Texas assisted living facility license: Type A, Type B and small homes

Where the four-resident line falls

Health and Safety Code §247.002 defines an assisted living facility by two tests. First, it “furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to the proprietor.” Second, it provides personal care services or has a licensed or authorized person administer medication.⁠¹ Personal care means help with feeding, dressing, moving, bathing or other personal needs. It also covers “general supervision or oversight” of the physical and mental well-being of someone who needs help to manage their life.⁠¹ Supervision alone can therefore meet the second test.

Nothing in the definition depends on size. HHSC says ALFs “can be large apartment-like settings or private residences.”⁠² Texas has no separate license for residential care homes, adult family homes or board-and-care homes. If you plan a four-to-sixteen bed house, this is your license.

What sits on either side of the line:

• Three or fewer unrelated residents. You fall below the statutory definition. You still may not use the term “assisted living” for the home or its services, unless you choose to get licensed anyway, which the statute allows.⁠¹
• Several small homes. Running two three-bed houses does not automatically keep you under the threshold. HHSC treats facilities as one establishment based on common ownership, physical proximity, shared services, staff or equipment, and any public appearance of joint operations. No single factor is conclusive.⁠⁷
• Boarding homes. A home that gives lodging to three or more elderly or disabled people, along with meals, housekeeping, transportation, money management or reminders to take medication, but gives no personal care, is a boarding home under chapter 260. It is exempt from the ALF law.⁠¹⁠²⁷ Counties and cities may require their own boarding home permit.⁠²⁷ Once staff help with bathing, dressing or transfers, the home has crossed into ALF territory.
• Other exemptions. Christian Science establishments, some religious-society retirement homes, and homes that serve only people enrolled in programs funded and monitored by the state’s intellectual and developmental disability or mental health authorities are exempt.⁠¹

Unlicensed operation now carries criminal exposure. HB 2510 (2025) added §247.0441, effective September 1, 2025. It makes operating without a license a Class A misdemeanor, and a third-degree felony after a prior conviction.⁠¹ Civil penalties for violations that threaten residents’ health and safety run from $100 to $10,000 per violation, and each day counts separately.⁠¹ Cities may also ban unlicensed ALFs by ordinance.⁠¹

If your clients stay in their own homes, look at the personal assistance services HCSSA license instead. Daytime-only programs need the day activity and health services license.

Type A or Type B: decided by who can get out in a fire

HHSC classifies an ALF by its residents’ ability to evacuate. The size of the building does not decide it.⁠⁶

Sources: ⁠⁶⁠²¹

Choose with care, because switching later costs money. A facility that wants to move from Type A to Type B, or from small to large, must meet the construction standards for a new facility of the new type and size.⁠¹⁵ Alzheimer certification is available only to Type B facilities (see below).⁠¹¹ The old Type C license, for four-bed adult foster care homes, is closed to new applicants. HHSC now requires a Type A or Type B license for an adult foster care contract.⁠⁶

Small (16 beds or fewer) versus large: where the rules split

26 TAC §553.3 defines a small facility as one “licensed for 16 or fewer residents” and a large facility as one licensed for 17 or more.⁠⁵ Most of the practical relief for small homes comes from that line.

• Manager education. In a small facility the manager needs a high school diploma or equivalency certificate. In a large facility the manager needs an associate’s degree in nursing, health care management or a related field, a bachelor’s degree, or a diploma plus one year of experience in management or health care industry management.⁠²¹ The statute sets the same 17-bed threshold.⁠¹
• One manager, several homes. A manager must be on duty 40 hours a week and may manage only one facility. The exception is small Type A facilities: one manager may cover no more than 16 residents across no more than four facilities, and must be reachable by phone or pager while off-site.⁠²¹
• Night staff. A small Type A home may have night staff who are immediately available but asleep. A large Type A, and every Type B, needs awake staff.⁠²¹
• Building code. New small facilities follow their own divisions of Subchapter D (Divisions 8 and 9), which tie them to the small-facility provisions in section 32.2 of NFPA 101, Chapter 32, New Residential Board and Care Occupancies. Large facilities have separate divisions.⁠¹⁵⁠¹⁷⁠¹⁹

One rule does not relax at any size: an attendant “must be in the facility at all times when residents are in the facility.”⁠²¹ A four-bed home cannot leave residents alone while the only caregiver runs errands.

