Last updated 2026-07-26
TL;DR
Texas doesn't issue a separate "assisted living manager license." Instead, HHSC requires the person running an assisted living facility to complete a state-approved manager training program under 26 TAC Chapter 553, or hold a nursing facility administrator license if the facility also serves that population. Requirements, hours, and renewal timelines vary by facility type.
What is an "assisted living manager license" in Texas, exactly?
Texas doesn't have a standalone credential called an "assisted living manager license" the way some states do. What Texas actually requires is that every licensed assisted living facility have a manager who has completed HHSC-approved manager training, under the rules in 26 Texas Administrative Code Chapter 553 (Assisted Living Facilities) [1]. The manager is the person HHSC treats as legally responsible for day-to-day operation of the facility, whether that person is also the owner or a hired employee. Separately, Texas licenses nursing facility administrators through the Texas Health and Human Services Commission under Chapter 242 and the related administrator licensing rules, and that's a true individual license with an exam, continuing education, and renewal cycle [2]. If your facility is a nursing home, or you're moving between nursing home and assisted living management, you'll run into that licensing board instead. Most people searching "assisted living manager license Texas" actually need the Chapter 553 manager training requirement, not the nursing facility administrator license, so that's the main focus here. Confirm with your state licensing agency which pathway applies to your specific facility type before you enroll in any training program, because HHSC periodically updates approved course lists and hour requirements.
What is assisted living?
Assisted living is a licensed residential care setting for adults who need help with daily activities like bathing, dressing, medication reminders, and meals, but who don't need the level of skilled nursing care a nursing home provides. Texas defines it through HHSC's assisted living facility license categories, which cover Type A, Type B, and Type C facilities based on the residents' mobility and evacuation capability [1]. A Type A facility serves residents who can evacuate a building on their own in an emergency without physical help. Type B facilities serve residents who need help evacuating, including some people with dementia. Type C, sometimes called adult foster care, is a small home setting of four or fewer residents. Each type has different staffing ratios and physical plant rules under Chapter 553. Assisted living sits between independent living and nursing home care on the spectrum. It's not a hospital-adjacent model. Think of it as supported housing with services layered in, not medical treatment.
What is a group home?
"Group home" is a broad term that usually means a small residential setting, often a single house, where a handful of people with disabilities, mental illness, or age-related needs live together with staff support. In Texas, depending on the population served, a group home might be licensed as a Type C assisted living facility (adult foster care model), an HCS (Home and Community-based Services) provider site for people with intellectual and developmental disabilities, or under separate behavioral health licensing rules. The term isn't a legal license category by itself in Texas. What license you actually need depends entirely on who lives there and what services you provide. A home for four seniors needing help with daily living tasks is a very different license application than a home for adults with IDD receiving Medicaid waiver services through HHSC's IDD program. If you're comparing group home models against traditional assisted living licensing, the assisted living facility overview breaks down how facility type drives which rules apply.
What is an assisted living facility?
An assisted living facility, under Texas law, is any establishment that furnishes food, shelter, and personal care services to four or more people who aren't related to the operator, and that isn't licensed as a nursing home or ICF/IID. Texas Health and Safety Code Chapter 247 is the statute that authorizes HHSC to license and regulate these facilities [3]. The statute's definition matters because it triggers licensing. Under Section 247.002, a facility qualifies as an assisted living facility if it provides personal care services (assistance with at least two activities of daily living) to four or more unrelated residents [3]. Fewer than four residents, or services limited to housing without personal care, may fall outside the licensing requirement, but don't assume that without checking with HHSC directly, because enforcement interpretations shift and local zoning rules can still apply even when state licensing doesn't. HHSC's current fee schedule, application forms, and facility type descriptions live on the agency's assisted living licensing page, and that's the first stop before you draft a business plan [4].
What is assisted living facility care actually provide?
