Wednesday, March 15, 2023

Texas Assisted Living License Lookup

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Applying for an Assisted Living Facility License

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In the state of Texas, assisted living facilities are licensed as ALFs. The governing body that oversees the licensing for assisted living in the state of Texas is DADS, or Department of Aging and Disability Services. There are 3 separate categories for assisted living in Texas.

ALF or Assisted Living Facility Single Occupancy Assisted Living Apartments and Residential Care Apartments which are double occupancy and Residential Care units or as termed non-apartments.

There are also 2 separate assisted living licensing categories: Category A and Category B. What category of licensing a Texas senior living facility gets is based upon whether or not the occupants can evacuate the premises on their own in an emergency. A Category B license will be given to any senior living facility that advertises or gives personal or specialized services to residents with dementia or Alzheimers.

If a senior living facility is not offering services that require a license, then it is unlawful for them to use the term Assisted Living in any way in their name.

The Community First Choice Program

The Community First Choice program is a lot like the STAR+PLUS HCBS waiver in what it offers, except that CFC is a Medicaid entitlement program, meaning there are no maximum recipient caps and no waiting lists for enrollment. Community First Choice offers Medicaid reimbursement to low-income assisted living residents for the provision of assistance with activities of daily living, such as personal grooming tasks, mobility, and basic house chores. People already enrolled to receive other Medicaid waiver services may elect to switch to the Community First Choice Program.

Services provided under the CFC Program may include:

  • Personal assistance with activities of daily living
  • Skills education for self-care and independent living
  • Emergency response services
  • Training for support staff management
  • Consumer-directed service options

Who is Eligible?

Applicants for the Community First Choice program must qualify for Medicaid and must be assessed by a physician as nursing home-eligible. Coverage of personal care services through this program is provided based on an assessment of which services an individual requires.

How to Apply

Interested parties can apply online at, or call 2-1-1 for guidance and consultation. Your local Area Agency on Aging can also help with Medicaid and non-Medicaid applications. To initiate an assessment and determine your eligibility, consult the directory in this guide to find a nearby Area Agency on Aging.

The Limitations Of Rules And Regulations

It’s great to be knowledgeable about the assisted living and nursing home rules in your state. However, just because these rules exist doesn’t mean they offer 100% protection. Some issues include these:

  • New situations: Many facilities were unprepared for COVID-19.
  • Issues that go beyond rules and regulations: Understaffing is one of several chronic problems. A facility could be staffed at the right level according to rules and still be stretched thin.
  • Samples vs. all residents: During inspections, teams look at a sample of residents instead of at each and every resident. Sampling makes inspections more expedient but increases the likelihood that violations are missed.
  • Inconsistent rule following: If a facility has just undergone an inspection, it may let its guard down in some areas.
  • Human nature: When an inspection takes place, it’s usually a team effort . A team minimizes the chances of oversight, but there’s always the chance that someone overlooks a violation.
  • Redress of violations: When an inspection uncovers violations, facilities usually have a set period of time to address these issues. That period of time might seem too long to some residents/families. Plus, there might not even be penalties, depending on the infraction and its severity.
  • Transparency of rules and regulations: It’s not always easy to find inspections reports or information on violations.

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Area Agencies On Aging

The AAA is a national, federally funded organization. It acts as a central agency, unifying hundreds of community outreach programs and supports for citizens over 60 years of age. Texas hosts 27 Area Agencies on Aging, making this a convenient resource for people in all regions of the state.

Area Agency on Aging

Background Checks For Assisted Living

The Waterton Inn Assisted Living in Tyler, TX (Texas ...

Before someone can be hired for work in any position at a Texas ALF, they must undergo a multi-faceted background check. Facilities must check prospective employees criminal history, Employee Misconduct Registry status, and Nurse Aide Registry status.

  • The Texas Department of Public Safety Crime Record Service is used to look for any criminal acts in an applicants past, especially any involving assault, abuse, or neglect.
  • The Employee Misconduct Registry ensures that personnel who have committed abusive, exploitive, or neglectful acts against consumers cannot find employment at a long-term care facility.
  • The Nurse Aide Registry is a credential management system, and checking it ensures that all personnel have the proper licensure.

Though all Texas ALF employees are required to be subject to an extensive background check, independent contractors who may be working on facility grounds are not subject to the same requirement.

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Nursing Home Vs Assisted Living: The Differences Matter

Many folks use the terms, nursing home and assisted living, interchangeably. This is understandable, especially since some assisted living facilities provide memory care or low-level nursing care. However, the distinction matters quite a bit, especially with regulations and cost.

Some quick background: Skilled nursing facilities and assisted living facilities are part of the many Continuing Care Retirement Communities across the United States. These communities offer a continuum of housing and care so residents can stay in the same place if their needs change or live near a spouse with different care needs. Of course, plenty of standalone skilled nursing facilities exist, as do standalone assisted living facilities.

