By Austin Senior Advisor Care Team · October 19, 2026
When a parent in a Type A Austin assisted living community starts needing hands-on help, Texas has a written process: retention forms, an HHSC evacuation waiver, or a 30-day move. Here is how it works and what to ask.
The call that starts with a physical therapist's note
Your mother is 84 and has lived in a Type A assisted living community in Austin for two years. She walks with a cane, eats in the dining room, and manages her own bedtime. In March she falls, breaks a hip, and spends three weeks in rehab. She comes back using a walker, and she needs someone to steady her when she stands up from the bed or toilet. A week later the executive director calls and uses the phrase "change of condition."
Most families hear that phrase as a warning that a move is coming. Sometimes it is. But Texas has a specific, written process for this exact situation, and it is not the same as the discharge process. Knowing the difference can buy your family weeks, and in some cases lets your mother stay put.
This post walks through that process. It is based on the state's licensing rules, 26 Texas Administrative Code Chapter 553, as they read on the Texas Administrative Code when I checked. HHSC has been reorganizing parts of that chapter, so if a section number below does not match what you find, ask the facility or HHSC to point you to the current one. The substance is what matters.
What Type A and Type B actually mean
Texas does not rate assisted living by amenities. It licenses each community as Type A or Type B, and the line between them is one question: can the residents get themselves out of the building in an emergency? That is the basis in 26 TAC 553.5.
A Type A resident must be physically and mentally capable of evacuating without physical help from staff, must not need routine attendance during nighttime sleeping hours, and must be able to follow directions in an emergency. A resident in a wheelchair or electric cart can still qualify if they can transfer and get out on their own.
A Type B resident may need staff help to evacuate, may need someone attending at night, may not be able to follow emergency directions, and may need help moving into or out of a wheelchair. The one hard limit is that a Type B resident must not be permanently bedfast.
Notice what this means. The license type is not about how much care a resident gets. It is about how fast the building can empty. A community can be warm, well staffed and beautifully run, and still be legally built and staffed for residents who walk out on their own. Our Type A vs Type B page has the side-by-side version.
The rule that sits underneath the whole conversation
Under 26 TAC 553.259, a facility "must not admit or retain a resident whose needs cannot be met by the facility." That sentence is why your mother's situation is a legal question and not just a preference. If the community cannot meet her needs, it is not allowed to keep her, whatever the staff may want.
The same section requires a comprehensive assessment and an individual service plan within 14 days of admission, and requires the plan to be updated annually and upon a significant change in condition. So a hip fracture should trigger a fresh assessment. Ask for it in writing, and ask for a copy. That document is the factual record everything else will rest on.
There is also a quieter requirement. The facility's disclosure statement, which you should have been handed before move-in, is supposed to explain the waiver process and the community's aging-in-place policies. If you cannot find it, ask for another copy today. It tells you what this particular operator says it will do when a resident declines.
What "inappropriately placed" means, and who can say it
Section 553.259(e) is titled inappropriate placement in Type A or Type B facilities. It says either HHSC or the facility can decide a resident no longer fits the license. HHSC usually finds this at an inspection, when a surveyor reads a chart and sees a Type A resident who now needs hands-on help to evacuate. The facility can also raise it on its own, which is what happened in our example.
The finding does not automatically mean the resident goes. It starts a clock. The rule gives the facility 10 working days to take one of two paths, and the paperwork for both is built around the same idea: someone with authority has looked at this resident and decided they can be kept safe.
The first path is a package of three HHSC forms, numbered 1124, 1125 and 1126. One is the facility's request to keep the resident. One is the resident's own request to remain, signed by your mother or her legal representative. One is a physician's assessment. This is the path where she says she wants to stay, her doctor agrees, and the community says it is willing.
The second path is an evacuation waiver. The facility asks the HHSC regional office to approve keeping a resident who does not meet the evacuation criteria. The request has to include the same forms plus supporting documents, among them an emergency plan, a floor plan drawn to scale, the evacuation plan, a recent assessment and service plan, and fire drill records for the last 12 months.
