Last updated 2026-07-25
TL;DR
Texas doesn't publish a single downloadable roster, but the Texas Health and Human Services Commission (HHSC) runs a free online search of every licensed assisted living facility, showing license type, capacity, and inspection history. Search it directly at HHSC's facility search tool rather than trusting third-party directories, which often list closed or unlicensed operations.
Where do I find the official list of licensed assisted living facilities in Texas?
Texas Health and Human Services Commission (HHSC) maintains the only authoritative list, and it lives inside their online search system, not as a static spreadsheet you can download in one click. The tool is called the HHSC Provider Search / Nursing Facility and Assisted Living search, and it lets you filter by county, city, license type, and capacity. Each record shows the facility's license number, license type (Type A, Type B, or Type C), bed capacity, licensee name, and a link to recent survey and inspection reports. That inspection history is the part most third-party "top assisted living facilities" websites never show you, and it's often the most useful piece of data if you're trying to size up a market before opening your own home. If you're building a business plan or scouting a county for a new facility, don't rely on aggregator sites like Caring.com or A Place for Mom for your list. Those are marketing directories, not regulatory records. They also charge providers to be listed prominently, so the results skew toward whoever pays, not whoever is actually licensed and in good standing. Pull your baseline numbers straight from HHSC. As of HHSC's most recent published counts, Texas licenses well over 2,000 assisted living facilities statewide, a number that shifts monthly as homes open, close, or change ownership [1]. There is no fixed "Texas has exactly X facilities" answer you can quote for more than a few weeks at a time, which is exactly why the live search tool matters more than any printed list.
What is assisted living?
Assisted living is a residential care setting for people who need help with daily activities like bathing, dressing, medication reminders, and meals, but who don't need the round-the-clock skilled nursing care a hospital or nursing home provides. Residents typically live in private or semi-private rooms or apartments and get some combination of personal care, housekeeping, and supervision. Texas defines this formally through its assisted living facility license categories under Texas Health and Safety Code Chapter 247, which HHSC administers [2]. The law requires a license before anyone can advertise, operate, or hold themselves out as providing assisted living services to the public, with narrow exceptions for certain family arrangements and adult foster care settings licensed under a different chapter. If you're researching this because you want to open a home rather than just find one for a family member, start with the state's own framework before you touch a floor plan or a lease. Our assisted living overview walks through how states define the service category, and how that definition drives everything else, staffing ratios, physical plant rules, and inspection frequency.
What is a group home?
A group home is a small residential setting, usually a single-family house or duplex, where a handful of unrelated residents live together with staff support. The term gets used loosely across the industry, but it most often refers to homes serving people with intellectual or developmental disabilities (IDD), behavioral health needs, or recovery populations, as opposed to the senior-focused assisted living model. In Texas, group homes for people with IDD are typically licensed as Intermediate Care Facilities (ICF/IID) or through HHSC's Home and Community-based Services (HCS) waiver program, while adult foster care homes fall under yet another set of rules [3]. Assisted living facilities, by contrast, are licensed specifically under Chapter 247 and tend to serve older adults or people needing personal care rather than clinical or behavioral supports. The practical difference matters most when you're filling out paperwork. A group home operator applying under the wrong license category will get bounced back by HHSC reviewers, sometimes months into the process, because the physical plant requirements, staff training hours, and resident assessment tools differ by category. Confirm which license type actually matches your target population with your state licensing agency before you sign a lease or start a floor plan.
What is an assisted living facility, exactly?
| Type A | Residents who are mobile and don't need overnight physical assistance | Awake staff required but not necessarily awake all night in every configuration | |
|---|---|---|---|
| Type B | Residents who need staff assistance to evacuate or have moderate physical/cognitive limitations | Awake, on-duty staff required 24 hours a day | |
| Type C (adult foster care license, small) | Small home settings, 4 or fewer residents in a family-style home | Different physical plant and staffing thresholds apply | This table reflects HHSC's general license type structure; exact bed counts, staffing hour requirements, and physical plant specifics should always be confirmed against the current Texas Administrative Code and HHSC licensing standards, since agencies update minimum requirements periodically [2] [4]. Every ALF, regardless of type, has to pass an initial life safety and health inspection before HHSC issues a license, and then gets re-inspected on a schedule the agency sets (routine surveys plus complaint-driven visits). If you want the full walkthrough of what an inspector actually checks room by room, our assisted living facility guide covers the standard survey categories most states use. |
An assisted living facility (ALF) is a licensed residential building where operators provide personal care services, supervision, and at least some level of assistance with daily living, to people who live there. Texas breaks its ALF licenses into three types based on resident needs and staffing. | License Type | Who it serves | Key staffing note |
What does assisted living provide, day to day?
