Memory care in Texas requires a Type B ALF license. Here's what San Antonio families need to know about securing the right placement for a parent with Alzheimer's or dementia — and what to verify before you sign.
By Linda Chen, CDP · March 15, 2026
In Texas, a facility that serves residents with Alzheimer's disease, vascular dementia, or other forms of cognitive impairment that affect the ability to self-evacuate must hold a Type B Assisted Living Facility license from HHSC under Ch. 247. Unlike California (which uses an RCFE memory care endorsement) or Florida (which has a separate ECC license), Texas uses the Type B ALF classification for both higher-acuity assisted living and most memory care.
A secured unit within a Type B ALF uses access-controlled entrances and perimeter design to reduce elopement risk for residents with moderate to advanced dementia. Confirm that the specific wing you're considering — not just the parent facility — holds the correct HHSC license type and that its secured unit is included in the licensed capacity.
The HHSC license is the floor, not the ceiling. The strongest predictors of good memory care outcomes are dementia-specific staff training (ask about CARES training or equivalent certification), consistent staffing (high turnover is a red flag), structured engagement programming tailored to cognitive stage, and family communication protocols.
Ask specifically: How many residents are in the secured unit, and what is the overnight staff-to-resident ratio? How does the facility respond to behavioral symptoms of dementia — agitation, sundowning, resistance to care? What is the process for a resident who needs a higher level of medical care? Walk the unit during an activity time and notice whether residents are engaged or isolated.
Type B ALF / memory care in San Antonio runs $4,200–$6,800 a month. STAR+PLUS HCBS Medicaid may cover personal care services in a participating ALF for income-qualifying seniors — contact AACOG at (210) 362-5200 to screen for eligibility. Long-term care insurance policies often specify memory care as a covered benefit; review the policy's 'cognitive impairment' trigger language carefully before placement.
A free, local advisor who specializes in memory care can match a family's budget and care stage to the right secured unit — and verify the HHSC Type B license before a tour is even scheduled.
Free, no-pressure call. We work for families, not facilities.