How to check a Texas assisted living license before you tour

Over the holidays, many Texas families tour homes for a parent for the first time. The houses can look lovely, with lights up and cider in the lobby. The question that protects your parent is a plain one: does this home hold a current license from the State of Texas for the care it is offering?

Do this check before the holiday open house, or at the kitchen table on Thanksgiving weekend while your brothers and sisters are home and can look with you. Here is how to check, what the license tells you, and what to do if something does not add up.

Why the license matters

In Texas, assisted living is licensed by Texas Health and Human Services (HHSC). Under Health and Safety Code Chapter 247, a home that gives food and shelter to four or more people who are not related to the owner, and also gives personal care or hands out medicine, is an assisted living home that needs a license. This is my plain-language reading, not legal advice.

A license means the state knows the home exists, has set rules for it, and sends inspectors. The Texas Long-term Care Ombudsman program, in its guide to how the state regulates long-term care, says regulatory visits are unannounced and that assisted living surveys happen every two years.

Step 1: Look the home up

You have two quick ways to do it.

1. The state's search. HHSC's long-term care provider search lets you find licensed providers in your area. Search by the name on the sign and the city.
2. This directory. The Texas Senior Care Directory lists every licensed Texas assisted living home from the HHSC provider file, by county, with the license type, the number of licensed beds and the license number. Pick your county, find the home, and compare the name and address to what you were told.

If you cannot find the home in either place, ask the home for its license number and look again. Some homes do business under a name that differs from the name on the license.

Step 2: Read what the license says

Three details matter most.

• Type A or Type B. The state's assisted living rule, 26 TAC 553.5, sets the difference. In plain words: a Type A home serves residents who can get out of the building in an emergency without physical help from staff, can follow directions in an emergency, and do not need routine attention during nighttime sleeping hours. A Type B home may also serve residents who need staff help to get out in an emergency, need attention at night, or cannot follow directions in an emergency, as long as they are not permanently bedfast. If your parent would need a hand to get out during a fire alarm, or needs someone at night, ask whether the home is Type B. If your parent wanders, also ask about memory care certification, below.
• Licensed beds. The license sets how many people the home may serve. A home with far more people living there than its license allows is a question to ask about.
• Memory care certification. Under the same rules, 26 TAC 553.27, a home that advertises specialized care for people with Alzheimer's disease must hold an Alzheimer's certification, and only a Type B home can hold one. Our guide to memory care vs. assisted living goes deeper.

Step 3: Ask about inspections and complaints

Ask the home to show you its most recent state inspection results. A good home expects the question and can walk you through anything that was cited and how it was fixed.

If you ever need to report a concern about an assisted living home or nursing home, HHSC's complaint hotline is 1-800-458-9858. Live agents answer weekdays.

The Texas Long-term Care Ombudsman program protects the rights of people who live in assisted living and nursing homes. Its services are free, confidential and statewide, at 800-252-2412.

Red flags worth a second look

• The home will not give you a license number.
• The name and address on the license do not match the house.
• The home says it offers memory care but does not hold an Alzheimer's certification.
• You are told a license is "in process" while people already live there and receive care.
• The home asks for a large cash deposit before you have seen anything in writing.

None of these proves wrongdoing. Each one is a reason to slow down and check.

Bring it to the tour

Write the license number, the type and the licensed bed count on a card and bring it with you. If family is in town for the holidays, hand one person the card and let the others watch the people. Then use our holiday tour questions to see whether the home lives up to its paperwork. And if you want to hear from people who do this work every day, the events calendar lists free resource fairs and caregiver meetings near you.