Assisted living provides help with what the industry calls activities of daily living (ADLs): bathing, dressing, toileting, transferring, and eating, plus instrumental activities like medication management, housekeeping, laundry, and transportation to appointments. Meals are typically provided in a communal dining setting, and most facilities run some kind of activities or social programming. What assisted living does not typically provide is skilled nursing care. You won't find IV therapy, wound vacs, or ventilator management in a standard ALF; those services usually require either a home health agency working alongside the facility, or a move to a skilled nursing facility. Texas law requires ALFs to have a written resident agreement disclosing exactly which services are included in the base rate and which cost extra, since a lot of consumer complaints trace back to unclear billing for a la carte services [2]. Staffing ratios aren't uniform across states, and Texas doesn't publish one blanket number for "residents per staff member" the way some states do. Instead, the requirement is functional: enough staff, awake and available, to meet the needs of the residents currently in the building, with Type B facilities specifically requiring an awake attendant at all times [4]. That's a meaningfully different compliance standard than a fixed ratio, and it means your staffing plan has to map to actual resident acuity, more than headcount.
What is assisted living vs nursing home, really?
| Care level | Personal care, supervision | Skilled nursing, medical care | |
|---|---|---|---|
| Staffing | Aides, med aides, some LVN/RN oversight depending on state | Licensed nurses on duty, physician oversight | |
| Medicare coverage | Not covered | Short-term skilled stays covered under specific conditions | |
| Medicaid coverage | Varies by state, often via waiver programs | Covered in all states under Medicaid nursing facility benefit | |
| Typical resident | Ambulatory or semi-ambulatory, cognitively intact or mild impairment | Higher acuity, often post-hospital or long-term medical needs | If you're deciding which license path to pursue as an operator, the population you want to serve should drive the decision, not the other way around. Trying to serve nursing-home-level acuity residents in an assisted living license is one of the fastest ways to draw a deficiency citation during survey. |
The short answer: assisted living is for people who need help with daily activities but not medical care, while a nursing home (skilled nursing facility) is for people who need ongoing medical or rehabilitative care from licensed nurses. The regulatory gap between the two is enormous, and it shows up in cost, staffing, and how each is paid for. Nursing homes are licensed under a different set of federal and state rules entirely, and they're subject to Medicare and Medicaid certification requirements that assisted living facilities generally are not. Centers for Medicare & Medicaid Services (CMS) regulates skilled nursing facilities directly because Medicare pays for short-term skilled nursing stays; assisted living has no equivalent federal payment program [5]. | Feature | Assisted Living | Nursing Home |
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board or personal care services in an assisted living facility, full stop. CMS is explicit about this: Medicare Part A and Part B do not pay for long-term custodial care, which is how assisted living is classified [5]. What Medicare does cover, even for someone living in an assisted living facility, is medically necessary services delivered by outside providers: doctor visits, some home health services if the person qualifies, physical therapy, and durable medical equipment. But the facility's monthly rate itself, the part covering the room, meals, and personal care staff, comes out of pocket, through long-term care insurance, or through Medicaid in states that offer an assisted living waiver. Texas Medicaid does have a mechanism for this: the STAR+PLUS Home and Community Based Services (HCBS) program, which can help cover assisted living-type services for eligible low-income Medicaid recipients who qualify for a nursing facility level of care but choose to receive services in a community setting [6]. It is not the same as Medicaid paying nursing home costs outright, and eligibility, waiting lists, and covered services vary. Anyone counting on Medicaid to cover a resident's assisted living costs should confirm current program rules and availability directly with HHSC, since waiver slots are limited and eligibility rules change.
How do I start a group home in Texas?
