How Texas regulates memory care: the Alzheimer's certification

Is memory care a separate license in Texas?

No. Texas has no memory care license; an assisted living facility that advertises or markets specialized care for people with Alzheimer's disease or a related dementia must hold an Alzheimer's certification from HHSC, and only a Type B facility can be certified.

Certification is checked by an on-site health inspection and a Life Safety Code inspection, and the certificate sets the maximum number of residents the certified unit may serve. A facility does not need certification to advertise medication reminders, escort service or care for short-term memory loss, so those phrases on a website do not mean a certified unit exists.

8 El Paso assisted living facilities hold an Alzheimer's certificate, covering 196 residents, from 16 places at the smallest to 38 at the largest.

What extra standards must a certified Alzheimer's unit in Texas meet?

Certified units must meet the standards in 26 TAC 553.311 on top of the regular assisted living rules, covering the unit's physical design and secured outdoor area, staff training in dementia care, activity programming and the information given to families.

The outdoor-space requirement is not a formality: one El Paso facility was penalized $3,000 in 2026 for failing to provide an approved outdoor area for its segregated unit, according to its TULIP record. Ask to walk the outdoor area on a tour, see whether residents use it, and ask how often it is open in the summer heat. Then ask how many staff are on the unit at night and whether they are assigned to it or float between halls.

How do we confirm an El Paso facility is certified for Alzheimer's care?

Look for an Alzheimer's certificate number and an Alzheimer's capacity on the facility's HHSC directory entry, which our memory care roster and facility pages reproduce with the certificate's expiration date.

The certified capacity can be smaller than the building's total license, which means the dementia unit is a distinct wing. If a facility says it offers memory care but has no certificate on the state's record, ask it to explain; it may be describing care for mild memory loss rather than a certified unit. A nursing facility can also list Alzheimer's beds; HHSC's directory shows those separately for nursing homes.

Can a person with dementia live in an uncertified Texas assisted living facility?

Yes, within limits: a Type B facility without certification can serve residents with some confusion who may need help to evacuate, but it may not market specialized dementia care, and a Type A facility must discharge a resident who can no longer evacuate alone or follow emergency directions.

What usually forces a move is behavior rather than the diagnosis: exit-seeking, nighttime wandering, or a failed fire drill. Ask any facility how it handles a resident who tries to leave, and at what point it would recommend a certified unit. In El Paso the certified units are concentrated in a handful of larger Type B communities, so openings can be limited.

Does Texas set a staff ratio for memory care?

No. Texas requires enough staff to meet every resident's needs and to evacuate everyone safely (26 TAC 553.253) rather than a fixed ratio, and several El Paso facilities have been penalized for failing that standard.

TULIP shows administrative penalties in El Paso for not having sufficient staff to supervise residents and for not having enough staff to evacuate in an emergency. That second test is the practical ratio: ask how many people are awake at 3 a.m., how many residents need help to evacuate, and how the last fire drill at night went. A facility should be able to show you its drill records.