State Medicaid programs for assisted living may require that participants meet what’s called a nursing home level of care. That doesn’t mean these folks need skilled nursing care around the clock. Rather, it typically means they cannot perform two of the activities of daily living . Criteria varies by state and program. For example, one state may require the inability to perform two ADLs, while just one ADL suffices in another state.

If you have second thoughts about entering a nursing home, chances are you mean assisted living and not skilled nursing. Check out the table below for a refresher on the differences.

Assisted Living Admission Requirements

An assisted living facility cannot accommodate residents whose medical needs exceed the capabilities of staff unless a resident is covered by a licensed home health agency. Home health agencies can be hired by residents with greater care needs, although there are limitations on residency in an ALF for more fully disabled individuals. The state of Texas determines the extent of care available at ALFs by designating two levels of assistance, Type A and Type B, with Type A residents not requiring the added assistance of a home health agency.

Residents cannot be admitted to an ALF if they are permanently bedridden, or if their medical needs cannot be met by the facility or by a contracting home health agency.

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Assisted Living Disclosures And Costs

Assisted living facilities must give prospective residents disclosure documents that detail the charges and fees for the different services available. This information should be in contracts, too.

If you’re just in the search stage, you’ll have to contact facility administrators to get specifics on charges. Only two states’ assisted living websites offer data on facility pricing . Cost is definitely something to pay extra attention to in disclosure documents and during conversations with administrators. Also, look over the sections having to do with eviction so you understand what happens if you cannot pay any longer.

When you’re about to sign a contract, review it carefully. Too many folks seal the deal in a hurry and don’t fully understand everything they’re on the hook for.

How Do I Use The Provider Location Search

Assisted Living License: How to apply for an ALL Provisional License
  • Enter the city, county or ZIP code where you want to receive services.
  • Choose the type of service you are looking for from the drop down list, such as a nursing home or home health provider.
  • A results page will give you a sortable list of the providers or facilities that fit the options you chose.
  • Note: You can search for only 1 type of provider or facility at a time. For example, you can’t search for both nursing homes and assisted living facilities or home health and adult day programs at the same time.

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    The Aging & Disability Resource Center

    This center was opened by the HHS as part of the national No Wrong Door initiative, and it is intended to streamline public access to resources and information concerning long-term services and supports. The Aging & Disability Resource Center helps to reduce confusion and facilitate access to care for long-term care recipients in all 254 counties of Texas.

    Contact them by calling YES-ADRC, or 937-2372. Find out more online by visiting

    Hospital And Health Facility License Lookup

    Licensing requirements for hospitals and other types of health facilities vary from State to State. Generally, each State offers online license lookup or verification of multiple types of healthcare facilities, including hospitals, through a common portal. All resources listed below include hospital license verification information and may include license lookup information about other types of health facilities, including, but not limited to, surgery centers, nursing homes, assisted living center, substance abuse treatment facilites, hospices, home health agencies, and end-state renal disease treatment centers. To find National Provider Identifier numbers, go to NPI NUMBER Lookup.

    links manually checked September 13, 2021

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    Assisted Living Medicaid Policy

    Unlike some other states, Texas does not provide Medicaid reimbursement to ALF residents unless they have a very low income or are Home- and Community-Based Services waiver recipients. Only nursing-home eligible residents can receive waiver services, and these individuals must reside in Type B assisted living communities. Waiver services are provided by managed care organizations, and all services they provide, such as personal care and medication assistance, can be reimbursed through Medicaid.

    Free Assisted Living Resources In Texas

    Texas drivers license gets makeover

    Texas is home to hundreds of nonprofits and government resource providers that assisted living residents can look to for added support. Some of these organizations, like the Area Agencies on Aging, operate in every state across the country, while others are dedicated only to specific regions in the state of Texas. All of these services are free to use. However, some organizations listed here may have income and health-related requirements intended to preserve resources for those who are most in need.

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    How To Start An Independent Living Home In Texas

    Independent living homes provide supervision and assistance with activities of daily living to elderly or disabled people who may not be able to live alone safely. According to Texas Health and Safety Codes, these homes are referred to and licensed as assisted living facilities. The Department of Aging and Disability Services oversees the licensing and operations of independent or assisted living homes. To open this type of facility in Texas, you must comply with the requirements set forth for by DADS and the general business requirements of both the state of Texas and your local city and county governments.


    Visit the DADS website and complete the computer-based Assisted Living Facility Pre-Licensure Training. You must verify completion of this training before applying for licensure. In addition, research and review the laws governing assisted living facilities in Texas, specifically personnel qualifications, building codes and service requirements. These can be found in the Texas Health and Safety Code, Chapter 247 and in the Texas Administrative Code, Title 40.




