Memory care inspection records in Houston, DFW, San Antonio and Austin
Last updated · Texas data: HHSC roster as of 10/28/2026, TULIP records collected through Oct 30, 2026
Texas's four biggest metros have 591 of the state's 733 Alzheimer's-certified assisted living facilities, with 17,763 certified beds between them. Here's how each metro's memory care looks in the state's inspection and enforcement records, and how it compares with other large Type B buildings nearby.
First, what "memory care" means here
We count a facility as memory care only if HHSC lists it with an Alzheimer's certification. Texas requires that certification for any facility that advertises specialized Alzheimer's or dementia care, and only Type B facilities can get it (§553.27). See Type A vs. Type B for more.
The four metros at a glance
| Metro | Certified facilities | Share of metro facilities | Certified beds | Whole-building memory care | Median licensed beds |
|---|---|---|---|---|---|
| Houston | 193 | 35.7% | 5,688 | 105 | 50 |
| Dallas–Fort Worth | 255 | 40.5% | 7,481 | 130 | 60 |
| San Antonio | 60 | 31.6% | 1,938 | 32 | 64 |
| Austin | 83 | 51.2% | 2,656 | 43 | 70 |
Inspection and enforcement records
| Metro | Citations per facility | Health citations per facility | With any Health citation | With a penalty | Penalties | Imposed |
|---|---|---|---|---|---|---|
| Houston | 5 | 0.8 | 28% | 13% | 31 | $86,575 |
| Dallas–Fort Worth | 8.1 | 2.5 | 57.6% | 18.4% | 63 | $153,775 |
| San Antonio | 8.1 | 1.6 | 56.7% | 30% | 22 | $64,125 |
| Austin | 3.3 | 0.8 | 26.5% | 48.2% | 70 | $171,275 |
Houston
193 certified facilities (35.7% of the metro's 540 licensed facilities) with 5,688 certified beds. 105 are memory care throughout; the rest have a certified unit inside a larger building. They average 5 citations per facility, 0.8 of them from Health inspections, and 28% have at least one Health citation on record. 25 (13%) have had an administrative penalty, 31 in total. The most common rule section in those penalties is §553.267 (residents' rights), in 20 of them.
Compared with the metro's 29 other large Type B facilities without certification: 5.6 citations per facility, 0.4 Health citations per facility, and 10.3% with a penalty. See every certified facility in Houston →
Dallas–Fort Worth
255 certified facilities (40.5% of the metro's 630 licensed facilities) with 7,481 certified beds. 130 are memory care throughout; the rest have a certified unit inside a larger building. They average 8.1 citations per facility, 2.5 of them from Health inspections, and 57.6% have at least one Health citation on record. 47 (18.4%) have had an administrative penalty, 63 in total. The most common rule section in those penalties is §553.267 (residents' rights), in 37 of them.
Compared with the metro's 59 other large Type B facilities without certification: 7.6 citations per facility, 2.6 Health citations per facility, and 8.5% with a penalty. See every certified facility in Dallas–Fort Worth →
San Antonio
60 certified facilities (31.6% of the metro's 190 licensed facilities) with 1,938 certified beds. 32 are memory care throughout; the rest have a certified unit inside a larger building. They average 8.1 citations per facility, 1.6 of them from Health inspections, and 56.7% have at least one Health citation on record. 18 (30%) have had an administrative penalty, 22 in total. The most common rule section in those penalties is §553.267 (residents' rights), in 13 of them.
Compared with the metro's 19 other large Type B facilities without certification: 8.3 citations per facility, 1.1 Health citations per facility, and 10.5% with a penalty. See every certified facility in San Antonio →
Austin
83 certified facilities (51.2% of the metro's 162 licensed facilities) with 2,656 certified beds. 43 are memory care throughout; the rest have a certified unit inside a larger building. They average 3.3 citations per facility, 0.8 of them from Health inspections, and 26.5% have at least one Health citation on record. 40 (48.2%) have had an administrative penalty, 70 in total. The most common rule section in those penalties is §553.267 (residents' rights), in 45 of them.
Compared with the metro's 18 other large Type B facilities without certification: 4 citations per facility, 0.9 Health citations per facility, and 22.2% with a penalty. See every certified facility in Austin →
What the numbers suggest, and what they don't
- Penalty rates vary a lot by metro. The share of certified facilities with a penalty ranges from 13% in Houston to 48.2% in Austin. That can reflect differences in complaint volume and how regional HHSC staff work, not just differences in care.
- In all four metros, certified facilities were more likely to have a penalty than other large Type B buildings. Memory care residents are among the most vulnerable, and certified units must meet additional standards (§553.311). Findings there may also be more likely to lead to fines. Our data can't separate these explanations.
- The comparison groups are small. The metros have between 18 and 59 large, uncertified Type B facilities each, so a handful of penalties can move the percentage a lot.
- None of this rates a specific facility. Look up the ones you're considering, read their TULIP records, and use our memory care tour questions.
How we got these numbers
Metros are groups of counties based on the federal metropolitan statistical areas (Houston: 10 counties, Dallas–Fort Worth: 11, San Antonio: 8, Austin: 5). "Certified" means the HHSC roster lists Alzheimer's certification. "Whole-building memory care" means certified beds equal or exceed licensed capacity. The comparison group is uncertified Type B facilities in the same metro with 17 or more licensed beds, the closest like-for-like group available. Citations per facility count all facilities in the group, including those with none. Penalty figures use TULIP enforcement actions. Imposed amounts can be reduced on appeal or settlement.
All counts on this page are computed from the same Texas data that powers the facility pages on Assisted Living Inspections: the HHSC licensed assisted living roster and the inspection citations and enforcement actions published in TULIP. They're recalculated every time the site is rebuilt. Full details are in our methodology.
Sources
- 26 TAC §553.27, Alzheimer's certification (unofficial copy, Cornell LII)
- 26 TAC §553.311, Physical plant requirements for Alzheimer's units (unofficial copy, Cornell LII)
- HHSC: Assisted Living Facilities (ALF) provider page, with links to 26 TAC Chapter 553 and Health and Safety Code Chapter 247 (official)
- TULIP long-term care provider search (HHSC) (official)
- Assisted Living Inspections: methodology and sources
Informational only, not medical or legal advice. This guide explains public records and Texas rules in plain language. It isn't a rating of any facility and isn't a substitute for advice from a doctor, lawyer or the state. Rules change. HHSC proposed a broad rewrite of Chapter 553 in September 2026, so check the current rule text before you rely on a specific section number. If something here doesn't match the official record, the official record wins.