In Texas, the license families see for assisted living is "Assisted Living Facility (Type A or Type B)", issued by the Texas Health and Human Services Commission (HHSC). Each resident must have a health examination by a physician within 30 days before or 14 days after admission, unless a transferring hospital or facility has a physical exam in the medical record. Except in an emergency, a community must give the resident, legal representative or a family member written notice at least 30 days before a transfer or discharge.
Key facts
- The median monthly cost of assisted living in Texas was $5,666 in CareScout's 2025 Cost of Care Survey, or $67,992 a year, $534 below the national median of $6,200 a month. (CareScout, 2026)
- Texas Medicaid's STAR+PLUS Home and Community Based Services (HCBS) program can cover assisted living services in a licensed facility that contracts with the member's managed care plan. (Texas HHSC, 2023)
- Each community must have written policies that address TB screening, and its TB screening of residents must follow the resident's doctor's recommendations and CDC guidelines. (26 Tex. Admin. Code 553.261, 2021)
- Only a licensed person such as a nurse, a staff member with a medication aide permit working under a nurse, or an employee a registered nurse has delegated the task to may administer medications. (Texas HHSC, 2023)
- A community that advertises or promotes memory care for people with Alzheimer's disease or related disorders must give each resident the Assisted Living Facility Memory Care Disclosure Statement and say whether it is Alzheimer's certified. (26 Tex. Admin. Code 553.259, 2022)
Texas calls it an assisted living facility, licensed by HHSC as Type A (residents can leave in an emergency without staff help and need no routine night care) or Type B (residents may need help to leave and night care, but are not permanently bedfast). The facts below apply to both, and only Type B can be Alzheimer's certified.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the Texas Health and Human Services Commission (HHSC). This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Each resident must have a health examination by a physician within 30 days before or 14 days after admission, unless a transferring hospital or facility has a physical exam in the medical record. Within 14 days of admission, the community must also complete a comprehensive assessment and a service plan based on it. [3] More on this |
|---|---|
| TB test | Each community must have written policies that address TB screening, and its TB screening of residents must follow the resident's doctor's recommendations and CDC guidelines. The rule does not name a specific test or deadline for new residents. [4] More on this |
| Notice before a move-out | Except in an emergency, a community must give the resident, legal representative or a family member written notice at least 30 days before a transfer or discharge. Allowed reasons are needs it cannot meet, improved health, danger to the resident's or another resident's health and safety, closing or leaving the program that pays, or not paying after reasonable notice. [5] More on this |
| Who may give medications | Only a licensed person such as a nurse, a staff member with a medication aide permit working under a nurse, or an employee a registered nurse has delegated the task to may administer medications. Unlicensed staff may give insulin injections for diabetes only if a registered nurse delegates the task and the resident's condition is stable and predictable. [6] More on this |
| Memory care and dementia | A community that advertises or promotes memory care for people with Alzheimer's disease or related disorders must give each resident the Assisted Living Facility Memory Care Disclosure Statement and say whether it is Alzheimer's certified. A certified community must also give HHSC Form 3641, Alzheimer's Assisted Living Disclosure Statement. [3] |
| Long-term care ombudsman | The free, confidential State Long-Term Care Ombudsman program advocates for people who live in assisted living facilities, and you can call 800-252-2412 to reach an ombudsman in your area. [7] Official page More on this |
| Medicaid help | Texas Medicaid's STAR+PLUS Home and Community Based Services (HCBS) program can cover assisted living services in a licensed facility that contracts with the member's managed care plan. The member pays room and board and possibly a copayment based on income. [8] Official page More on this |
What assisted living costs in Texas
The median monthly cost of assisted living in Texas was $5,666 in CareScout's 2025 Cost of Care Survey, or $67,992 a year, $534 below the national median of $6,200 a month. [12]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in Texas
Look up licensed assisted living facilities in HHSC's Long-term Care Provider Search. Complaint information and investigation reports for a facility can be requested from HHSC by email, fax or mail. Search Texas's records. [2]
The licensing agency: Texas Health and Human Services Commission (HHSC). [1] Our guide on how to read an inspection report explains what to look for.
Put Texas's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in Texas?
The median monthly cost of assisted living in Texas was $5,666 in CareScout's 2025 Cost of Care Survey, or $67,992 a year, $534 below the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does Texas require before moving into assisted living?
Each resident must have a health examination by a physician within 30 days before or 14 days after admission, unless a transferring hospital or facility has a physical exam in the medical record. Within 14 days of admission, the community must also complete a comprehensive assessment and a service plan based on it.
Does Texas require a TB test for assisted living?
Each community must have written policies that address TB screening, and its TB screening of residents must follow the resident's doctor's recommendations and CDC guidelines. The rule does not name a specific test or deadline for new residents.
How much notice must an assisted living community in Texas give before a move-out?
Except in an emergency, a community must give the resident, legal representative or a family member written notice at least 30 days before a transfer or discharge. Allowed reasons are needs it cannot meet, improved health, danger to the resident's or another resident's health and safety, closing or leaving the program that pays, or not paying after reasonable notice.
Who can give medications in assisted living in Texas?
Only a licensed person such as a nurse, a staff member with a medication aide permit working under a nurse, or an employee a registered nurse has delegated the task to may administer medications. Unlicensed staff may give insulin injections for diabetes only if a registered nurse delegates the task and the resident's condition is stable and predictable.
Who can help with a complaint about assisted living in Texas?
The free, confidential State Long-Term Care Ombudsman program advocates for people who live in assisted living facilities, and you can call 800-252-2412 to reach an ombudsman in your area.
Does Medicaid pay for assisted living in Texas?
Texas Medicaid's STAR+PLUS Home and Community Based Services (HCBS) program can cover assisted living services in a licensed facility that contracts with the member's managed care plan. The member pays room and board and possibly a copayment based on income.
Sources
- Texas HHSC: Long-Term Care Facility Regulation Fact Sheet, published by the State Long-Term Care Ombudsman (2025) (checked October 22, 2026)
- Texas HHSC, TULIP: LTC Provider Search, Resources: Requesting Additional Information (2024) (checked October 22, 2026)
- 26 Tex. Admin. Code 553.259(a)(4), (a)(5) and (b), Admission Policies and Procedures (via Cornell LII), 2022 (checked October 22, 2026)
- 26 Tex. Admin. Code 553.261(f)(4), Coordination of Care, Infection Prevention and Control (via Cornell LII), 2021 (checked October 22, 2026)
- 26 Tex. Admin. Code 553.267(a)(3)(X) and (Y), Rights (via Cornell LII), 2021 (checked October 22, 2026)
- Texas HHSC: Assisted Living Facility Frequently Asked Questions, RN Delegation and Medication FAQs (updated October 2023) (checked October 22, 2026)
- Texas State Long-Term Care Ombudsman: Homepage (2026) (checked October 22, 2026)
- Texas HHSC: STAR+PLUS Handbook, 7200 Assisted Living Services (rev. 2023) (checked October 22, 2026)
- 26 Tex. Admin. Code 553.5, Types of Assisted Living Facilities (via Cornell LII), 2021 (checked October 22, 2026)
- 26 Tex. Admin. Code 553.3(8), Definitions: Alzheimer's facility (via Cornell LII), 2022 (checked October 22, 2026)
- Texas HHSC, TULIP: How to use the LTC Search Page (2024) (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)