Making a house meet the Life Safety Code

Every ALF must comply with NFPA 101, the Life Safety Code, plus the physical plant rules in Subchapter D of chapter 553.⁠¹⁵ Any facility first licensed on or after August 31, 2021 is a “new” facility for these rules. If you convert an existing house now, you are building to the new-facility divisions, not the older existing-facility ones.⁠¹⁵ HHSC publishes separate Life Safety Code checklists for new small Type A (PR 2388) and new small Type B (PR 2389) facilities.⁠²

For a new small facility, the Type A and Type B construction rules read almost word for word alike:⁠¹⁷⁠¹⁹⁠²⁰⁠³⁶⁠³⁷⁠³⁸

• Fire-rated sheathing. Interior walls and ceilings need a fire resistance rating of at least 20 minutes, and exposed columns, beams and trusses must be encased to the same rating. A sprinkler system does not substitute for this. The only exception is a building that meets the construction-type rules for new health care occupancies in NFPA 101, Chapter 18.
• Separation. The facility must be separated from any other occupancy, including another ALF, by a 2-hour fire barrier.
• Sprinklers. You may use an NFPA 13, 13R or 13D system, with electrical supervision.
• Alarm and detection. You need a manual fire alarm system, with smoke detectors in bedrooms, corridors, living and dining rooms, offices, kitchens and laundries. Heat detectors are allowed in kitchens, laundries and garages. The alarm panel goes where staff can see it 24 hours a day, unless every staff member carries a monitoring device.
• Upper floors. If residents use any floor above the ground floor, you need at least two separate approved stairs, reachable without passing through another room.
• Doors. Resident room doors must latch to resist the passage of smoke.
• Extinguishers. No point in the building may be more than 75 feet from an extinguisher.

The space rules for a new small Type A facility (§553.212) set the room math:⁠¹⁸

• Bedrooms. No bedroom may be below finished ground level. A single room needs at least 80 square feet of usable floor space, and a shared room 60 square feet per resident. Space narrower than 8 feet does not count.
• Room sharing. No more than four residents may share a bedroom, and no more than half your licensed capacity may live in rooms of three or more.
• Windows. Each bedroom needs an operable window with a sill no higher than 44 inches.
• Living and dining. You need 15 square feet per resident of living space and 15 of dining space, each with at least one room of 120 square feet or more. Alternatively, you can combine them in one space of at least 240 square feet.

Site rules apply to every size: one parking space per four licensed residents (or the local requirement, if stricter), ramps no steeper than 1 in 12, and a firefighting unit and water supply that meet that unit’s requirements.⁠¹⁶ In a county of more than 3.3 million residents, a facility that applies for or receives its initial license on or after December 6, 2022 may not be in a 100-year floodplain.⁠¹⁶⁠⁷

Local codes apply alongside HHSC’s. You must meet the codes of the local authority having jurisdiction and submit its documentation, and you need approval from the local fire authority.⁠¹⁵⁠⁷ Where local and HHSC standards differ, you must meet both.⁠¹⁵ If the Texas Department of Licensing and Regulation requires it, you also need to register the project and get a review by a Registered Accessibility Specialist.⁠¹⁵ For building questions, HHSC’s FAQ points to the Architecture Unit at 512-438-2371.⁠³⁵

Manager, attendants and training

Texas sets no numeric staff-to-resident ratio for ALFs. Each facility writes staffing policies with ratios “based upon the needs of the residents” in their service plans. Before admission, you must disclose your normal 24-hour staffing pattern to prospective residents and families, and post it monthly.⁠²¹ Full-time attendants must be at least 18 or a high school graduate.⁠²¹

Training requirements under §553.253:⁠²¹

• Manager. At least one management course of 24 hours or more, including 8 hours on the assisted living standards within the first three months. The course must be finished by the first anniversary in the job, and in-house in-services do not count, and a manager who documents a previously completed comparable course is exempt. After that, 12 hours of continuing education a year. HHSC posts a list of manager course providers on the ALF page.⁠²
• All staff. Four hours of orientation before taking on any duties, covering abuse reporting, confidentiality, universal precautions, residents’ rights and evacuation.
• Attendants. Sixteen hours of on-the-job supervision and training right after orientation, including fall prevention and behavior management.
• Direct care staff. Six hours a year, including one hour on fall prevention and one on behavior management.