Starting a group home or assisted living facility in Texas runs through HHSC, and the process generally follows the same skeleton regardless of which license category you're pursuing: pick your population and license type, secure a compliant property, submit your application and required policies, pass a pre-licensing inspection, and get your license issued before you admit a single resident. Here's the rough sequence, though you should confirm every step and current form number with HHSC before committing money: 1. Decide your license type (Type A, Type B, or a related category) based on the population you intend to serve and the level of care you're prepared to staff for. 2. Check local zoning. Group homes often qualify for reasonable accommodation under the Fair Housing Act, but zoning compliance, fire code, and occupancy limits still apply and vary heavily by city and county. 3. Secure and prepare the physical property to meet HHSC's life safety code and physical plant standards for your license type (things like exit width, sprinkler requirements, bedroom square footage per resident, and bathroom counts). 4. Write your policy and procedure manuals: admission and discharge criteria, medication management, emergency preparedness, staff training, resident rights, and abuse/neglect reporting protocols. HHSC reviewers check these documents against the application, more than against a checklist. 5. Hire and document staff qualifications, including required background checks through the Texas Department of Public Safety and the HHSC nurse aide registry check, before you open. 6. Submit your license application to HHSC with the required fee and supporting documents. 7. Pass the pre-licensing survey, an in-person inspection confirming the building and your operations match what you submitted on paper. Expect this whole process to take months, not weeks, especially if this is your first facility. Nobody publishes a reliable average timeline because it depends heavily on how complete your initial application is and how backed up your regional HHSC office is at the time you apply. Budget extra time, not less. This is the exact stage where a lot of first-time operators either overspend on consultants or, worse, submit incomplete paperwork and get sent back to the start of the queue. A structured State Group Home Licensing Kit ($299 one-time) exists specifically to give you the policy manual templates, staffing plan structure, and application checklists so you're not building all of this from a blank page, though it doesn't replace confirming current requirements directly with HHSC.
How do I start a group home if I've never run one before?
If you have zero operational experience, the honest first move is working or volunteering in an existing licensed facility for a few months before you sign a lease on your own. Regulators can tell the difference between an application built on real operational understanding and one built entirely from a template, and it shows up in your policy manual's specificity and in how you answer questions during the pre-licensing interview. Second, line up your money before you line up your paperwork. Between property costs (purchase or lease plus renovation to meet life safety code), staffing during the pre-opening period, licensing fees, insurance, and working capital to cover the gap before you have paying residents, first-time operators consistently underestimate startup costs. There's no single reliable published figure for "how much it costs to open a group home in Texas" because it depends entirely on whether you're buying, leasing, or renovating, and on your license type and bed count; treat any flat number you see online with skepticism. Third, get your zoning and property questions answered before you fall in love with a specific house. A property that looks perfect on paper can fail on setback requirements, parking minimums, or a use classification that doesn't permit residential care in that zone. Our zoning-and-property guides walk through how to vet a property before you commit to it, and it's worth doing that homework before you even talk to HHSC.
How do I check if a specific facility is currently licensed and in good standing?
Use HHSC's provider search tool directly and look up the facility by name, city, or license number. The record will show the current license status (active, pending, revoked, or expired), the license type, and a link to recent inspection and complaint history. Don't rely on a facility's own website or a Google Business listing to confirm licensure status; those can be outdated, and in rare cases a facility keeps operating and advertising for a period after a license lapses or gets revoked before enforcement catches up. If you're a family member vetting a facility, or a competitor doing market research, the inspection history tab is the most revealing part of the record, since it lists specific deficiencies cited during past surveys, more than a pass/fail summary. If you're researching multiple facilities in one county for site selection purposes, the search tool lets you filter by county and license type, which is the closest thing to a real-time "list" you'll get, since HHSC doesn't publish a static downloadable file that stays current for more than a snapshot in time.
What's the difference between assisted living, memory care, and adult foster care in Texas licensing terms?
These three terms get used interchangeably by consumers but mean very different things to a licensing agency. Assisted living (Type A or B) serves people who need help with daily activities but are generally ambulatory or semi-ambulatory. Memory care is typically a specific unit or certification within an assisted living or nursing facility license, addressing residents with Alzheimer's or related dementia, and Texas requires additional disclosure and staff training standards for facilities marketing themselves as memory care providers under Chapter 247 [2]. Adult foster care is its own separate license category in Texas, generally covering smaller, home-like settings, often with lower resident counts than a typical assisted living facility, and it follows a distinct set of physical plant and staffing rules from Chapter 247 ALF licensing [3]. If you're not sure which category your planned home fits, that's a conversation to have with HHSC licensing staff directly, in writing if possible, before you finalize a property or a business plan. Applying under the wrong category is one of the more common and expensive mistakes first-time operators make, since it usually means redoing the physical plant plan from scratch.
Frequently asked questions
What is assisted living?
