Frequently Asked Questions (FAQ)

Under Texas law, an assisted living facility is an establishment that:

• furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to theproprietor of the establishment;
• provides:
  • personal care services; or
  • administration of medication by a person licensed or otherwise authorized in this state to administer themedication;
• may provide assistance with or supervision of the administration of medication; and
• may provide skilled nursing services for the following limited purposes:
  • coordination of resident care with outside home and community support services agencies and otherhealth care professionals;
  • provision or delegation of personal care services and medication administration as described by Health andSafety Code, Chapter 247;
  • assessment of residents to determine the care required; and
  • for periods of time as established by department rule, delivery of temporary skilled nursing treatment for a minor illness, injury, or emergency.

The state laws pertaining to assisted living facilities are contained, for the most part, in Health and Safety Code, Chapter247. The state regulations/standards that govern ALFs are contained in the Texas Administration Code, Title 26, Part I,Chapter 553.

The following links will direct you to the licensing standards and statues for ALFs

• Chapter 553, Licensing Standards for Assisted Living Facilities:https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=26&pt=1&ch=553
• Health and Safety Code Chapter 247- Assisted Living Facilities:https://statutes.capitol.texas.gov/Docs/HS/htm/HS.247.htmhttp://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=90

Assisted living facilities (ALFs) must be licensed to operate in Texas. The Texas Health and Human Services(HHSC) licenses assisted living facilities based on residents' physical and mental ability to evacuate the facility inan emergency and whether nighttime attendance is necessary.

• A Type A facility cares for residents who do not require routine attendance during sleeping hours and arecapable of following directions in an
• A Type B facility is for residents who require staff assistance to evacuate, are not capable of followingdirections in an emergency and require nighttime

Additionally, HHSC classifies facilities based on size - a large ALF is 17 residents or more and a small ALF is 16 residentsor fewer.

A Type B assisted living facility can have a memory care unit / be Alzheimer certified. Additional requirements need to be met to achieve certification and there are additional fees.

Note, a facility that advertises, markets, or otherwise promotes that the facility or a distinct unit of the facility provides specialized care for persons with Alzheimer's disease or related disorders must be certified or have the unit certified.

HHSC licenses and certifies ALFs based upon compliance with state regulations. To become licensed, a location must:

• Complete the pre-survey computer-based
• Properly complete and submit the electronic license
• Upload all required
• Pay the required license
• Electronically submit appropriate ownership
• Pass on-site Life Safety Code and Health
• Be approved by the Licensure and Certification

Licensure Fees

• The license fee is $300, plus $15 for each bed for which a license is sought, with a maximum of

$2,250 for a three-year license. The license fee for a two-year license issued in accordance with

• 553.15(b)(1) or (c)(1) of this chapter is $200, plus $10 for each bed for which a license is sought, with amaximum of $1,500. The fee must be paid with an initial application, change of ownership application, or renewal application.
• Increase capacity fee: $15.00 per
• Late fee of one half the basic fee will be assessed if the renewal application is submitted less than 45 daysbefore the license expiration

Time Frames

License application for an initial, renewal, CHOW and or relocation:

• Upon receipt of a license application in the HHSC Licensing and Credentialing Unit has up 30 days to reviewthe
• If HHSC receives an incomplete application, the HHSC Licensing and Credentialing Unit will notify theapplicant in writing of any deficient items in the The applicant must respond with complete and correct information within 30 days from the date of notification. If the application is no completed timelythe application will be denied.
• The applicant must provide written notice the building is in compliance with the Subchapter D of the LicensingStandards for Assisted Living Facilities and ready for a LSC (Initial and Relocation applications.)
• When the LSC survey is passed one resident but no more than three may be admitted to the Theapplicant must submit a written notification that at least one resident has been admitted and the location isready for the health survey. (Initial and relocation applications)
• Upon receipt of a complete application and LSC and Health survey approvals, the Licensing andCredentialing Unit will issue the license within 45
• If a location does not complete the application or pass LSC or health surveys the application will be denied.

Types of Applications

• Initial - An initial application, is a application that has never been issued a license to operate in
• Change of Ownership - A Change of Ownerships (CHOW) occurs when the facility changes its Tax Identification
• Renewal- A renewal application for a current license holder must be submitted at least 45 days prior tolicensure expiration Late fee may apply. Any application submitted after the licensure expiration datewill not be accepted.
• Relocation - A license may not be transferred from one location to another without prior notice to 26 TAC§553.17

Changes of Information

• Change in the facility name (legal entity or doing business as)- If license holder intends to change itsname (legal entity or doing business as) but does not undergo a change of ownership, the change must reportthe name Another license will be issued to reflect thischange.
• Changes in telephone number - Changes in telephone number or operating hours must be submitted inwriting as soon as
• Fax number and email address- report as soon as
• Changes in management - report as soon as
• Changes in Controlling Person (Stock Transfers)- Changes in controlling person, as defined in 26 TAC553.2(b)(16), report as soon as possible.
• Closures- A license holder must notify HHSC in writing about the closure and return

TULIP – The online licensing portal

• The following link will direct you to the TULIP information page:
  https://hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/tulip-online- licensure- application-system
• The following link will direct you to the TULIP website to access the ALF application:
  https://txhhs.force.com/TULIP/s/login/?startURL=%2FTULIP%2Fs%2F&ec=302

Texas does not license or certify Assisted Living managers. Texas requires all Assisted Living managers to have a 24-hour course withing their first year of employment. Proof of completion must be maintained in the AL manager’s personnel file at the community. The 24 hours is broken down into 8 hours of Texas Regulations and 16 hours of administrative overview. The Regs portion must be taken before you start or within 90 days of your start date. The administrative overview course must be taken before or within the first year.