Hiring checks tightened in 2026. Each personnel file must document a criminal history check. Before hiring, you must also search both the Nurse Aide Registry and the Search Engine for Multi-Agency Reportable Conduct (SEMARC), then search both again at least every 12 months. Anyone listed in SEMARC is unemployable.⁠²² HHSC told providers that SEMARC use is required beginning August 3, 2026, and the rule was amended effective July 30, 2026.⁠³⁴⁠²² If an applicant lived in another state in the past five years, you must run a name-based check in each of those states. Until the results come back, the person may not have direct contact with residents.⁠²²⁠¹

Licensing steps, in HHSC’s order

1. Take the pre-licensure course

   The person applying for an initial license must complete HHSC’s online ALF Pre-Licensure Training before submitting the application. Applicants already licensed under chapter 247 are exempt.⁠⁹ The course takes one to two hours, and progress is not saved if you exit. Print, sign and submit the participation certificate, because HHSC states that “application packets will not be accepted without this document.”⁠⁴

2. Have the building plans reviewed, if you are building or converting (optional)

   You may submit plans to HHSC’s architectural staff before construction. HHSC reviews them within 30 days, and once approved, the architectural requirements for that project are locked in.⁠¹ Plan review carries its own fee.⁠¹⁴

3. File in TULIP

   Use Form 3720 with the full fee.⁠³⁠¹⁴ The application discloses owners, controlling parties, affiliates and real estate. HHSC’s PL 2025-03 lists the uploads: survey request letters, the fire marshal inspection report, a taxpayer ID document, an assumed name certificate, a letter to the local health authority, business entity documents and any management company agreement.⁠³³ HHSC suggests applying 45 days before the building is expected to meet the Life Safety Code and architectural requirements.⁠³

4. Answer deficiency notices

   HHSC reviews the application within 30 days.⁠⁸ If items are missing, HHSC’s page says you have 30 days to respond.⁠³ Under the rule, an application still incomplete 120 days after receipt is denied.⁠⁸ HHSC also creates a federal ASPEN facility ID at this stage.⁠³⁰

5. Pass the Life Safety Code survey

   Notify HHSC through TULIP that the building is ready, either with the application or within 120 days of filing. If you do not meet the requirements within 120 days after the first inspection, the application is denied.⁠⁹ The statute lets you buy an expedited inspection within 15 days, and the rule charges $25 per bed (minimum $1,000) for a third or later Life Safety Code inspection on the same application.⁠¹⁠¹⁴

6. Admit one to three residents, then pass the health survey

   Only after the building passes may you admit at least one but no more than three residents. You then tell HHSC you are ready for the health inspection, which includes watching staff care for a resident. You get 120 days after the first health inspection to meet the standards.⁠⁹ An expedited health inspection within 21 days is also available for a fee.⁠¹

7. Receive the license

   The rule says HHSC issues the license within 30 days of finding all requirements met.⁠⁹ HHSC’s web page says 45 days.⁠³ Only after that may you fill the home to its licensed capacity.