Assisted living provides help with activities of daily living (bathing, dressing, toileting, transferring, eating), medication management or reminders, meals, housekeeping, laundry, social activities, and 24-hour staff availability for supervision and emergencies. It does not typically provide skilled nursing care, IV therapy, ventilator support, or the kind of medical monitoring a nursing home offers. Texas rules require assisted living facilities to have staff awake and available around the clock in Type B and C facilities, and to maintain specific staff-to-resident ratios that scale with resident acuity and the facility's licensed capacity [1]. A Type A facility, since residents are more independent, has somewhat lighter staffing rules than Type B, where residents may need physical assistance to evacuate. Medication administration is a common gray area. Texas allows certain unlicensed staff to perform "medication administration" tasks in assisted living settings after completing a state-approved medication aide training program, separate from nursing licensure, under rules administered by HHSC and the Texas Board of Nursing's delegation framework. If your facility plans to handle medications beyond simple reminders, get clear on which staff certifications that requires before you open.
How to start a group home in Texas: the licensing sequence
Starting a group home or assisted living facility in Texas runs through several sequential steps, and skipping ahead usually costs you time later. Here's the realistic order. 1. Decide your population and facility type. Seniors needing personal care, adults with IDD, mental health recovery residents, and adult foster care each point to different HHSC license categories or different state agencies entirely. 2. Check zoning and building code fit before you sign a lease or buy property. A residence zoned single-family may or may not allow a licensed group home under local ordinance, and Texas has some state preemption protections for small group homes serving people with disabilities, but you still need to confirm locally. 3. Complete manager training. For assisted living facilities, the designated manager must complete HHSC-approved training that covers state rules, resident rights, medication rules, and emergency preparedness, consistent with Chapter 553 requirements [1]. 4. Submit the license application to HHSC, including facility floor plans, fire marshal approval, staffing plan, policies and procedures manual, and the application fee. HHSC's licensing page lists current forms and fee amounts, and those change periodically, so pull the current fee schedule rather than relying on older articles [4]. 5. Pass a pre-licensing inspection. HHSC surveyors check life safety code compliance, staffing documentation, and policy manuals against the rules before issuing the license. 6. Hire and train direct care staff, and get your first cohort of residents assessed and admitted under the resident agreement rules required by Chapter 247. Building the policy manual and staffing plan from scratch is where most first-time operators lose the most time. If you want a structured starting point instead of building every document from a blank page, our $299 State Group Home Licensing Kit gives you state-specific application checklists and policy templates to adapt, though you'll still need to confirm current fees and forms directly with HHSC before submission.
What's the difference between assisted living and a nursing home?
| Governing statute | Health and Safety Code Ch. 247 [3] | Health and Safety Code Ch. 242 [5] | |
|---|---|---|---|
| Care level | Personal care, ADLs, med reminders | Skilled nursing, medical treatment | |
| Manager credential | HHSC-approved manager training | Licensed nursing facility administrator [2] | |
| Staffing | Direct care staff, awake overnight staff | Licensed nurses on duty, RN/LVN required | |
| Typical payer | Private pay, some Medicaid waiver programs | Medicare (short-term), Medicaid, private pay | Many residents move from assisted living to a nursing home as their medical needs increase, which is why some operators eventually pursue both licenses under one company, though that means managing two separate regulatory relationships with HHSC. |
The core difference is the level of medical care. Assisted living is personal care and supportive housing. A nursing home (skilled nursing facility) provides 24-hour licensed nursing care, rehabilitation services, and medical treatment for residents who need ongoing clinical management. Texas licenses nursing homes under Health and Safety Code Chapter 242, separate from the Chapter 247 assisted living statute [3][5]. Nursing home administrators need a state license through the nursing facility administrator licensing program, which involves education requirements, an exam, and continuing education, a heavier regulatory lift than the assisted living manager training requirement [2]. | Feature | Assisted living (Texas) | Nursing home (Texas) |
Does Medicare cover assisted living facilities in Texas?
No. Medicare does not cover the cost of room, board, or personal care services in assisted living, in Texas or any other state. CMS is direct about this: Medicare covers medically necessary skilled nursing care in a certified skilled nursing facility for a limited period after a qualifying hospital stay, but it does not pay for custodial or personal care in assisted living settings [6]. Medicare.gov states plainly that "Medicare doesn't cover room and board costs for long-term care or assisted living" [7]. This is one of the most common financial misunderstandings families run into when researching senior care. Medicaid is a different story, but only partially. Texas Medicaid, through the STAR+PLUS waiver program, can cover some personal care services delivered inside certain licensed assisted living or adult foster care settings, but it does not pay for room and board in most cases. HHSC's STAR+PLUS program page describes which service categories the waiver actually funds [8]. If your business model depends on Medicaid waiver reimbursement, get specific about which services are covered and which aren't before you build your budget around it, because room and board is usually the resident's or family's financial responsibility regardless of Medicaid eligibility.
