposits within 30 days of the resident's departure, minus documented charges for damages beyond normal wear and tear. Facilities can discharge a resident involuntarily only for specific reasons: nonpayment after proper notice, the resident's needs exceed what the facility is licensed to provide, the resident engages in behavior that poses an immediate threat to others, or the facility closes ^[1]. The facility must provide at least 30 days' written notice (except in emergencies) and assist the resident in finding alternative placement.

What services must an assisted living facility provide?

Texas law defines assisted living as a residential program that "provides personal care services, assistance with activities of daily living, or the administration of medication by a licensed health professional" ^[2]. The specific services you must provide depend on your license type and what you promise in each resident's service plan. At minimum, every assisted living facility provides housing in a homelike environment, at least three meals daily or access to food preparation areas, and housekeeping and laundry services ^[1]. These are baseline expectations that apply across all license types. Personal care services include help with bathing, dressing, grooming, toileting, eating, and mobility. Staff typically assist residents who can't manage these tasks independently due to age, disability, or cognitive impairment. Activities of daily living (ADL) assistance covers a similar scope but emphasizes the resident's participation. Rather than passively receiving care, the resident does as much as they can while staff provide cueing, standby supervision, or hands-on help as needed. Medication assistance in a Type B facility means staff can remind residents to take medications, open containers, read labels aloud, and observe the resident self-administer the dose ^[1]. Staff cannot touch the medication or place pills in a resident's mouth unless they're a licensed nurse or unless the resident is physically unable to self-administer and has a physician's order authorizing the higher level of assistance. Type A facilities provide more extensive medication administration, meaning licensed nurses or trained medication aides can administer medications directly. Type A facilities also typically offer structured social and recreational programming, transportation to appointments, and coordination with outside healthcare providers. Type C facilities serving cared-for elderly residents provide all of the above with additional environmental modifications and staff training specific to dementia care, such as secured outdoor areas, visual cues for wayfinding, and de-escalation techniques for responsive behaviors. What assisted living does not provide: skilled nursing care, physical therapy, occupational therapy, speech therapy, or any service that Texas law reserves for licensed healthcare professionals unless the facility separately contracts with those providers. Facilities can arrange for hospice, home health, or private-duty nursing to come into the building and serve residents, but those services are billed and regulated separately.

Does Medicare or Medicaid pay for assisted living in Texas?

Medicare does not cover assisted living room and board or personal care services ^[3]. Medicare is a health insurance program, not a long-term care program. It pays for hospital stays, doctor visits, outpatient therapy, and up to 100 days of skilled nursing facility care following a qualifying hospital admission. It does not pay monthly assisted living rent. Medicaid does not pay for room and board in assisted living either, but Texas offers two waiver programs that cover some assisted living services ^[4]. The Community Based Alternatives (CBA) waiver serves individuals who meet nursing home level of care criteria but choose to remain in a community setting, including assisted living. CBA pays for personal care services, medication assistance, and nursing oversight, but the resident or their family must pay rent, food, and utilities out of pocket ^[4]. Average CBA reimbursement for assisted living services runs roughly $1,200 to $1,800 per month in 2024, though actual rates vary by region and service intensity. The STAR+PLUS waiver integrates Medicaid acute care and long-term services through managed care organizations. STAR+PLUS participants living in assisted living can access personal attendant services and some nursing supports, again with the resident responsible for room and board ^[4]. Both waivers have financial and functional eligibility requirements. Residents must have income below roughly $2,829 per month (the 2024 institutional income limit) and countable assets under $2,000 for an individual ^[4]. They must also meet nursing facility level of care, meaning they need help with at least three activities of daily living or have a cognitive impairment requiring substantial supervision. Waiver slots are limited. Texas operates these programs under federal caps, and waiting lists exist in many regions. Application goes through the local Area Agency on Aging or a Medicaid managed care plan. In practice, most Texas assisted living residents pay privately, either from savings, retirement income, long-term care insurance, or family contributions. Monthly private-pay rates for a shared room in a Type B facility average $3,200 to $4,500 in metro areas; single rooms and higher-acuity memory care units cost $4,500 to $6,500 ^[8]. Rural areas tend to run 15% to 25% lower. Veterans with service-connected disabilities may qualify for Aid and Attendance benefits through the U.S. Department of Veterans Affairs, which can add $1,200 to $2,400 per month toward assisted living costs ^[9]. That benefit is paid to the veteran, not the facility, and the veteran remains responsible for the full monthly bill.