HHSC must deny the application if anyone required to be disclosed has been excluded from Medicare or Medicaid, is under an injunction barring them from running a facility, or had a facility license revoked in any state in the past five years.⁠⁷ For accredited operators, HHSC accepts an on-site survey by an accreditation commission (CARF, The Joint Commission or another organization HHSC approves) in place of its own inspections.⁠¹⁠⁷

Two exceptions: good standing and provisional licenses

Initial license for an applicant in good standing. An applicant (or its controlling person) that has run a licensed Texas Type A or Type B facility for at least six consecutive years may file Form 3720-G.⁠¹⁰⁠³ Every facility it operated must have no violations that caused actual harm or posed an immediate threat, and no penalties, injunctions, license denials, suspensions, revocations or emergency closures in the past six years.⁠¹⁰ Such an applicant submits its policies and procedures, proof of background checks and staff credentials. It gets a license after passing the Life Safety Code survey and HHSC’s policy review, without first admitting residents.⁠¹⁰⁠²⁸ It may then admit up to capacity. HHSC conducts the health inspection within 90 days, and until then the facility must attach a written addendum to its disclosure statement saying the survey has not happened.⁠¹⁰⁠²⁸

Six-month provisional license for new construction. HHSC issues one without a prior Life Safety Code inspection if you:⁠¹²

• submitted working drawings for plan review before construction began;
• obtained all local approvals, including a certificate of occupancy;
• filed a complete application within 30 days of the last local approval and paid the fee;
• passed the on-site health inspection; and
• (you or a controlling owner) previously built another Texas facility that met HHSC’s Life Safety Code standards.

The provisional license lasts 180 days, and the Life Safety Code survey follows.⁠¹²⁠²⁹ HHSC may also issue a provisional license after a corporate change of ownership.⁠¹² A first-time founder converting a house qualifies for neither route and follows the standard steps above.

Fees as published on 2026-10-12

Sources: ⁠¹⁴⁠³

At these rates, a 6-bed home pays $390 and a 16-bed home pays $540 for three years. All fees are nonrefundable, except a refund you can request if HHSC misses its processing deadlines.⁠¹⁴⁠⁸ Expedited inspection and plan review fees are set in graphics attached to §553.47, which the Secretary of State’s rule viewer does not display as text; HHSC’s FAQ refers applicants to its “Plan Review Fees & Expedited Life Safety Code Fee Charts.”⁠¹⁴⁠³⁵ Ask the Licensing and Credentialing Unit (512-438-2630) for the charts before you budget. Each expedited Life Safety Code inspection carries its own fee, so a failed expedited inspection means paying again for an expedited follow-up.⁠³ HHSC’s provider page still lists a two-year fee ($200 + $10 per bed, maximum $1,500) and a Type C fee next to the three-year figures.⁠³ The rule shows only the three-year fee.⁠¹⁴

Alzheimer’s certification and memory care advertising

Texas does not require certification to serve residents with dementia. It requires certification to advertise that service. A facility or unit that “advertises, markets, or otherwise promotes” specialized care for Alzheimer’s disease or related disorders must be certified, and only a Type B facility can be.⁠¹¹⁠¹ Phrases such as “medication reminders,” “escort service” or “short-term memory loss, confusion, or forgetfulness” do not trigger certification.⁠¹¹

Certification is requested in TULIP on Form 3721 (Form 3721-G for good-standing applicants), with the $300 fee.⁠³⁠¹⁴ HHSC certifies the facility or unit after a Life Safety Code inspection and a health inspection that observes care for at least one resident admitted to the Alzheimer’s facility or unit.⁠¹¹ The certificate is valid three years, must be posted, and is cancelled on a change of ownership.⁠¹¹ Its extra standards:

• Manager. At least 21, with an associate’s degree in nursing or health care management, a bachelor’s in psychology, gerontology, nursing or a related field, or a diploma plus one year working with people with dementia. Six hours of dementia continuing education a year.⁠²³
• Staff training. Four hours of dementia-specific orientation for all staff. Attendants also need 16 hours of on-the-job training and 12 hours of Alzheimer’s in-service education a year.⁠²⁴
• Staffing. Large facilities or units with 17 or more residents need two staff immediately available whenever residents are present.⁠²⁵
• Physical plant. A monitoring station, access to two remote exits, and an outdoor area of at least 800 contiguous square feet. Electronic locks on control doors are allowed only in buildings with an approved sprinkler system and fire alarm, and must release on alarm, power failure or a switch at the staff stations. Exit doors follow the same conditions or NFPA 101’s own locking rules.⁠²⁶