Assisted living is residential care for people who need help with daily activities like bathing, dressing, and medication reminders but don't need full-time skilled nursing care. Residents live in private or shared rooms and receive personal care, meals, housekeeping, and supervision. In Texas, these facilities are licensed by HHSC under Texas Health and Safety Code Chapter 247.
What is a group home?
A group home is a small residential setting, often a house, where a handful of unrelated residents live together with staff support. The term covers homes for seniors, people with intellectual or developmental disabilities, and behavioral health or recovery populations, and the license category depends heavily on which population the home serves.
What is an assisted living facility?
An assisted living facility is a licensed building where operators provide personal care, supervision, and daily living assistance to residents. Texas licenses ALFs as Type A or Type B depending on residents' mobility and care needs, with Type B requiring awake staff on duty 24 hours a day.
What is assisted living vs nursing home?
Assisted living serves people who need help with daily activities but not medical care; nursing homes serve people who need ongoing skilled nursing or rehabilitative care. Nursing homes have licensed nurses on duty and are Medicare-certifiable for short-term stays, while assisted living is generally private-pay or covered through state Medicaid waiver programs, not Medicare.
Does Medicare cover assisted living facilities?
No. Medicare does not pay for room, board, or personal care in an assisted living facility, per CMS guidance on long-term custodial care. Medicare can cover separate medical services like doctor visits or physical therapy delivered to a resident, but not the facility's monthly rate itself.
How do I start a group home in Texas?
Choose your license type based on the population you'll serve, confirm zoning compliance, prepare a property meeting HHSC's life safety and physical plant standards, write your policy manuals, complete staff background checks, submit your application to HHSC, and pass the pre-licensing survey before admitting residents. Confirm every step and fee with HHSC directly.
How do I start a group home if this is my first facility?
Get hands-on experience in an existing licensed facility first if you can, line up your full startup budget before applying, and nail down zoning and property fit before signing a lease. First-time applicants who submit incomplete or generic paperwork commonly get sent back in the review queue, which costs more time than doing the homework upfront.
Where can I find a list of licensed assisted living facilities in Texas?
The Texas Health and Human Services Commission maintains a searchable online database of every licensed facility, filterable by county, city, and license type, including license status and inspection history. This is the only authoritative source; third-party directory sites are marketing tools, not regulatory records.
What is the difference between Type A and Type B assisted living licenses in Texas?
Type A facilities serve residents who are mobile and generally don't need physical assistance to evacuate in an emergency. Type B facilities serve residents who need staff assistance to evacuate or have greater physical or cognitive limitations, and Type B requires awake staff on duty at all times.
Does Texas Medicaid pay for assisted living costs?
Texas Medicaid doesn't pay assisted living room-and-board costs directly, but the STAR+PLUS Home and Community Based Services program can help cover certain community-based services for eligible low-income Medicaid recipients who qualify for a nursing facility level of care. Eligibility and available slots vary, so confirm current details with HHSC.
How long does it take to get an assisted living license in Texas?
There's no fixed published timeline, since it depends on application completeness, property readiness, and regional HHSC office workload. Expect the process to take months rather than weeks, especially for first-time operators, and build extra time into your opening date projections.
What's the difference between assisted living and adult foster care licensing in Texas?
Assisted living facilities are licensed under Chapter 247 and generally serve larger resident counts in a more institutional setting. Adult foster care is a separate license category for smaller, home-like settings with different physical plant and staffing rules. Confirm which category fits your planned home with HHSC before finalizing a property.
Sources
- Texas Health and Human Services Commission, Long-term Care Regulation: HHSC oversees licensing and regulation of assisted living facilities and other long-term care providers in Texas
- Texas Health and Safety Code, Chapter 247: Texas assisted living facilities require a license under Chapter 247, which defines license categories and resident agreement disclosure requirements
- Texas Health and Human Services Commission, Adult Foster Care: Adult foster care is a distinct license category in Texas separate from assisted living facility licensing under Chapter 247
- Texas Administrative Code, Title 26, Chapter 553 (Assisted Living Facilities): Texas assisted living facility staffing and physical plant requirements, including awake staff requirements for Type B facilities, are set in state administrative code
- Centers for Medicare & Medicaid Services, Medicare Coverage of Long-Term Care: Medicare does not cover room, board, or custodial personal care services in assisted living facilities
- Texas Health and Human Services Commission, STAR+PLUS Program: Texas Medicaid's STAR+PLUS program can help cover home and community-based services for eligible individuals who qualify for a nursing facility level of care