How to Become an ALF Provider | Salud y Servicios Humanos de Texas

Texas Health and Human Services licenses, certifies and surveys assisted living facilities for compliance with state and federal laws and regulations. Through these regulatory activities, HHS protects Texas citizens receiving these services.

What is an Assisted Living Facility?

An ALF is an establishment that furnishes, in one or more facilities, food and shelter to four or more people who are unrelated to the proprietor of the establishment and provides either:

Personal care services.
Administration of medication by a person licensed or otherwise authorized in this state to administer the medication.
Services described in clauses (i) and (ii) of this subparagraph; and can provide assistance with or supervision of the administration of medication.

Becoming Licensed in Texas

Assisted living facilities must be licensed to operate in Texas. To become licensed, a location must:

Complete the pre-survey, computer-based training and submit a copy of the certificate of completion (ALFs only).
Properly complete and submit the license application.
Submit all required documents.
Pay the required license fee.
Submit appropriate ownership documents, if applicable.
Pass Life Safety Code and health inspections.
Be approved by the Licensure and Certification Unit.

Process Maps

The following process maps provide an overview of the licensure process.

Types of Applications

Initial

An initial application, is an application that has never been issued a HHS license number to operate in Texas. Changes of ownership are also considered an initial application.

Change of Ownership

A change of ownership occurs when the facility changes the tax identification number.

Relocation

A relocation application is the closing of a facility and the movement of its residents to another location.

Renewal

A renewal application for current license holder must be submitted on or before the licensure expiration date. A late fee can apply. Any application submitted after the licensure expiration will be considered an initial application.

Increase in Capacity

An increase in capacity application must be submitted for an increase in capacity. A license holder must not increase a facility's licensed capacity without approval from HHS.

Time Frames for Applications

License Application for an Initial, Relocation, Renewal and Change of Ownership

Upon receipt of a license application the HHS Licensing and Credentialing Unit has up to 30 days to review the application.
If HHS receives an incomplete application, the Licensing and Credentialing Unit will notify the applicant in writing of any deficient items in the application. The applicant must respond with complete and correct information within 30 days from the date of notification. If the application is not completed timely, it will be denied.
The applicant must submit a current and approved fire marshal inspection.
The applicant must provide written notice the building is in compliance with the Subchapter D of the Licensing Standards for Assisted Living Facilities and ready for a Life Safety Code survey.
When the Life Safety Code survey is passed, one resident but no more than three can be admitted to the building. The applicant must submit a written notification that at least one resident has been admitted and no more than three residents are admitted, and the location is ready for the health survey and pass the inspection.
Upon receipt of a complete application and passing recommendations about Life Safety Code and health surveys, the Licensing and Credentialing Unit will issue the license within 45 days.

Licensure Fees

Initial, renewal, change of ownership, relocation type A and type B licensing fees: $300 fee plus $15 per bed. There is a $2,250 maximum fee for a three-year license. The license fee for a two-year license is $200, plus $10 per bed with a maximum of $1,500.
Type C the license fee is $150 for a three-year license. The license fee for a two-year is $100 (renewal only)
Alzheimer Certification (3-year certification): $300
Increase capacity fee: $15 per bed.
Late fee of one half the basic fee will be assessed if the renewal application is submitted less than 45 days before the license expiration date.
Decrease in Capacity: No charge

Changes of Information

Change in the Facility Name

If a license holder intends to change its name (legal entity or doing business as) but does not undergo a change of ownership, the change must report the name change. Another license will be issued to reflect this change.

Relocation

A license cannot be transferred from one location to another without prior notice to HHS. 26 TAC §553.17.

Changes in Phone Number

Changes in phone number must be submitted in writing as soon as possible.

Fax Number and Email Address

Report as soon as possible.

Changes in Management

Report as soon as possible.

Changes in Controlling Person

Changes in controlling person (stock transfers), as defined in 26 TAC §553.2(b)(16), must report as soon as possible.