Uncertified facilities that still care for residents with dementia have their own floor, set by HB 1673 (2023). Direct service staff need four hours of training and a competency evaluation before giving any direct care to those residents. Managers need four hours on a wider list of topics, other staff need shorter training, and trained staff need two hours of continuing education a year.⁠¹ Any facility promoting memory care must also tell each resident in writing whether it is certified.⁠¹

HB 3595: power outages and areas of refuge

HB 3595 (2025) added §247.073, which took effect September 1, 2025. Each ALF’s emergency preparedness plan must provide:⁠¹

• a climate-controlled area of refuge with at least 15 square feet per resident;
• a separate climate-controlled room for each bedfast resident;
• temperatures between 68 and 82 degrees Fahrenheit in those spaces; and
• notice to HHSC of any unplanned power loss lasting more than 12 hours.

PL 2026-11 set January 1, 2026 as the deadline for plans and said HHSC would enforce from September 1, 2026.⁠³¹ The plan must name each area of refuge and describe any generator or backup power. It must also list residents who are bedfast or depend on powered medical equipment.⁠³¹

For facilities whose construction permit is issued after September 1, 2026, the statute directs HHSC to set construction and licensure standards for backup power, such as generator connection boxes, and for evacuating residents to areas of refuge.⁠¹ HHSC told the Senate in July 2026 that it will survey against those standards “once the rules are in effect.”⁠³² That July update listed September 1, 2026 as the date construction standards take effect but did not say the rules had been adopted.⁠³² If you are pulling a building permit now, ask the Architecture Unit (512-438-2371) which backup-power and area-of-refuge standards will apply to your project.⁠³⁵ Separately, every licensed ALF must register with the Texas Information and Referral Network for disaster evacuation planning.⁠¹

Renewal, inspections and running the license

A license expires three years after issue and is not renewed automatically.⁠¹⁠¹³ File the renewal in TULIP at least 45 days before expiration to avoid the late fee. A license that lapses cannot be renewed: you must start a new initial application, and you may not operate in the meantime.⁠¹³ Renewal requires an on-site inspection that includes observing a resident’s care.⁠¹³ Between renewals, HHSC inspects each facility at least every two years and may visit at other times. Each inspection ends with an exit conference, and you have 10 working days to submit a plan of correction.⁠¹

Day to day, the statute requires you to:

• print your license number or state facility ID in all advertising;⁠¹
• give each prospective resident a consumer disclosure statement on HHSC’s form;⁠¹ and
• notify HHSC of a change of ownership before it takes effect; failing to do so can draw an administrative penalty.⁠¹

HHSC also requires prior notice before a license moves to a new location, and its approval before you increase licensed capacity. Under HHSC’s definition, a change of ownership happens when the facility’s tax identification number changes.⁠³

Medicaid contracts are a separate application

A license does not let you bill Medicaid. HHSC notes that a TULIP application “only applies to the license itself,” and providers holding HHSC contracts deal with a contract manager separately.⁠³ Contracting rules for assisted living and residential care services are in 26 TAC chapter 276. Adult foster care contracts now require a Type A or Type B license.⁠⁶ For statewide context on other care licenses, see the Texas state page.

