How to Start an Assisted Living Facility in Texas: Step-by-Step Guide

Starting an Assisted Living Facility (ALF) in Texas can be a rewarding business opportunity. With a growing senior population, the demand for quality care is rising rapidly. But before you open your doors, you must meet specific licensing, regulatory, and business requirements set by the state.

This guide walks you through the step-by-step process of starting an Assisted Living Facility in Texas.

1. Understand What an Assisted Living Facility Is

In Texas, an Assisted Living Facility provides housing, meals, and personal care services for residents who need help with daily activities but do not require full-time nursing care.

Texas categorizes ALFs into two types:

• Type A – Residents can evacuate on their own and do not require overnight staff assistance.

• Type B – Residents may need staff assistance during emergencies or overnight supervision.

Understanding these categories is important because it affects your licensing, building requirements, and staffing.

2. Create a Business Plan

A solid business plan will guide your ALF from startup to success. Include:

• Startup and operating costs

• Funding options (loans, investors, grants)

• Facility type (small residential home vs. large community)

• Services offered (memory care, rehabilitation, respite care, etc.)

• Marketing and occupancy strategy

3. Choose a Location and Facility

The facility must meet Texas Health and Human Services Commission (HHSC) standards. Consider:

• Zoning laws and permits in your city/county

• Building safety codes and fire marshal inspections

• Accessibility (ramps, hallways, restrooms)

• Space for common areas, bedrooms, and dining

Pro Tip: Decide early whether you’ll convert a residential property or build a new facility.

4. Apply for Licensing with HHSC

All ALFs in Texas must be licensed by the Texas Health and Human Services Commission (HHSC). The process includes:

1. Completing the Pre-Licensure Training (PLT)

2. Submitting an initial license application with required fees

3. Background checks for the owner and administrator

4. Passing Life Safety Code and health inspections

5. Receiving the license before admitting residents

5. Hire and Train Staff

Texas requires ALFs to have qualified staff, including a licensed administrator. Training must cover:

• Resident rights and care practices

• Medication assistance rules

• Emergency preparedness

• Dementia and mental health awareness

Staffing levels must match the type of facility (Type A vs. Type B) and the number of residents.

6. Establish Policies and Procedures

Your facility must have written policies for:

• Admission and discharge

• Resident assessments

• Medication management

• Abuse and neglect prevention

• Emergency and disaster response

These policies are critical for compliance during HHSC inspections.

7. Prepare for Inspections

Before opening, your facility must pass inspections for:

• Fire safety

• Health and sanitation

• Emergency preparedness

Regular inspections will continue after opening to ensure compliance.

8. Market Your Assisted Living Facility

Once licensed, you’ll need to attract residents. Some proven strategies:

• Build referral relationships with hospitals, doctors, and senior centers

• Create a professional website with virtual tours

• Use social media and local advertising

• Host open houses and community events

9. Maintain Compliance and Quality Care

After opening, you must stay compliant with Texas regulations. Keep up with:

• Staff training requirements

• Resident care documentation

• Annual license renewals

• Ongoing inspections

Providing quality care not only keeps you compliant but also helps maintain a strong reputation and high occupancy.