Texas doesn't grade assisted living by "level of care" — it licenses two facility types, Type A and Type B. Here's what each license legally requires, and why the difference matters more than the brochure when you're touring for a Houston parent.
Texas licenses two facility types — not a scale of "levels"
When families start touring Houston-area assisted living communities, almost every brochure uses the same soft language: "personalized levels of care," "tailored support," "care plans that grow with your loved one." None of that is a legal category. What actually governs a community, under the eye of the Texas Health and Human Services Commission (HHSC), is one of two license types set out in the Texas Administrative Code: Type A or Type B. Every licensed assisted living facility in Texas holds one or the other, and the type is tied to a narrow, specific legal test — not to marketing, not to amenities, and not to how much the facility charges.
That test comes down to two questions HHSC asks about the residents a facility is licensed to serve: can they get themselves out of the building in an emergency, and do they need someone awake and watching over them at night. Everything else — the chandelier in the lobby, the activities calendar, the dining room — sits on top of that legal foundation.
What a Type A license actually requires
Under 26 Texas Administrative Code §553.5, a Type A facility is licensed to serve residents who:
- Are physically and mentally capable of evacuating the facility without physical assistance from staff
- Are capable of following directions in an emergency
- Do not require staff to routinely check on or attend to them during sleeping hours
Because the resident population is defined this way, a Type A facility is not required to keep awake staff on the premises overnight the way a Type B facility is. That does not mean no staff, and it does not mean no one will hear a call button — it means the regulatory floor is lower, and exactly how a specific community staffs its overnight hours is something you have to ask about directly, because it varies by operator.
What a Type B license actually requires
A Type B facility is licensed for residents with higher support needs. Under the same rule, Type B residents:
- Require staff assistance to evacuate the building
- May not be capable of following directions in an emergency
- Require attendance during sleeping hours, so the facility must have staff awake and on duty overnight
- May need help transferring, including wheelchair transfers, but cannot be permanently bedfast — that crosses into nursing-home-level care, which assisted living in Texas is not licensed to provide
In practice, most Houston-area memory care households, and most families whose parent uses a wheelchair or walker and could not self-direct during a fire alarm, are looking at Type B communities, whether or not the tour brochure ever uses the words "Type B."
Type C: a license Texas no longer issues
You may still see "Type C" referenced in older documents. It used to describe a small, four-bed adult foster care home. HHSC no longer issues new Type C licenses; any facility offering that kind of small-home foster care model today is licensed as Type A or Type B.
Why this is not the same thing as quality
This is the part families most often get backward. Type B is not a "higher tier" community and Type A is not a "budget" one. The type reflects the legal ceiling on how much support the residents in that building are allowed to need — not how nice the building is, how experienced the staff are, or how much it costs. A beautifully renovated, expensive Type A community can be the wrong fit for a parent who needs overnight supervision, no matter how good it looks on a tour. A modest Type B home a mile away might be exactly the right level of support. Ask directly which type a community holds; do not assume it from the price or the marketing.
Facility size is a separate question from A or B
Size is tracked independently of type. Texas rule treats a facility with 17 or more residents as a large facility and one with 16 or fewer as a small facility, and each size has its own set of building and space requirements layered under Chapter 553. A community can be small and Type A, small and Type B, large and Type A, or large and Type B — size tells you about the physical scale of the building and the feel of the community, not about the acuity of care it is licensed to provide.
Memory care and the Alzheimer's certification
"Memory care" is not, on its own, a third license type in Texas. It is a certification a facility can add on top of its base license, and in practice that certification is layered onto Type B facilities, since most residents living with a dementia diagnosis eventually need the evacuation assistance and overnight staffing that Type B requires. Earning the certification means meeting additional state requirements beyond the base Type B rules, and it carries its own fees. When you tour a "memory care" community, it is fair to ask to see the actual license and confirm the Alzheimer's certification is current — do not take the marketing name at face value.
What happens if your parent's needs change after move-in
This is where the license type matters most for planning ahead, not just for the first move. If a parent moves into a Type A community and later needs help evacuating or requires overnight attendance — common after a fall, a stroke, or dementia progression — the facility itself does not automatically start providing Type B-level supervision. State rule treats a change from Type A to Type B as a reclassification that the facility must formally apply for and meet the construction and operating requirements of a new facility to receive. A community cannot simply decide informally to "start doing" Type B-level overnight care. In practice, this means some families who chose a Type A community for a parent in relatively good shape are told, months or years later, that the community cannot keep their parent and a move to a Type B facility is required. Asking a Type A community directly what happens if care needs increase, and whether they hold any Type B beds or a sister community that does, is worth doing at the first tour, not after a crisis.
How to verify a community's license type before you tour
You do not have to take a salesperson's word for it. HHSC's Long-Term Care Provider Search is the state's public directory of every licensed facility, and it lists the license type, the licensed capacity, and recent inspection history for any Harris, Fort Bend, Montgomery, Brazoria, Galveston, Liberty, Waller, or Chambers County community you are considering. Look the address up before you tour, and bring the questions the listing raises with you.
On the tour itself, it is worth asking a community directly:
- Are you licensed Type A or Type B, and is that current with HHSC?
- If Type A, is there awake staff on the premises overnight, even though it is not required?
- If my parent's needs increase, do you have Type B capacity, or a related community we would move to?
- If this is memory care, is the Alzheimer's certification current, and what does it add beyond the base license?
The answers tell you more about whether a community can actually meet your parent's needs, today and a year from now, than any brochure will.
If you are trying to sort through Type A and Type B options across Greater Houston and want a second set of eyes on what you are seeing on tours, call a free local advisor at (346) 385-3815. It costs families nothing, and the team only works with licensed Texas communities.
Last updated August 27, 2026. This guide is general information for Greater Houston families, not medical, legal, or financial advice.