Sources

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   Texas Legislature, Texas Health and Safety Code, chapter 247 (Assisted Living Facilities) Checked 12 Oct 2026 · Back to text ↑
2. 2
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   Texas Health and Human Services Commission, How to Become an ALF Provider Checked 12 Oct 2026 · Back to text ↑
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   Texas Health and Human Services Commission, ALF Pre-Licensure Computer-based Training Information Checked 12 Oct 2026 · Back to text ↑
5. 5
   Texas Secretary of State, 26 TAC §553.3, Definitions Checked 12 Oct 2026 · Back to text ↑
6. 6
   Texas Secretary of State, 26 TAC §553.5, Types of Assisted Living Facilities Checked 12 Oct 2026 · Back to text ↑
7. 7
   Texas Secretary of State, 26 TAC §553.17, Criteria for Licensing Checked 12 Oct 2026 · Back to text ↑
8. 8
   Texas Secretary of State, 26 TAC §553.21, Time Periods for Processing All Types of License Applications Checked 12 Oct 2026 · Back to text ↑
9. 9
   Texas Secretary of State, 26 TAC §553.23, Initial License Application Procedures and Requirements Checked 12 Oct 2026 · Back to text ↑
10. 10
    Texas Secretary of State, 26 TAC §553.25, Initial License for an Applicant in Good Standing Checked 12 Oct 2026 · Back to text ↑
11. 11
    Texas Secretary of State, 26 TAC §553.27, Certification of a Type B Facility or Unit for Persons with Alzheimer's Disease Checked 12 Oct 2026 · Back to text ↑
12. 12
    Texas Secretary of State, 26 TAC §553.31, Provisional License Checked 12 Oct 2026 · Back to text ↑
13. 13
    Texas Secretary of State, 26 TAC §553.33, Renewal Procedures and Qualifications Checked 12 Oct 2026 · Back to text ↑
14. 14
    Texas Secretary of State, 26 TAC §553.47, License Fees Checked 12 Oct 2026 · Back to text ↑
15. 15
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16. 16
    Texas Secretary of State, 26 TAC §553.103, Site and Location for all Assisted Living Facilities Checked 12 Oct 2026 · Back to text ↑
17. 17
    Texas Secretary of State, 26 TAC §553.211, Construction Requirements for a New Small Type A Assisted Living Facility Checked 12 Oct 2026 · Back to text ↑
18. 18
    Texas Secretary of State, 26 TAC §553.212, Space Planning and Utilization Requirements for a New Small Type A Assisted Living Facility Checked 12 Oct 2026 · Back to text ↑
19. 19
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20. 20
    Texas Secretary of State, 26 TAC §553.215, Fire Protection Systems Requirements for a New Small Type A Assisted Living Facility Checked 12 Oct 2026 · Back to text ↑
21. 21
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22. 22
    Texas Secretary of State, 26 TAC §553.257, Personnel Checked 12 Oct 2026 · Back to text ↑
23. 23
    Texas Secretary of State, 26 TAC §553.301, Manager Qualifications and Training (Certified Alzheimer's Facilities) Checked 12 Oct 2026 · Back to text ↑
24. 24
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25. 25
    Texas Secretary of State, 26 TAC §553.305, Staffing (Certified Alzheimer's Facilities) Checked 12 Oct 2026 · Back to text ↑
26. 26
    Texas Secretary of State, 26 TAC §553.311, Physical Plant Requirements for Alzheimer's Units Checked 12 Oct 2026 · Back to text ↑
27. 27
    Texas Legislature, Texas Health and Safety Code, chapter 260 (Boarding Home Facilities) Checked 12 Oct 2026 · Back to text ↑
28. 28
    Texas Health and Human Services Commission, Licensure process map: ALF Initial – Good Standing Checked 12 Oct 2026 · Back to text ↑
29. 29
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30. 30
    Texas Health and Human Services Commission, Licensure process map: ALF Initial Checked 12 Oct 2026 · Back to text ↑
31. 31
    Texas Health and Human Services Commission, Provider Letter PL 2026-11, ALF Emergency Preparedness (July 1, 2026) Checked 12 Oct 2026 · Back to text ↑
32. 32
    Texas Health and Human Services Commission, House Bill 3595 (89R) Implementation Update, Senate Health and Human Services Committee (July 8, 2026) Checked 12 Oct 2026 · Back to text ↑
33. 33
    Texas Health and Human Services Commission, ALF Provider Webinar with LTCR (October 22, 2025) Checked 12 Oct 2026 · Back to text ↑
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35. 35
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36. 36
    Texas Secretary of State, 26 TAC §553.221, Construction Requirements for a New Small Type B Assisted Living Facility Checked 12 Oct 2026 · Back to text ↑
37. 37
    Texas Secretary of State, 26 TAC §553.223, Means of Escape Requirements for a New Small Type B Assisted Living Facility Checked 12 Oct 2026 · Back to text ↑
38. 38
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