Last updated 2026-07-25
TL;DR
Texas assisted living facilities are licensed by the Health and Human Services Commission (HHSC), and anyone can search current licenses, license type, capacity, and inspection history free through the HHSC Provider Search tool. To check a specific facility, search by name, city, or license number; to confirm your own application status, call HHSC Long-term Care Regulation directly since online status updates lag real time.
How do I do a Texas assisted living license search?
Texas Health and Human Services Commission (HHSC) runs the public database you want. It's called the HHSC Facility/Provider Search, and it covers assisted living facilities, nursing facilities, and several other regulated provider types in one lookup tool. You can search by facility name, city, county, or license number. If you only have a partial name (say, "Sunrise" or "Comfort"), the tool will pull every match statewide, which is useful if you're comparing facilities before a family placement decision or checking whether a competitor's license is current. The results page shows license status (active, pending, revoked, or closed), license type (Type A, Type B, or Type C, explained below), licensed bed capacity, and a link to recent survey and inspection reports. That inspection link matters more than most people realize. It's where you'll find deficiency citations, the date of the last full survey, and whether the facility is under an enforcement action like a provisional license or a directed plan of correction. One honest caveat: the database updates on HHSC's schedule, not in real time. If a facility was cited last week, it may take a few weeks to show up. If you need a status that's more current than what's posted, call the HHSC Long-term Care Regulation (LTCR) regional office that covers the facility's county. Regional office contact information is listed on the HHSC website.
What is assisted living?
Assisted living is a licensed residential care setting for adults, usually seniors, who need help with daily activities like bathing, dressing, medication reminders, or mobility, but who don't need the round-the-clock skilled nursing care a nursing home provides. Residents typically live in private or semi-private rooms or apartments and get meals, housekeeping, and staff supervision built into the arrangement. In Texas, the state's own regulatory language defines an assisted living facility as an establishment that furnishes food, shelter, and personal care services to four or more people unrelated to the proprietor, for periods of 24 hours or more per day, per the Texas Health and Safety Code Chapter 247 [1]. That four-resident threshold is what pulls a home out of the "just a rental house" category and into licensed facility territory. Assisted living sits in the middle of the long-term care spectrum. Independent living is the least intensive tier (no personal care included). Assisted living is the middle tier. Skilled nursing facilities are the most medically intensive tier, licensed under a different set of state and federal rules entirely.
What is a group home?
A group home is a small residential setting, often a single-family style house, where a handful of unrelated residents live together and receive supervision or care from staff. The term gets used loosely across the industry, but it usually refers to smaller-capacity settings (often 3 to 16 residents) serving specific populations: people with intellectual or developmental disabilities (IDD), adults recovering from substance use, people with serious mental illness, or in some contexts, seniors. Group homes are licensed differently depending on who they serve. In Texas, a home serving people with IDD may fall under HHSC's Home and Community-based Services (HCS) or Intermediate Care Facility (ICF/IID) rules, while a home serving seniors needing personal care assistance would fall under the assisted living license type described above [1]. The population served, not the building style, determines which license and rulebook applies. If you're comparing an assisted living model against a group home model for a different population, the licensing agency, staffing ratios, and inspection standards can differ substantially even within the same state.
What is an assisted living facility (and what is assisted living facility, exactly, under Texas law)?
An assisted living facility, under Texas Health and Safety Code Chapter 247, is a licensed establishment that provides personal care services, meals, and shelter to four or more unrelated residents for 24 hours or more, with services falling short of continuous skilled nursing care [1]. HHSC issues three license types, and the difference matters a lot for what conditions you're allowed to accept residents with. Type A facilities serve residents who are physically capable of evacuating the building without staff help in an emergency and who don't require routine attendance during nighttime sleeping hours beyond occasional assistance. Type B facilities serve residents who need staff assistance to evacuate, or who need nighttime attendance, or who have a diagnosis requiring more supervision (this is the more common license type for residents with dementia or mobility limitations). Type C, sometimes called an adult foster care setting or small facility, generally applies to smaller four-to-person homes and carries its own staffing and physical plant expectations [2]. The physical building has to meet HHSC's minimum standards under 26 Texas Administrative Code Chapter 553, covering things like room square footage, fire safety systems, call systems, and bathroom ratios [3]. These are inspected before initial licensure and again on the state's routine survey cycle.