What inspections and compliance obligations do Texas ALFs face?

Every licensed assisted living facility in Texas undergoes at least one unannounced inspection per year conducted by HHSC Regulatory Services surveyors ^[1]. High-risk facilities and those with recent complaint investigations may be inspected twice annually. Annual surveys cover the full scope of licensing standards: physical plant safety, staffing qualifications and training records, medication management logs, resident rights, service plan documentation, food service sanitation, and financial records. Surveyors tour the building, interview residents and staff, and examine documentation going back several months. Deficiencies are classified by severity. Class I violations (immediate threat to health or safety) require correction within 24 hours. Class II violations (serious risk) must be corrected within 10 to 30 days. Class III violations (administrative or minor issues) allow up to 45 days for correction ^[1]. Facilities that fail to correct deficiencies face escalating enforcement: written warning, administrative penalty (fine), probation, emergency suspension, or license revocation. Administrative penalties for a single violation range from $500 to $10,000 depending on severity and whether the facility has prior violations ^[1]. Facilities that knowingly operate without a license face penalties up to $25,000 per day. Texas also investigates complaints filed by residents, families, or staff. Any person can report suspected abuse, neglect, or exploitation to the HHSC complaint hotline at 1-800-458-9858 ^[7]. Complaint investigations are unannounced and focus on the specific allegations, but surveyors often expand into related compliance areas once on-site. Facilities must report certain incidents to HHSC within 24 hours: deaths, serious injuries requiring emergency transport, allegations of abuse or neglect, law enforcement involvement, disasters that disrupt facility operations, and any event that requires activation of the facility's emergency plan ^[1]. Failure to report is itself a citable violation. You must maintain detailed records for every resident: the signed admission contract, the initial and updated service plans, a log of all services provided, medication administration records, incident reports, and documentation of the resident's preferences regarding end-of-life care and emergency contacts ^[1]. HHSC requires records be kept for at least three years after a resident's discharge. Beyond HHSC licensing, you'll face inspections from your local fire marshal (annual), the health department if you operate a commercial kitchen (frequency varies by county), and possibly the Texas Department of State Health Services if you store or administer controlled substances.

How do you start an assisted living facility in Texas?

Starting an assisted living facility in Texas involves business formation, real estate, regulatory compliance, and care model design. Expect nine to 18 months from initial planning to your first resident move-in. Form a legal entity first. Most operators use a limited liability company (LLC) or nonprofit corporation. Register with the Texas Secretary of State and obtain a federal Employer Identification Number (EIN) from the IRS ^[10]. If you plan to accept Medicaid waiver services, your entity must also enroll as a Medicaid provider with the Texas Health and Human Services Commission, a separate process that adds three to six months ^[4]. Secure a property. You can lease or purchase. The building must meet HHSC's physical plant standards (room sizes, exits, accessibility), local zoning for group residential use, and fire safety codes. Many operators find that converting a large single-family home works for six to 12 residents, while larger operations require commercial property or new construction. Zoning varies by city. Houston, Dallas, and Austin allow Type B assisted living in most residential zones with few restrictions if you house fewer than 12 unrelated residents ^[11]. San Antonio and Fort Worth impose conditional use permit requirements even for smaller facilities in some zones. Always verify with the local planning department before signing a lease. Renovate the property to meet code. Budget for grab bars, ramps, fire doors, commercial kitchen equipment if you'll cook on-site, and sprinklers if you plan for 17+ residents. Expect $30,000 to $80,000 in build-out for a 6-bed home and $200,000 to $600,000 for a 20- to 40-bed facility, depending on the condition of the structure you start with. Hire and train staff. Recruit a licensed administrator first; that person can help you hire direct care workers and coordinate training. Complete the 12-hour orientation for every caregiver and document it before they work alone with residents ^[1]. Develop your policy and procedure manual. HHSC requires written policies covering resident admission and discharge, service planning, medication management, infection control, emergencies and disasters, staff training, and complaint resolution ^[1]. The manual typically runs 80 to 150 pages. You can draft it from scratch using the statutes as a guide or adapt a template from a state-specific licensing kit. Obtain liability insurance. Minimum coverage is $100,000 per occurrence and $300,000 aggregate ^[1]. Most insurance brokers recommend at least $1 million per occurrence for realistic protection. Expect annual premiums of $8,000 to $15,000 for a small facility and $25,000 to $60,000 for a 30-bed operation. Submit your application to HHSC with all required attachments and the application fee ^[7]. Wait for the pre-licensing inspection. Correct any deficiencies. Once the license is issued, you can begin marketing and accepting residents. Startup capital requirements vary widely. A six-bed Type B home in a leased single-family property might launch with $90,000 to $150,000 covering first and last month's rent, renovations, insurance, licensing fees, initial marketing, and three months of operating expenses. A 30-bed new-construction facility can require $1.5 million to $3 million. Most operators use a combination of personal savings, bank loans, and investor equity.

