How to read a Texas assisted living inspection report

Texas inspects every licensed assisted living facility. The results are public, but they're spread across a state database that wasn't built with families in mind. This guide covers what the numbers mean and how much weight to give them.

Who inspects, and how often

The Texas Health and Human Services Commission (HHSC) licenses assisted living facilities under Chapter 247 of the Health and Safety Code and the standards in 26 TAC Chapter 553. State law requires an inspection at least once every two years after the initial licensing inspection. HHSC also visits for complaint investigations, abuse or neglect investigations and follow-ups, and most of those visits are unannounced.

Two kinds of inspection

Health inspections look at care and operations, things like medication handling, staffing and training, resident assessments, food service, and resident rights. Life Safety Code inspections look at the building, things like fire alarms and sprinklers, exits and corridors, emergency power, and evacuation plans.

Life Safety Code citations are often the bulk of a facility's count, and many of them are building or paperwork items that get fixed quickly. Health citations are more likely to be about how residents are treated day to day. That's why we show the two types separately.

What a citation is, and isn't

A citation means an inspector found that a specific licensing standard wasn't met on that visit. It isn't a finding that a resident was harmed (some citations do involve harm), and it isn't a grade. When you compare facilities, keep in mind:

• Size matters. A 120-bed building gets more scrutiny, and usually more citations, than a 6-bed home.
• Visits matter. A facility that had complaint investigations will have more visits, and more chances to be cited.
• Timing matters. Ten citations from three years ago, all corrected, are a different story from ten citations last month.
• Zero isn't a gold star. It can mean a clean record, or it can mean the facility simply hasn't been visited much in the period the state database shows.

Correction dates

After a citation, the facility submits a plan of correction, and the state records the date the problem was corrected. On our facility pages, each cited visit shows when its last citation was corrected. If a recent visit has no correction date, it may still be in progress.

Enforcement actions

When problems are serious or keep coming back, HHSC can take enforcement action, most often an administrative penalty (a fine). We list the date imposed, the amount, and the rule numbers cited, so a reference like 26 TAC §553.267(a)(3) points you to the exact standard. An imposed amount can be reduced on appeal or settled, so treat it as what the state proposed, not necessarily what was paid.

Read the original

Every facility page links to its record in TULIP, the state's public long-term care provider search. There you can read the state's own description of each citation. We deliberately don't copy that text. We summarize the facts (dates, types, counts, amounts) and send you to the source for the details.

Questions to bring to a tour

1. "I saw citations from your visit on [date]. What happened, and what did you change?"
2. "Can I see your most recent inspection report and plan of correction?"
3. "What's your staff-to-resident ratio overnight?"
4. "How do you handle medication errors and falls?"

This guide is general information, not legal or medical advice. Rules change, so check HHSC for the current standards.