Continuing care retirement communities in San Antonio are regulated by the Texas Department of Insurance, not HHSC — here's what that actually protects before you pay an entrance fee.
By San Antonio Senior Advisor Care Team · September 28, 2026
A continuing care retirement community, or CCRC, is different from a standard assisted living community or nursing home. Instead of paying month to month for one level of care, a resident pays an upfront entrance fee — often tens of thousands to several hundred thousand dollars — plus ongoing monthly charges, in exchange for the right to move between independent living, assisted living, memory care, and skilled nursing on the same campus as their needs change, without having to re-apply, re-qualify, or move across town during a health crisis. San Antonio has several established CCRCs, including Army Residence Community near Fort Sam Houston (open to qualified adults 62 and older, not only military-affiliated families, with a full continuum from independent apartments through skilled nursing and rehabilitation), Blue Skies of Texas, and Morningside Ministries at The Meadows. Each structures its entrance fee, refund policy, and levels of care differently, which is exactly why Texas law requires a facility-specific disclosure statement before anyone signs.
This CCRC or 'life care' model is legally and financially distinct from simply choosing an assisted living facility (ALF) on a month-to-month lease. Because a family is prepaying for future care that may not be needed for years, Texas treats the entrance-fee contract itself as a financial product with its own oversight — separate from, and in addition to, the day-to-day HHSC licensing that already applies to any assisted living or nursing wing on the same campus. Understanding which agency oversees which part of the arrangement is the first thing a San Antonio family evaluating a CCRC needs to get straight.
Families researching senior care in San Antonio usually learn quickly that the Texas Health and Human Services Commission (HHSC) licenses assisted living facilities under Health & Safety Code Chapter 247 and nursing facilities under Chapter 242, and that HHSC inspection reports are searchable through apps.hhs.texas.gov/HSPubDisclosure. CCRCs break that pattern. Under Texas Health and Safety Code Chapter 246 (Continuing Care Facilities), it is the Texas Department of Insurance (TDI) — the same agency that regulates insurance companies — that licenses continuing care providers, not HHSC. A CCRC operator must hold a TDI Certificate of Authority before it can lawfully accept entrance fees from residents.
TDI regulates CCRCs this way because an entrance-fee contract functions like an insurance-style promise: the provider is committing to deliver escalating levels of care, potentially decades in the future, funded partly by fees collected today. TDI's financial examiners review the provider's solvency, reserve funds, and actuarial assumptions the way they would review an insurer — not the quality of the dining room or the caregiver-to-resident ratio, which is where HHSC's inspection authority still applies to any licensed ALF or nursing unit on the CCRC's campus. Importantly, TDI itself is explicit that it does not regulate the CCRC's rates or the specific language of its resident contracts — that oversight gap is exactly why an independent legal and financial review of the contract, discussed below, matters so much.
Before a San Antonio family can be asked to sign a continuing care contract or pay a deposit, Chapter 246 requires the provider to deliver a precontractual disclosure statement, formatted to TDI's own template (CCRC Form 6, filed under 28 Texas Administrative Code Chapter 33). This is not marketing material — it is a standardized financial disclosure covering the provider's ownership structure and financial history, the specific levels of care included in the contract, entrance fee and monthly fee amounts and how they can be increased, and — critically — the exact refund and cancellation terms that apply if a resident changes their mind, moves out, or passes away before occupancy.
Texas law also gives residents a statutory right to rescind a continuing care contract (Health & Safety Code §246.056), but the specific rescission window and refund mechanics are set out in each provider's own disclosure statement and contract rather than a single number that applies identically everywhere — so a San Antonio family should ask the community, in writing, exactly how many days they have to cancel and get their deposit back before paying anything. TDI's own consumer guidance recommends having a lawyer or financial advisor review the disclosure statement and contract before signing, precisely because TDI licenses the provider but does not police the fairness of individual contract terms.
Texas's continuing care statute had not been substantially updated since 1987, and the 89th Legislature passed Senate Bill 1522 to modernize it, effective January 1, 2026 — meaning San Antonio families evaluating a CCRC this year are the first to be covered by the new rules. SB 1522 sharpened the legal definition of 'continuing care' to focus on communities that offer priority, guaranteed, or discounted access to progressive levels of health care in exchange for an entrance fee, which clears up confusion that previously led some independent living communities offering only minimal services to register as CCRCs when they weren't functioning like one.
Three changes matter most for anyone signing a contract in 2026: TDI's commissioner can now reject a CCRC's certificate application if the provider does not own the real property the community operates on, closing a gap that previously left residents exposed if a facility's ground lease was terminated or the underlying property was sold out from under them. Entrance-fee escrow accounts must now be established as soon as a provider begins accepting deposits, rather than only after the facility receives its certificate of authority, giving earlier deposits stronger protection. And providers must now give residents a copy of the community's most recent disclosure statement on request at any time, not only at the point of signing — useful if a family wants to check on a parent's existing contract years into their stay. The law also now bars CCRC contracts from prohibiting residents from assembling, a resident-rights protection that hadn't previously been spelled out in the statute.
Before any deposit changes hands, ask the community for its current TDI-format disclosure statement in writing and read the entrance-fee refund schedule line by line — refund percentages typically decline the longer a resident stays, and some contracts offer 0% refund after an initial period while others promise a declining but ongoing refund for life. Confirm the provider currently holds a valid TDI Certificate of Authority (TDI's Consumer Help Line, 1-800-252-3439, or its online complaint portal can confirm licensing status and any past enforcement actions, including cease-and-desist orders TDI has authority to issue under Chapter 246). Ask directly whether the community owns its real property outright, per the SB 1522 change, or operates on a ground lease.
Because a CCRC's assisted living and nursing wings are still separately licensed by HHSC even though the entrance-fee contract itself falls under TDI, also pull the community's HHSC inspection history at apps.hhs.texas.gov/HSPubDisclosure — a clean TDI financial filing says nothing about day-to-day care quality, and a clean HHSC inspection record says nothing about the entrance fee's financial safety. Finally, have an elder law attorney or CPA review the actual contract, not just the disclosure statement summary, before any money is paid; TDI has confirmed it does not regulate contract language or rates, so that review is the family's own responsibility, not a box the state has already checked for them.
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