What are the most common licensing deficiencies in Texas ALFs?

HHSC publishes annual enforcement data, though detailed facility-level deficiency breakdowns are not publicly aggregated ^[7]. Surveyors and consultants in the Texas market consistently report that the following issues trigger the most citations. Medication management errors top the list. Common violations include missing or incomplete medication administration records, expired medications still in use, over-the-counter drugs administered without a physician's order, and staff who haven't completed required medication management training assisting residents with medications ^[1]. HHSC treats medication errors seriously because they pose direct risk to residents. Incomplete or outdated service plans are a close second. The regulation requires an individual service plan for every resident, updated at least annually or whenever the resident's needs change ^[1]. Facilities often admit a resident with a solid initial assessment but then fail to revise the plan when the resident's ADL needs increase or their medication regimen changes. Staffing documentation gaps: missing criminal background checks, expired administrator licenses, caregivers working before they've completed the 12-hour orientation, and no records proving the annual 12-hour in-service training. HHSC can cite each missing record individually, so a facility with six staff members and incomplete training files can rack up a dozen violations in one survey. Physical plant deficiencies don't go away after the initial license is issued. Broken grab bars, blocked exits, missing or non-functional smoke detectors, and inadequate lighting in stairways all generate citations. Regular self-inspections and prompt maintenance prevent most of these. Resident funds mismanagement: facilities that help residents manage their personal spending money must keep detailed, auditable records ^[1]. Commingling resident funds with facility operating accounts or failing to provide monthly statements results in a Class II violation. Incident reporting failures: forgetting to report a fall that resulted in an ER visit within 24 hours, or not documenting the incident in the resident's file, violates both reporting and record-keeping standards. Most deficiencies are correctable without serious penalty if you respond quickly. The state's goal is compliance, not punishment. Document your correction (photos, updated policies, new training rosters), submit it to HHSC by the deadline, and the case usually closes. Repeat violations or a pattern of noncompliance trigger fines and probationary status.

Frequently asked questions

What is assisted living?

Assisted living is a residential care setting that provides housing, meals, and assistance with activities of daily living such as bathing, dressing, and medication management for adults who need support but don't require 24-hour skilled nursing care. In Texas, assisted living facilities are licensed by the Health and Human Services Commission under three types: Type A, B, and C.

What is a group home?

A group home is a residential facility where a small group of unrelated individuals live together and receive care or supervision. In Texas, the term typically refers to community homes serving people with intellectual disabilities or mental health needs, regulated separately from assisted living facilities. Some smaller assisted living operations function like group homes but are licensed as Type B assisted living facilities.

What is an assisted living facility?

An assisted living facility (ALF) in Texas is a licensed residential program providing personal care services, help with daily activities, and medication assistance to residents. ALFs range from small homes with six residents to large campuses with hundreds. All must meet physical plant, staffing, and care standards set by the Texas Health and Human Services Commission.

Does Medicare cover assisted living facilities?

No. Medicare does not pay for assisted living room and board or personal care services. Medicare covers hospital care, doctor visits, and short-term skilled nursing after a hospital stay, but it does not cover long-term residential care. Most assisted living residents pay privately or receive limited Medicaid waiver services covering care but not rent.

How do I start a group home in Texas?

To start a small group home-style assisted living facility in Texas, form a legal entity, secure a residential property that meets zoning and safety codes, hire a licensed administrator, complete renovations to meet HHSC physical plant standards, develop policies and procedures, obtain liability insurance, and apply for a Type B assisted living license. Plan for nine to 18 months and $90,000 to $150,000 in startup capital for a six-bed home.

Can you run a Texas assisted living facility from a single-family home?

Yes, if the home meets licensing standards for room size, exits, accessibility, and fire safety, and local zoning allows group residential use. Many small Type B facilities operate in converted single-family homes serving six to 12 residents. You'll likely need grab bars, ramps, and additional smoke detectors, and you must verify zoning with your city or county planning department.