What is assisted living vs nursing home, in plain terms?
| Licensing authority | State agency (Texas: HHSC) [1] | State agency + federal CMS oversight [4] | |
|---|---|---|---|
| Nursing staff required | Not continuously, varies by type | RN coverage required per federal rule [4] | |
| Typical resident need | Help with ADLs, supervision | Skilled nursing, rehab, complex medical care | |
| Medicare coverage | Generally not covered (see below) | Short-term skilled stays can be covered [5] | |
| Setting | Home-like, apartment or room-based | Clinical, hospital-adjacent feel | Families often move a loved one from assisted living to a nursing home when care needs escalate past what personal-care staff can safely manage. That's a clinical and financial threshold, more than a preference. |
Assisted living is for people who need help with daily living tasks but not continuous medical or nursing care. A nursing home (formally, a skilled nursing facility or SNF) is for people who need daily nursing oversight, rehabilitation therapy, or management of complex medical conditions. The practical differences show up in staffing, licensing agency oversight intensity, and cost. Nursing homes must have a registered nurse on duty for specified hours and are subject to federal Medicare/Medicaid Conditions of Participation on top of state licensing, under 42 CFR Part 483 [4]. Assisted living facilities are licensed at the state level (in Texas, under HHSC and Chapter 247) and don't carry the same federal nursing staffing mandate. | Feature | Assisted Living | Nursing Home (SNF) |
What does assisted living provide, day to day?
Assisted living typically provides three meals a day, housekeeping and laundry, medication administration or reminders, help with bathing and dressing, transportation to appointments, social and recreational activities, and 24-hour staff availability for emergencies. What's included in the base rate versus billed as an add-on varies a lot facility to facility, so read the resident agreement closely. Texas rule requires licensed assisted living facilities to have sufficient qualified staff on duty at all times to meet resident needs, and staffing plans have to reflect the acuity level of the current resident population, more than a flat ratio, under 26 TAC Chapter 553 [3]. That means a Type B facility with residents who have dementia will need a materially different staffing plan than a Type A facility with mobile, independent residents, even if the bed count is the same. Medication management is one of the most heavily regulated pieces. Staff administering medications generally need specific training or delegation from a licensed nurse under Texas Board of Nursing delegation rules, and the facility has to maintain medication administration records that HHSC surveyors will pull during inspection [3].
How to start a group home (or assisted living facility) in Texas
Starting a licensed assisted living facility or group home in Texas runs through several sequential steps, and skipping ahead on any one of them tends to cost you time later. 1. Decide your population and license type. Serving seniors needing personal care points you toward an HHSC assisted living license (Type A, B, or C). Serving people with IDD points you toward HCS or ICF/IID licensure instead. These are different application packets, different rulebooks, and sometimes different HHSC divisions entirely. 2. Confirm zoning and property compliance with your local city or county planning department before you sign a lease or purchase. Residential care use isn't automatically allowed in every zoning district, and fire marshal sign-off (often required for four or more unrelated residents) can require sprinkler retrofits or exit modifications that are expensive to discover after the fact. Pair this with a zoning-and-property review specific to your county. 3. Build your policy and procedure manual. HHSC will want to see written policies covering admission and discharge criteria, medication management, emergency preparedness, staffing plans, resident rights, and abuse/neglect reporting, generally mirroring the standards in 26 TAC Chapter 553 [3]. 4. Submit the license application to HHSC along with the required fee (confirm current fee amounts with HHSC, since these are adjusted periodically) and pass the pre-licensure inspection. 5. Complete required background checks (Texas requires criminal history checks for facility staff and owners through the Texas Department of Public Safety and HHSC's own screening process) before residents move in. 6. Pass the initial licensing survey. HHSC inspects the physical plant, reviews your policy manual, checks staff files, and confirms fire and life-safety compliance before issuing the license. This process realistically takes several months from initial application to opening day, and delays are common when the property needs life-safety upgrades. Building your policy manual and staffing plan early, in parallel with the property search, saves real time. That's exactly the kind of prep work the $299 State Group Home Licensing Kit at /licensing-kit-builder is built around: state-specific application checklists and policy manual templates so you're not starting from a blank page when HHSC asks for your admissions policy or emergency preparedness plan.