How HHSC decides on a waiver
HHSC reviews the package and notifies the facility in writing, granting or denying the waiver, within 10 working days after it receives the request. The decision turns on the emergency plan. It has to show enough trained staff on every shift to move all the residents, and it has to address where a fire might start, whether the alarm system is adequate, and how the location of a fire gets communicated. It also cannot make things worse for other residents who have their own waivers or special needs.
If HHSC grants the waiver, the facility must immediately put the emergency plan into effect. The waiver is not permanent paper. HHSC reviews it again during the facility's annual renewal inspection.
If the facility does not request a waiver, or HHSC denies it, or the required statements never arrive, the rule says the facility must discharge the resident, and the resident gets 30 days after the date of the discharge notice to move. That 30 days comes from this section. It is a separate road from the contract-termination process we explain in our post on 30-day discharge notices, though the practical result for your family looks similar.
I could not find any published count of how often HHSC grants or denies these waivers, in Austin or statewide. If a community tells you waivers are "always approved" or "never worth trying," ask what that is based on.
What to ask the community in the first 48 hours
You have a short window and a lot of emotion in the room. These questions turn it into facts.
Is this an HHSC finding or the community's own decision? The paths and the people involved are different. A surveyor's finding after an inspection is not the same as an administrator's concern after a bad week.
Is the community willing to keep her? Willingness comes first. A waiver is something the facility has to ask for. You cannot file it on your own, so get a clear yes or no and the reason for it.
What exactly would change at night? The Type A test turns partly on whether she needs routine attendance during sleeping hours. Ask what overnight staffing looks like and who would reach her room first. A waiver depends on this answer. If the honest answer is one aide for the whole building, that tells you something.
Can I see the emergency plan and the last 12 months of drill records? The facility has to assemble them for a waiver request anyway. A community that will not show you its drill records before a waiver is a community to think hard about.
If the waiver is denied, who helps with the move? Ask whether the same operator has a Type B building nearby and whether your mother would move to the front of the line. Some operators run both license types and some do not; I found no published list, so ask each one.
When staying is the wrong answer
A waiver is a legal tool. It is not a promise that staying is a good idea. If your mother needs two-person transfers, wanders at night, or has stopped being able to follow simple instructions, the paperwork might get approved and still leave her in a building that is not the right fit.
Think about the move as a license question and a care question. A Type B community, particularly one with a dementia certification if her thinking is changing, is built and staffed for exactly this stage. Our post on certified memory care standards explains what that certificate does and does not guarantee, and our touring checklist works for a Type B tour too.
Look up the license before you tour. The state's TULIP provider search shows current license status, and the older HHSC search shows survey history. Our license lookup guide walks through both. Check the license type on the listing, not only on the brochure.
Also keep money in the picture. Moving up a license type usually moves the monthly price too, and no published median exists for Texas memory care, so do not trust anyone who quotes one as fact. Ask for the full fee schedule in writing, including the level-of-care charges for the care your mother will need on day one.
Who to call if it feels wrong
If you think the facility is rushing you, skipping the written process, or using "change of condition" as a way to avoid a hard resident, call the long-term care ombudsman. For Austin and the rest of Travis County that is the Capital Area Area Agency on Aging at 512-916-6054, at 6800 Burleson Rd., Building 310, Suite 165. The ombudsman is free, independent of HHSC, and acts with your mother's consent. Do not confuse it with the Area Agency on Aging of Central Texas in Belton, which serves a different set of counties.
The state ombudsman's office is at 4601 Guadalupe St. in Austin, with a toll-free line at 1-800-252-2412. For a complaint about the facility itself, the HHSC Complaint and Incident Intake line is 1-800-458-9858, open Monday through Friday, 7 a.m. to 7 p.m. Central. Adult Protective Services at 1-800-252-5400 handles community settings, such as your mother's own home, and not licensed facilities.
One last thing. Keep the paper. Save the assessment, the service plan, the discharge or change-of-condition letter, and every email about the decision. In a hard month, a folder with dates in it is the most useful thing you can bring to any of those phone calls.