How do I start a group home if I'm serving people with IDD instead of seniors?
If your group home will serve adults with intellectual or developmental disabilities, you're likely looking at HHSC's Home and Community-based Services (HCS) program or the ICF/IID licensing track, not the assisted living Chapter 247/553 pathway described above. These have separate provider enrollment processes, separate training requirements for direct support staff, and separate inspection standards focused on person-centered planning and behavior support rather than the ADL-focused assisted living model. The practical steps look similar on the surface (pick a property, secure zoning approval, build a staffing and policy plan, apply for licensure, pass inspection), but the specific forms, training hours, and Medicaid enrollment steps differ substantially. Don't assume your assisted living manager training satisfies IDD group home staff training requirements. It doesn't. If you're weighing which population and license track fits your goals, the assisted living facilities overview and facility assisted living guide both cover how facility type decisions cascade into licensing choices.
What training or hours does the Texas assisted living manager need to complete?
HHSC requires the designated manager of a licensed assisted living facility to complete an approved orientation and training program before or shortly after taking on the role, covering topics like resident rights, medication rules, emergency preparedness, infection control, and the specific requirements of the facility's license type (A, B, or C) under 26 TAC Chapter 553 [1]. The exact hour requirement and renewal cycle for manager training is set in the current HHSC rule text and provider guidance, and HHSC updates approved training vendor lists periodically. Rather than quoting a specific hour count here that could be outdated by the time you read this, confirm the current requirement directly on HHSC's assisted living licensing and training pages [1][4], since acting on a stale number is worse than checking first. Managers of Type B facilities, which serve residents needing evacuation assistance, typically face additional training content around mobility assistance and emergency response compared to Type A managers, reflecting the higher acuity of residents in that setting.
What does the assisted living license application actually require in Texas?
A complete Texas assisted living facility license application generally includes: a completed HHSC application form, the facility's floor plan and fire marshal life safety inspection approval, proof of the manager's completed training, a staffing plan showing coverage by shift, a policies and procedures manual covering resident rights, medication management, emergency preparedness, and incident reporting, and the applicable license fee [1][4]. HHSC also conducts a pre-licensing survey of the physical building and records before issuing the initial license. Deficiencies found at this stage are common for first-time applicants, usually around fire safety details, staffing documentation gaps, or incomplete policy manuals rather than anything exotic. Because fee amounts and specific form numbers change over time, always pull the current fee schedule and forms list from HHSC's own licensing page rather than trusting a fixed number in any third-party article, including this one [4].
What happens at inspection, and how often does Texas inspect assisted living facilities?
HHSC conducts both the initial pre-licensing survey and ongoing periodic inspections of licensed assisted living facilities, along with complaint-driven investigations when a report comes in. Inspectors check life safety code compliance, staffing ratios against the census, medication management practices, resident records, and whether the facility's actual operations match its policy manual. Deficiencies get documented in a statement of deficiencies, and the facility submits a plan of correction with a timeline. Repeated or serious violations can lead to enforcement action, including license suspension or revocation in serious cases, under HHSC's enforcement authority in Chapter 247. Keeping your policy manual current and matching it against your actual day-to-day practice before an inspector arrives is the single best preparation move. Manuals that were accurate at opening but never got updated as staffing or procedures changed are the most common inspection headache operators create for themselves.
Frequently asked questions
What is assisted living, in plain terms?
Assisted living is housing with built-in personal care support for adults who need help with daily tasks like bathing, dressing, or medication reminders but don't need 24-hour skilled nursing care. In Texas, it's licensed by HHSC under Health and Safety Code Chapter 247, with facility types A, B, and C based on residents' evacuation ability.
What is a group home?