What is the difference between assisted living and nursing home in terms of regulation and cost?
Beyond the care-level difference already covered, assisted living and nursing homes are regulated under separate legal frameworks with different inspection cycles and different payer structures. Nursing homes that accept Medicare or Medicaid must comply with federal Conditions of Participation under 42 CFR Part 483 and are surveyed on a cycle set by the Centers for Medicare & Medicaid Services (CMS), generally not exceeding 15 months between standard surveys [4]. Assisted living facilities in Texas are surveyed by HHSC under state law and rule (Texas Health and Safety Code Chapter 247 and 26 TAC Chapter 553), and the survey cycle and enforcement mechanisms are set at the state level rather than federal [1] [3]. Cost-wise, both settings can run high, but nursing home stays tend to bill at a materially higher daily rate because of the clinical staffing intensity. Neither figure is something to guess at; check current facility rate sheets directly and confirm with your state's HHSC office or the facility itself, since rates vary widely by region and level of care.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board at an assisted living facility. CMS is direct about this: Medicare Part A and Part B do not pay for long-term custodial care of the kind assisted living provides, including help with bathing, dressing, and other activities of daily living, when that's the only service needed [5]. What Medicare will cover, even for someone living in an assisted living facility, is medically necessary services delivered there: doctor visits, some home health services if the person qualifies, durable medical equipment, and short-term skilled nursing care under specific conditions (usually following a qualifying hospital stay, and typically in a certified skilled nursing facility, not an assisted living building) [5]. Medicaid is a different story and a common point of confusion. Some states offer Medicaid waiver programs that help cover personal care costs in assisted living settings, though room and board is still typically excluded from Medicaid payment even under a waiver [6]. Texas offers Medicaid waiver programs (such as STAR+PLUS) that can help cover certain assisted living services for eligible low-income residents, but eligibility rules and covered services are specific and change, so confirm current waiver terms directly with HHSC or your state Medicaid office [6]. For a broader look at how funding programs interact with licensing, see funding-and-medicaid resources.
How do I start a group home if I'm serving a specialty population (IDD, mental health, recovery)?
The process mirrors assisted living licensure in its bones (application, background checks, facility inspection, policy manual) but runs through a different HHSC program depending on who you're serving. For IDD group homes in Texas, licensure typically runs through HHSC's Home and Community-based Services (HCS) waiver program or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) licensure, each with its own provider enrollment and certification standards distinct from Chapter 247 assisted living rules. For mental health or substance use recovery residences, Texas doesn't require a state license for a basic peer-run recovery residence in the same way it licenses assisted living, but many operators voluntarily seek certification through the Texas Recovery Housing Provider certification framework to qualify for referrals and funding eligibility. Requirements and the certifying body can shift, so confirm current certification requirements directly with HHSC or the relevant state agency before assuming what applies. Across every population type, the constants are: confirm your zoning allows the use, build a policy manual matching the specific regulation set for that population, complete required background checks, and pass your pre-opening inspection. Trying to write a generic policy manual and hoping it fits every license type is the most common mistake first-time operators make; the manual has to match the specific chapter of code you're licensed under.
How do I read an HHSC inspection or survey report once I find it?
Once your Texas assisted living license search pulls up a facility, click through to the survey history. You'll typically see a list of past surveys with dates and, for each one, a set of "tags" or deficiency citations if problems were found. Each deficiency citation references a specific rule number from 26 TAC Chapter 553, describes what the surveyor observed, and states the scope and severity of the problem [3]. A facility with no deficiencies on its last survey isn't necessarily flawless (surveys are a snapshot), but a pattern of repeat citations on the same rule across multiple surveys, or a recent provisional license status, is worth a direct phone call to the regional HHSC office before you place a loved one there or consider it a model for your own operation. If you're researching before opening your own facility, reading several inspection reports for comparable license types in your area is one of the most useful (and free) pieces of due diligence you can do. It shows you exactly what surveyors flag in practice, more than what the rule book says in theory.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential care setting for adults who need help with daily activities like bathing, dressing, or medication management, but not continuous skilled nursing care. Residents live in private or shared rooms and receive meals, housekeeping, and staff supervision. In Texas, it's regulated under Health and Safety Code Chapter 247 and licensed by HHSC [2].
