Understanding the Different Types of Assisted Living Facilities in Texas

When it comes to finding the right assisted living arrangement in Texas, one size does not fit all. The Lone Star State offers several types of licensed assisted living facilities (ALFs) to meet the unique needs of residents, whether they require minimal assistance or need a higher level of care and supervision.

Choosing the right facility type is critical for ensuring that residents receive the appropriate support, live safely, and maintain the highest possible quality of life. In this guide, we break down the different types of assisted living facilities in Texas, their key differences, and what families and providers need to know.

What Is an Assisted Living Facility (ALF) in Texas?

In Texas, an Assisted Living Facility (ALF) is a licensed residential facility that provides food, shelter, and personal care services to four or more residents who are unrelated to the owner.

Personal care services can include:

• Assistance with daily activities like bathing, dressing, grooming, and eating
• Medication administration or supervision
• 24-hour support and supervision based on individual needs

All ALFs in Texas are regulated by the Texas Health and Human Services Commission (HHSC) and must meet strict standards for licensing, staffing, building safety, resident rights, and healthcare oversight.

The Three Types of Assisted Living Facilities in Texas

Texas recognizes three main categories of assisted living facilities based on the level of care provided and the residents' needs:

1. Type A Assisted Living Facility

Type A facilities are designed for residents who:

• Are physically and mentally capable of evacuating the facility unassisted in an emergency.
• Do not require routine nighttime attendance by staff.
• Are able to follow directions during emergencies.
• Typically manage their own personal care with minimal support.

Example residents: Seniors who need help with tasks like meal preparation or occasional reminders for medications but are otherwise independent.

Common features of Type A facilities:

• Apartment-style living with private or shared rooms
• Community dining and activity areas
• Scheduled personal care assistance
• Greater resident independence compared to other types

2. Type B Assisted Living Facility

Type B facilities serve residents who:

• May need staff assistance to evacuate during emergencies.
• Require supervision during nighttime sleeping hours.
• May not be able to follow directions in an emergency.
• May require staff assistance for mobility (e.g., wheelchair transfers, walking support).

Example residents: Seniors who may use walkers or wheelchairs, need memory reminders, or require regular monitoring due to medical conditions like diabetes or dementia.

Key features of Type B facilities:

• 24-hour staff availability
• Assistance with emergency evacuation
• Frequent health monitoring
• Care plans tailored to higher acuity needs
• Specialized Alzheimer's or dementia care options (if certified)

Note: Many Type B facilities seek optional Alzheimer’s Certification if they serve residents with memory impairments (more on this below).

3. Type C Assisted Living Facility

Type C facilities refer specifically to Adult Foster Care (AFC) homes. These are small, home-based environments where:

• The caregiver provides 24-hour supervision, room, board, and personal care.
• Services are offered to individuals with physical or mental impairments who qualify for Medicaid programs such as Community Attendant Services (CAS) or Primary Home Care (PHC).

Type C facilities are different because:

• They operate under a foster care model rather than a traditional senior housing model.
• They typically serve no more than four residents in a home-like setting.

Type C ALFs are often ideal for individuals who prefer a smaller, more personalized care environment rather than a larger facility.

Alzheimer’s Certification for Assisted Living Facilities in Texas

In addition to Types A, B, and C licenses, Texas allows facilities to seek Alzheimer’s Certification to serve residents with Alzheimer's disease or related memory disorders.

To earn this certification, facilities must:

• Meet specialized staff training requirements
• Have secure environments to prevent wandering
• Develop individualized care plans focusing on cognitive support
• Offer therapeutic activities for memory care residents

This certification is essential for families seeking specialized dementia care and helps facilities distinguish themselves in a competitive marketplace.

Quick Comparison of ALF Types in Texas

Feature	Type A Facility	Type B Facility	Type C Facility (Adult Foster Care)
Resident Mobility	Must evacuate unassisted	May require evacuation assistance	Residents may need personal and medical support
Nighttime Care	No regular nighttime supervision needed	Staff must be available at night	24/7 supervision in a small setting
Environment	Apartment-like settings	Apartment or shared rooms with more supervision	Family-style home environment
Certification	Optional Alzheimer's Certification available	Optional Alzheimer's Certification available	No Alzheimer's certification for Type C

 

Facility Types: Understanding ALF Categories in Texas

Texas recognizes four main types of Assisted Living Facilities based on resident capabilities and supervision needs:

Facility Type	Resident Capability	Supervision Requirement
Type A	Residents are capable of evacuating without staff assistance	No routine staff attendance needed during sleep
Type B	Residents require staff assistance to evacuate	Staff may be required to attend during nighttime hours
Type C	Small group homes (foster care settings) serving four or fewer residents	Continuous supervision in a home-like environment
Type E	Home-like settings that qualify for special exemptions from certain requirements	Based on specific program and structural approvals

Quick Overview:

• Type A is suited for more independent residents.
• Type B is for residents needing extra assistance and supervision.
• Type C is usually for small, personal home environments.
• Type E applies to specially exempted homes, often with fewer facility requirements.

Assisted Living Facility Size Categories in Texas

In addition to the type of facility, Texas categorizes ALFs based on their size:

Size Category	Number of Residents	Minimum Bedroom Size (Single Occupancy)	Minimum Bedroom Size (Multiple Occupancy)	Facility Type
Small ALF	4 to 16 residents	80 sq. ft.	60 sq. ft. per resident	Typically Type C (Small group homes)
Medium ALF	17 to 49 residents	100 sq. ft.	80 sq. ft. per resident	Typically Type A or Type B
Large ALF	50 or more residents	100 sq. ft.	80 sq. ft. per resident	Typically Type A or Type B

This ensures that facilities are appropriately sized for the number of residents they serve, maintaining both safety and comfort.

Minimum Room Size and Occupancy Rules

Texas also requires minimum bedroom sizes and sets rules on how many residents can share a room:

Facility Type	Room Type	Minimum Size (sq. ft.)
Type A	Single-Occupancy	80 sq. ft.
Type A	Multiple-Occupancy	60 sq. ft. per resident
Type B	Single-Occupancy	100 sq. ft.
Type B	Multiple-Occupancy	80 sq. ft. per resident
Type C	Single-Occupancy	80 sq. ft.
Type C	Multiple-Occupancy	60 sq. ft. per resident

In addition:

• Type A minimum room width: 8 feet
• Type B minimum room width: 10 feet
• Maximum number of residents per room: 4
• Maximum facility capacity in rooms with 3+ residents: 50%

These requirements help ensure that residents have adequate living space, privacy, and safe evacuation paths if needed.

Final Thoughts

The world of assisted living facilities in Texas is much broader and more diverse than many people realize. Choosing the right facility type — Type A, B, C, or E — and ensuring the environment matches the resident’s needs is crucial for their safety, independence, and happiness.

Whether you are opening a facility or seeking care for a loved one, knowing the standards for resident capabilities, room sizes, and supervision requirements can help you make better, more informed decisions.

With Texas’s strong focus on regulation and resident protection, families and providers alike can have peace of mind knowing that high standards are in place to ensure quality of life for all.

Book a Free Consultation Today

If you are serious about starting your Assisted Living Facility in Texas and want expert guidance, we are here to support you. Discuss the steps, requirements, and necessary documentation with one of our licensing experts at CarePolicy.US. We can help you understand the process, avoid common mistakes, and ensure a smoother path to licensure.

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