    File an Assumed Name with your local county clerk’s office. Assisted living homes operating as anything other than a sole proprietorship or partnership must also register the appropriate business entity papers with the Texas Secretary of State. Additionally, ask the county clerk about any local business licenses or permits you may need.






    Assisted Living Licensing & Reports: Texas

    When choosing assisted living care, consumers are reliant on their states regulatory agencies to provide information about communities and their backgrounds. Public access to assisted living records varies greatly state by state. Here is a snapshot of the level of transparency in the state of Texas:

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    Looking Up Facility Ratings And Complaints In Texas

    Another video in our series on how to look up facility information, including ratings, inspections and complaints using trusted, State of Texas resources and data:

    We think that one of the most important aspects about searching for assisted living, is to look into what type of track-record facilities that you are interested in have.

    Most states, including Texas, offer information and details concerning surveys, inspections, complaints and enforcement actions on most care facility types, including assisted living facilities.

    Unfortunately, as we have found, most people dont know that this information exists, or that it is readily accessible to the general public. Even more unfortunate is that there are often-times companies that will charge to provide this information to consumers, when it is easily available to the general public free-of-charge.

    Most of the time, you simply need to look at a states Department of Health or Office on Aging website to find this information. For Texas, we found it here:

    Our video will show you how to look up facilities by county, city or zip code, and how to discover whether a facility has had any complaints or enforcement actions taken against it.

    This is also a great way to double-check information that you may have found elsewhere. We hope our video is a helpful guide for you to further your senior care research in Texas.

    What Is An Assisted Living Facility

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    Assisted living facilities provide individualized health and personal care assistance in a homelike setting with an emphasis on personal dignity, autonomy, independence and privacy. Facilities can be large apartment-like settings or private residences. Services include meals, bathing, dressing, toileting and administering or supervising medication.

    Texas Health and Human Services licenses assisted living facilities based on residents’ physical and mental ability to evacuate the facility in an emergency and whether nighttime attendance is necessary.

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

    The Assisted Living Facility Information brochure explains the variety of assisted living facilities available in Texas, who they care for, and the services they provide. Assisted living facilities are regulated under Health and Safety Code, Chapter 247 and Texas Administrative Code, Title 26, Part I, Chapter 553.

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    When Nursing Homes Do Not Comply With Rules

    If a survey finds that nursing homes are out of compliance, what happens depends on how serious the non-compliance is. An immediate jeopardy finding means that temporary management could be appointed while the nursing home remedies its deficiencies. Otherwise, the facility is terminated from the Medicare and Medicaid programs and the residents moved elsewhere.

    • Immediate jeopardy means that there’s a reasonable expectation that residents would die or become seriously injured or impaired if adverse circumstances persist.8
    • Nursing homes can still receive Medicare and Medicaid funding for as long as six months after an immediate jeopardy finding if it’s in the best interest of residents to stay put . The facility must repay funds received during this period if it doesn’t correct its deficiencies during an approved timetable.
    • If a survey reveals deficiencies but they’re not immediate jeopardy, the nursing home has up to six months to undertake corrective action.
    • Civil money penalties can be imposed, with the range for immediate jeopardy being $6,525 to $21,393 per deficiency. Penalties range from $107 to $6,417 for deficiencies that caused harm or had the potential to cause more than minimal harm.
    • Part of these CMP funds go back to the states to enhance nursing home care.
    • Nursing homes found persistently deficient on three standard surveys in a row are subject to state monitoring and denial of Medicare and Medicaid payments.

    Top 10 Assisted Living In Texas

  • Esdras Mendoza
  • Esdras Mendoza provides assisted living services in San Antonio, Texas. It can house a maximum of 12 senior citizens at a time. With a location at 4618 Manitou, in the 78228 area code inside Bexar county, Esdras Mendoza assists those older adults who need assistance with activities of daily living. Some of the amenities offered by Esdras Mendoza include 24 hour staff, walking gardens and emergency pendants. Esdras Mendoza has an active license by Texas to provide assisted living care, with license number 101083.

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    Medical Qualifications For Assisted Living

    You must qualify medically for Medicaid/a waiver program to pay for assisted living services in any form. Often , you must meet what’s called a nursing home level of care. That doesn’t mean you need skilled nursing facility care or similar 24-hour medical care. Rather, in many states, it means you can’t perform at least two of the activities of daily living. Criteria varies by state and program, so one state may require the inability to do two ADLs, while just one ADL may suffice in another state.

    It is usually professionals such as nurse practitioners and social workers who certify you’re unable to carry out these ADLs. Get started as soon as possible to expedite the process and save money. Ask your physician to refer you for an assessment or to otherwise get the ball rolling.

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