What is a group home?
A group home is a small residential setting, often a house, where unrelated residents live together and receive supervision or care, commonly for people with IDD, mental illness, substance use recovery needs, or seniors. The license type and governing rules depend on the population served, not the building's style.
What is an assisted living facility?
Under Texas law, an assisted living facility is a licensed establishment providing food, shelter, and personal care services to four or more unrelated residents for 24 hours or more per day, without providing continuous skilled nursing care. Texas licenses these as Type A, Type B, or Type C facilities under Health and Safety Code Chapter 247 [2].
What is the difference between assisted living and nursing home?
Assisted living serves people who need help with daily activities but not continuous medical care; nursing homes serve people needing daily nursing oversight or complex medical management. Nursing homes require RN coverage under federal Conditions of Participation (42 CFR Part 483); assisted living is licensed at the state level without that federal nursing mandate [5].
What does assisted living provide?
Typical services include three daily meals, housekeeping, laundry, medication administration or reminders, help with bathing and dressing, transportation, activities, and 24-hour staff availability. Exact inclusions vary by facility and contract, so review the resident agreement for what's in the base rate versus billed separately.
Does Medicare cover assisted living facilities?
No. Medicare does not pay for room, board, or custodial personal care in assisted living. CMS states Medicare covers medically necessary services like doctor visits or short-term skilled nursing under specific conditions, but not the ongoing cost of assisted living itself [6]. Some state Medicaid waivers help cover personal care costs, but not room and board [7].
How do I start a group home in Texas?
Confirm your population and license type (assisted living through HHSC Chapter 247, or IDD/HCS licensure for a different population), check local zoning and fire code compliance, build a policy manual matching your license type, complete background checks, submit your HHSC application, and pass the pre-licensure inspection before accepting residents.
How do I search for a Texas assisted living license?
Use HHSC's Facility/Provider Search tool, searchable by facility name, city, county, or license number [1]. Results show license status, license type (A, B, or C), bed capacity, and links to recent inspection and survey reports. For a status update more current than the database, call the HHSC regional Long-term Care Regulation office.
What's the difference between Type A, Type B, and Type C assisted living licenses in Texas?
Type A serves residents who can evacuate without staff help and need minimal nighttime attendance. Type B serves residents needing evacuation assistance, nighttime attendance, or more supervision (common for dementia care). Type C generally applies to smaller homes, often four to a small number of residents, with its own staffing standards [3].
How long does it take to get an assisted living license in Texas?
There's no single guaranteed timeline; it depends on how quickly your property passes fire and life-safety inspection, how complete your application and policy manual are, and HHSC's current processing volume. Budget for several months from application submission to opening day, and confirm current processing expectations with HHSC directly.
Is a background check required to open an assisted living facility in Texas?
Yes. Owners and staff at licensed assisted living facilities in Texas must complete criminal history background checks as part of HHSC's licensing and screening process before working with or around residents. Confirm current screening requirements and any fee amounts directly with HHSC, since processes are periodically updated.
Can I check inspection history before choosing an assisted living facility for a family member?
Yes, and you should. HHSC's Facility/Provider Search links to each facility's survey and inspection reports, showing deficiency citations, dates, and enforcement actions like provisional licensure [1][4]. Repeat citations on the same rule across multiple surveys are a stronger warning sign than a single isolated finding.
Sources
- Texas Health and Safety Code, Chapter 247 (Assisted Living Facilities): Legal definition and licensing framework for assisted living facilities in Texas
- Texas HHSC, Assisted Living Facility License Types: Explanation of Type A, Type B, and Type C assisted living license categories
- 26 Texas Administrative Code, Chapter 553 (Licensing Standards for Assisted Living Facilities): Physical plant, staffing, and medication management standards for licensed assisted living facilities
- Code of Federal Regulations, 42 CFR Part 483 (Requirements for Long Term Care Facilities): Federal Conditions of Participation and nursing staffing requirements for Medicare/Medicaid certified nursing facilities
- Medicare.gov, Long-term Care coverage: Medicare does not cover custodial long-term care such as room and board in assisted living
- Medicaid.gov, Home & Community Based Services: Medicaid waiver programs can help cover certain personal care services in residential settings, though room and board is generally excluded