How Texas licenses assisted living, and why it matters here
Texas does not license assisted living by how much care a resident needs. It licenses by whether the resident can get out of the building. That single distinction, set out in 26 TAC 553.5, decides which communities can legally accept your parent.
Type A
- Must be physically and mentally capable of evacuating without physical assistance from staff. This can include a resident who is mobile but non-ambulatory, such as a wheelchair or electric cart user who can transfer and evacuate independently.
- Does not require routine attendance during nighttime sleeping hours.
- Must be capable of following directions under emergency conditions.
Type B
- May require staff assistance to evacuate.
- May require attendance during nighttime sleeping hours.
- May be incapable of following directions under emergency conditions.
- May require assistance transferring to and from a wheelchair.
- Must not be permanently bedfast.
A legacy four-bed adult foster care license. HHSC no longer issues Type C licenses.
Source: 26 TAC 553.5 full text
Why Texas chose evacuation as the dividing line
Most states license assisted living by acuity. Texas licenses by whether a resident can get out of the building, which is fundamentally a fire-safety judgement rather than a care judgement. The logic is that a building's staffing and construction must match the evacuation capability of the people inside it.
The consequence for families is that two residents who need identical daily help can require different licence types. A woman who uses a wheelchair but transfers and propels herself independently may be Type A. A man who walks unaided but cannot follow directions under stress may be Type B.
What this changes about how you shop
Ask the licence type before the tour rather than after. It is the cheapest possible filter and it prevents the most common expensive mistake in this market, which is choosing a community your parent will have to leave within a year.
Ask the second question too: at what point would you no longer be able to keep my parent? A community that answers precisely is telling you they have had the conversation before. One that says it never happens is not.