We offer both components virtually on alternating months. You can register for the classes on our website: https://tala.org/assisted-living-manager-courses/

The regulations require AL managers to have 12 hours of Continuing Education Units every year. Below is the regulation. You must have a least two of the listed categories (see below). There are no requirements on where you get these CEUs. TALA offers a yearly conference that provides all the needed CEUs in the month of April. Additionally, HHSC requires you to take a yearly course from them on aging in place and retaliation.

553.253 Employee Qualifications and Training

(a) Manager qualifications. Each facility must designate, in writing, a manager to have authority over the operation.

(3) Continuing education. All managers must show evidence of 12 hours of annual continuing education. This requirement will be met during the first year of employment by the 24-hour Assisted Living management course. The annual continuing education requirement must include at least two of the following areas:

(A) resident and provider rights and responsibilities, abuse and neglect, and confidentiality;

(B) basic principles of management;

(C) skills for working with residents, families, and other professional service providers;

(D) resident characteristics and needs;

(E) community resources;

(F) accounting and budgeting;

(G) basic emergency first aid; or

(H) federal laws, such as the Americans with Disabilities Act of 1990, as amended; the Civil Rights Act of 1991; the Rehabilitation Act of 1973, as amended; the Family and Medical Leave Act of 1993; and the Fair Housing Act, as amended.

553.259 Admission Policies and Procedures (e) (6) After the first year of employment and no later than the anniversary date of the facility manager's hire date, the manager must show evidence of annual completion of HHSC training on aging in place and retaliation.

In addition to the 12 hours of CEUs that all AL managers need you must have 6 hours of dementia care education.

553.301 Manager Qualifications and Training

(a) The manager of the certified Alzheimer's facility or the supervisor of the certified Alzheimer's unit must

be 21 years of age, and have:

(1) an associate's degree in nursing or health care management;

(2) a bachelor's degree in psychology, gerontology, nursing, or a related field; or

(3) proof of graduation from an accredited high school or certification of equivalency of graduation and at

least one year of experience working with persons with dementia.

(b) The manager or supervisor must complete six hours of annual continuing education regarding dementia

care.

When you register online you can submit payment using your credit card. If you didn’t do it when you registered, you can pay by calling in a credit card or you can send a check.

Please make a check payable to Texas Assisted Living Association and mail to:

Texas Assisted Living Association

Attn: Diana Martinez

4505 Spicewood Springs Rd., Suite 350

Austin, TX 78759

To make a payment by credit card, please call Naomi Ball at 512-653-6604 ext. 1.

Texas has a regulation (553.253 (a)(2)(B)) which allows a manager who can show documentation of a previously completed comparable course of study to be exempt from the 24-hour training requirements. Someone coming from another state can probably show that the 16 hours administrative overview is comparable.

Keep in mind that many of the rules in (a)(2) are specific to ALFs.  So, the ones that might be comparable would be “basic principles of management, food and nutrition services, federal laws, with an emphasis on accessibility requirements under the ADA, ethics and financial management”.

The new manager would need to be able to prove the courses are comparable.  The title and or course description needs to be clear that it would be comparable.  This is what a surveyor would probably look for. All the information will need to be in her/his personnel file.

TALA suggests any person coming in from out of state take the 8 hours of Texas regulations.  We don’t see how someone coming from another state or with from a nursing home background could have a comparable course. 

553.253 Employee Qualifications and Training (a) (2)

(A) The course must be at least 24 hours in length.

(i) A manager must complete eight hours of training on the Assisted Living standards within the first three months of employment.

(ii) The 24-hour training requirement may not be met through in-services at the facility, but may be met

through structured, formalized classes, correspondence courses, training videos, distance learning programs, or off-site training courses. All training must be provided or produced by academic institutions, Assisted Living corporations, or recognized state or national organizations or associations. Subject matter that deals with the internal affairs of an organization will not qualify for credit.

(iii) Evidence of training must be on file at the facility and must contain documentation of content, hours, dates, and provider.

(B) A manager who can show documentation of a previously completed comparable course of study are

exempt from the training requirements.

(C) A manager must complete the training required by subparagraph (A) or (B) of this paragraph, as

applicable, by the first anniversary of employment as manager.

(D) An Assisted Living manager who was employed by a licensed Assisted Living facility as the manager and

changes employment to another licensed Assisted Living facility as the manager, with a break in employment

of no longer than 30 days, is exempt from the 24-hour training requirement.

https://tala.org/wp-content/uploads/2022/09/AL-Info-Sheet.April-2022.pdf