Form 3720

Facilities should use Form 3720, Application for State License to Operate a Long-term Care Facility, to:

Apply for a License

Initial.
Initial new construction - provisional license (assisted living facilities only).
Change of ownership.
Relocation of a facility.

Report Changes and Update

Management company.
Replacement of facility.
Change of real estate owner, lien holder or other encumbrance changes.
Changes-of-ownership interests or stock transfers of 5 percent to 49 percent.

Other Uses

Licensing fee payment.
Management Company Agreement (if applicable).

License Application Forms

Visit the TULIP website for application forms and instructions. Go to TULIP.

Form 3720, Application for State License to Operate a Long-Term Care Facility.
This application applies to initial, relocation, change of ownership, capacity increase, changing administrator or manager or director, update controlling parties, update management companies, and update stock transfer.
Form 3720-G, Assisted Living Facility Type A or B Application in Good Standing for State License to Operate a Long-Term Care Facility.
This application is used for applicants that meet certain criteria identified in 26 TAC 553.21.
Form 3721, Application to Certify Long-Term Care Facility for Alzheimer's Disease and Related Disorders or Alzheimer's Assisted Living Facility.
Form 3721-G, Application to Certify Alzheimer's Assisted Living Facility in Good Standing.
This application is used for applicants who meet certain criteria identified in 26 TAC 553.22.
Form 3736, Application for State License to Operate a Type C Assisted Living Facility
This application is for four-bed facilities and there are no new applications, renewals only.

Types of Licenses

Request for a Provisional License

For newly constructed assisted living facilities only. The department shall, upon submission of a written request by the applicant, automatically issue a six-month provisional license without conducting a Life Safety Code survey if:

Before beginning construction, the license applicant has submitted building plans (including working drawings and specifications) to HHS for an early compliance review in accordance with Health and Safety Code Section 247.0261 and Texas Administrative Code, Title 26, Part 1, Chapter 553, Section 553.64.
All local approvals, including a certificate of occupancy where required, have been obtained.
A complete license application form 3720 is submitted within 30 days of receipt of all local approvals.
The license fee has been paid.
The department determines the license applicant (or a person who owns the license applicant and controls the operations of the license applicant) constructed in this state another facility that complies with the department's Life Safety Code standards.
The facility is in compliance with resident care standards based on an on-site health inspection.

Request an Expedited Life Safety Code (ELSC) Inspection – Assisted Living Facilities Only

An applicant for an initial license can obtain an ELSC inspection after HHS receives a completed application, all fees and all required documents.

To request an ELSC inspection, you must submit:

A written request informing the License and Credentialing unit that the facility meets the architectural requirements and is ready for its ELSC inspection.
The required Life Safety Code fee in accordance with the Assisted Living Licensing Standards, 26 TAC §553.4(g)(2) expedited Life Safety Code and physical plant inspection fees.
A fee is required for each ELSC inspection. This fee covers only one ELSC inspection. If the applicant doesn't pass the first Life Safety Code inspection and requests the follow-up be expedited, the applicant must pay the ELSC inspection fee again.
HHS will conduct the ELSC inspection within 15 business days after receipt of the request and fee, and after all requirements are met.

Use the following form if you are requesting an ELSC inspection for Alzheimer's Certification or a Licensed Capacity increase:

Form 3721, Application to Certify Long Term Care Facility for Alzheimer's Disease and Related Disorders or Alzheimer's Assisted Living Facility Type B only (if applicable)

For New Construction, Remodeled Buildings or Buildings That Have Never Been Licensed

Completed applications for a license should be submitted 45 days before the building is expected to conform to the LSC and architectural requirements.

Please click here to be directed to the TULIP website to access the applications and instructions page

Rules and Statutes

HHSC Contracting

When submitting an application through the online portal (TULIP), this action only applies to the license itself. ALF providers who also have contracts with HHSC need to contact their contract manager to discuss how a licensure action could impact the contract they hold.

For more information, see the following links: