Type A vs. Type B assisted living, and what Alzheimer's certification means in Texas

Last updated Oct 30, 2026 · Texas data: HHSC roster as of 10/28/2026, TULIP records collected through Oct 30, 2026

Every Texas assisted living license says "Type A", "Type B" or, rarely, "Type C". The letter isn't a quality grade. It tells you which residents the building is allowed to serve, mainly whether they could get out on their own in a fire. And if a place says it offers memory care, there's a separate state certification you can check.

The three license types

HHSC sorts facilities by residents' ability to evacuate in an emergency and whether they need care at night (26 TAC §553.5; HHSC's ALF page).

Type A: residents can evacuate without help, don't need routine attendance during sleeping hours, and can follow directions in an emergency.
Type B: residents may need staff help to evacuate, may not be able to follow directions in an emergency, and may need attendance at night. They can need help transferring, for example to a wheelchair, but they must not be permanently bedfast. Type B buildings are held to different fire-safety construction requirements, and night staff must be awake.
Type C: four-bed homes originally licensed as adult foster care. HHSC no longer issues new Type C licenses.

Separately, the rules call a facility with 16 or fewer residents "small" and one with 17 or more "large" (§553.3). The fire-safety requirements are written separately for each size and type, which is why you'll see rule titles like "existing large Type B facility" in penalty records.

What this means for your family

If the person moving in might not get out of the building alone, or needs someone up at night, a Type A license isn't the right fit, however nice the place is. If their needs could grow, ask how the facility handles a resident who no longer meets its license type, and what happens then. Our tour questions cover this.

Memory care is a certification, not a marketing term

Under §553.27, a facility that advertises or promotes specialized care for people with Alzheimer's disease or related disorders must be certified (or have a certified unit). Only a Type B facility can be certified. Phrases like "medication reminders", "escort service" or "short-term memory loss" don't require certification.

To certify a facility or unit, HHSC checks it against the Alzheimer's physical plant rules (§553.311) in a Life Safety Code inspection, and does an on-site health inspection that includes watching care for at least one resident admitted to the unit. The certificate must be posted where the public can see it. It's valid for three years, and the facility can't go over the number of residents it lists.

In our data, 733 Texas facilities hold Alzheimer's certification. In 366 of them the certified beds cover the whole licensed capacity, so the entire building is a memory care facility. The other 367 have a certified unit inside a larger building. One entry in the state roster (a single facility) lists Alzheimer's beds on a Type A license. Check that facility's certificate directly with HHSC.

How the types compare in state records

License type	Facilities	Licensed beds	Median beds	Citations per facility	Health citations per facility	Share with a penalty
Type A	335	11,604	16	6.6	1.9	11.6%
Type B	1,669	70,689	16	5.4	1.4	14.2%
Type C	8	32	4	1	1	0%

Type B is by far the most common license in Texas: 1,669 of 2,012 facilities. Per facility, Type A buildings in our data have slightly more citations (6.6 vs. 5.4), while Type B buildings are a bit more likely to have had an administrative penalty (14.2% vs. 11.6%).

Size is a bigger divide than type. Large facilities (17+ beds) were fined at 20.8% of buildings, compared with 8% of small ones, while citations per facility were closer (6.2 vs. 5.1). Bigger buildings have more residents, more staff and more complaint visits. None of these averages tells you anything about a specific facility, so look up the one you're considering.

How we got these numbers

License type, licensed capacity, Alzheimer's certification and certified beds come from the HHSC assisted living roster. "Whole building" memory care means the roster's certified Alzheimer's beds are equal to or greater than the licensed capacity. Citations per facility divide total citations by all facilities of that type, including those with none. "Share with a penalty" is the share of facilities with at least one administrative penalty in TULIP. Small and large follow the §553.3 definitions (16 or fewer, 17 or more), using licensed capacity.

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

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.