A group home is a small residential setting where several unrelated people with disabilities, mental illness, or age-related needs live together with staff support. It's not a single legal license category; in Texas, the applicable license depends on the population served, whether that's assisted living, IDD services, or another category.
What is the difference between assisted living and a nursing home?
Assisted living provides personal care and supportive housing; nursing homes provide 24-hour skilled nursing and medical treatment. Texas licenses them under separate statutes (Chapter 247 for assisted living, Chapter 242 for nursing homes), and nursing home administrators need a distinct state license with exam and continuing education requirements.
Does Medicare cover assisted living facilities?
No. Medicare.gov states directly that Medicare doesn't cover room and board for assisted living or long-term custodial care. Medicare only covers short-term skilled nursing care after a qualifying hospital stay, in a certified skilled nursing facility, not assisted living room and board or personal care services.
How do I start a group home in Texas?
Pick your resident population and facility type, confirm zoning fit, complete required manager training, submit your HHSC license application with floor plans and a staffing/policy plan, pass the pre-licensing inspection, then hire and train staff before admitting residents. The exact license track depends heavily on who you plan to serve.
Is there a separate "assisted living manager license" exam in Texas?
Not in the way nursing facility administrators have a licensing exam. Assisted living managers in Texas complete HHSC-approved manager training covering resident rights, medication rules, and emergency preparedness under Chapter 553, rather than sitting for a standalone licensing exam like nursing facility administrators do.
Can the facility owner also be the manager?
Yes, in most cases the owner can serve as the facility's designated manager as long as they complete the required HHSC-approved manager training. Larger facilities or multi-site operators sometimes hire a separate manager instead, but Texas rules don't require the owner and manager to be different people.
What's the difference between Type A, Type B, and Type C assisted living facilities in Texas?
Type A serves residents who can evacuate independently in an emergency. Type B serves residents who need physical help evacuating, often including people with dementia. Type C is a small adult foster care home model licensed for four or fewer residents. Staffing and physical plant rules differ by type under 26 TAC Chapter 553.
Does Medicaid pay for assisted living in Texas?
Texas Medicaid, through the STAR+PLUS waiver program, can cover certain personal care services delivered in some licensed assisted living or adult foster care settings, but it generally does not cover room and board. Confirm current covered services directly with HHSC's STAR+PLUS program materials before budgeting around Medicaid revenue.
What license does someone need to run a nursing home instead of assisted living in Texas?
Nursing homes require a licensed nursing facility administrator, a distinct individual license under Texas's administrator licensing program that involves education requirements, a state exam, and ongoing continuing education. This is separate from and more extensive than the assisted living manager training requirement.
How much does it cost to get an assisted living facility licensed in Texas?
Fees vary by facility type and change periodically, so there's no single reliable number to quote. Confirm the current application and license fee schedule directly on HHSC's assisted living facility licensing page before budgeting, since older published figures may no longer be accurate.
What documents does HHSC require for the assisted living manager training requirement?
HHSC expects proof that the designated manager completed an approved training program covering resident rights, medication management rules, emergency preparedness, and facility-type-specific requirements. Keep the training certificate and course documentation on file, since inspectors check for this during licensing surveys and periodic inspections.
Sources
- Texas Administrative Code, Title 26, Chapter 553 (Assisted Living Facilities): Texas assisted living facility rules, facility types, and manager training requirements
- Texas HHSC, Nursing Facility Administrator Licensing: Nursing facility administrators require a separate individual license with exam and continuing education
- Texas Health and Safety Code, Chapter 247 (Assisted Living Facilities): Statutory definition of assisted living facility and four-or-more-unrelated-residents licensing trigger
- Texas HHSC, Assisted Living Facilities licensing page: Current license application forms, fee schedule, and training vendor information
- Texas Health and Safety Code, Chapter 242 (Nursing Facilities): Statutory basis for nursing home licensing separate from assisted living
- CMS, Medicare & You Handbook: Medicare coverage limits for skilled nursing facility care after a qualifying hospital stay
- Medicare.gov, Long-term care coverage: Medicare does not cover room and board costs for long-term care or assisted living
- Texas HHSC, STAR+PLUS Program: STAR+PLUS Medicaid waiver may cover certain personal care services but not room and board