How much does a Texas assisted living license cost?

The application fee ranges from $500 for facilities with 1-16 residents to $1,000 for facilities with more than 100 residents. Annual renewal fees match the application fee. These fees do not include the costs of renovations, insurance, training, or the administrator's license, which collectively can add tens of thousands of dollars to your startup budget.

What training do assisted living staff need in Texas?

Direct care staff must complete 12 hours of orientation covering residents' rights, emergency procedures, infection control, abuse recognition, and facility policies before working unsupervised with residents. An additional 12 hours of in-service training is required every year. Staff who assist with medications must complete a state-approved medication management training program and demonstrate competency.

How long does it take to get a Texas ALF license?

From submission of a complete application to license issuance typically takes 60 to 90 days, assuming you pass the pre-licensing inspection or correct deficiencies promptly. Delays occur if your documentation is incomplete, the facility fails the initial inspection, or staff haven't completed required training. HHSC does not guarantee processing timelines.

Can a Texas assisted living facility accept Medicaid?

Medicaid does not pay for room and board in assisted living, but Texas Medicaid waiver programs (CBA and STAR+PLUS) cover personal care services and medication assistance for eligible residents living in assisted living. The resident or family must pay rent and food costs privately. Facilities must enroll as Medicaid providers to bill for waiver services, a separate process from licensing.

What is the difference between Type A, B, and C assisted living in Texas?

Type A facilities house 16 or more residents and provide full services including medication administration and activities. Type B facilities can be any size and provide personal care and medication assistance; this is the most common license for smaller operations. Type C facilities serve only cared-for elderly (65+ or Alzheimer's/dementia diagnosis) and offer specialized memory care environments.

Do you need a nursing license to operate an assisted living facility in Texas?

No. The facility administrator must hold an assisted living administrator license, which requires a 500-hour training program and passing a state exam, but no nursing license is required. Direct care staff do not need nursing licenses either. If your facility employs licensed nurses (RN or LVN), you gain flexibility to provide more complex care, but it's not mandatory.

How often are Texas assisted living facilities inspected?

Every licensed facility undergoes at least one unannounced inspection per year. Facilities with recent complaints or high-risk populations may be inspected twice annually. Inspections cover staffing, care documentation, physical plant safety, resident rights, and medication management. Complaint investigations occur as needed and are always unannounced.

Can you operate an assisted living facility without a license in Texas?

No. Operating an unlicensed assisted living facility is illegal in Texas and carries penalties up to $25,000 per day. If you provide housing plus personal care or medication assistance to unrelated individuals, you must hold a valid HHSC license. Even small homes serving a handful of residents require licensure.

Sources

1. Texas Health and Human Services Commission, 40 TAC Chapter 92, Licensing Standards for Assisted Living Facilities: Licensing standards including facility types, physical plant requirements, staffing, training, resident rights, and enforcement penalties for Texas assisted living facilities.
2. Texas Human Resources Code, Section 102.003, Definitions: Definition of 'assisted living facility' and 'cared-for elderly' under Texas law.
3. Centers for Medicare & Medicaid Services, Medicare Coverage of Skilled Nursing Facility Care: Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay; it does not cover assisted living.
4. Texas Health and Human Services, Medicaid Long-Term Services and Supports: Texas Medicaid waiver programs (CBA, STAR+PLUS) cover personal care and services in assisted living but not room and board; eligibility and income limits detailed.
5. Texas Health and Safety Code, Chapter 437, Food Service Establishments: Assisted living facilities that prepare and serve meals must meet food service establishment standards and obtain local health department permits.
6. Texas Health and Human Services Commission, Assisted Living Facility Administrator Licensing: Requirements for assisted living facility administrator license: 500-hour training, state exam, and continuing education.
7. Texas Health and Human Services Commission, Apply for an Assisted Living Facility License: Application process, forms, fees, and timelines for Texas assisted living facility licensing.
8. Genworth Cost of Care Survey 2023: Average monthly costs for assisted living in Texas and national comparisons.
9. U.S. Department of Veterans Affairs, Aid and Attendance and Housebound Benefits: Veterans with service-connected disabilities may receive monthly Aid and Attendance benefits to help cover assisted living costs.
10. Texas Secretary of State, Business and Public Filings Division: Entity formation and registration for Texas businesses including LLCs and corporations.
11. Texas Local Government Code, Section 245.002, Group Homes: Zoning protections for group homes serving fewer than 12 unrelated individuals in Texas municipalities.