How to read a Texas assisted living inspection report

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

Texas inspects every licensed assisted living facility, and the results are public. They're just spread across a state database that wasn't designed with families in mind. Here's 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. Under the current inspection rule (§553.327), HHSC inspects each facility at least once every two years after its initial license inspection. It also visits to investigate complaints and incidents and to follow up on earlier problems. Inspections and investigations are generally unannounced.

Two kinds of inspection

Health inspections look at care and operations: medications, staffing and training, resident assessments and service plans, food, residents' rights, and how the facility handles abuse and neglect. Life Safety Code (LSC) inspections look at the building: fire alarms and sprinklers, exits and corridors, smoke barriers, emergency power and evacuation plans.

The two are very different in what they tell you. Across Texas, our data has 11,225 citations. 8,292 of them (73.9%) came from Life Safety Code visits and 2,933 (26.1%) from Health visits. A typical cited LSC visit produced 5.8 citations, compared with 3.6 for a cited Health visit. So a big citation count is often mostly building items. That's why every facility page on this site shows 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 (though some citations do involve harm), and it isn't a grade. When you compare facilities, keep these in mind:

Size matters. A 120-bed building has more rooms, staff and residents to look at than a 6-bed home, so it has more chances to be cited.
Visits matter. A facility that's had complaint investigations has had more inspectors through the door.
Timing matters. Ten citations from a 2019 visit, all corrected, tell a different story from ten citations last month.
Zero isn't a gold star. 440 of the 2,009 Texas facilities we matched in TULIP show no citations at all. That can mean a clean record. It can also mean the facility hasn't had a cited visit in the period TULIP displays.

What TULIP actually shows

TULIP doesn't publish a facility's full inspection history. In practice it shows the most recent cited visit of each type, and occasionally a second one. In our data the cited visits run from Sep 3, 2018 to Oct 27, 2026, but 61.8% of them are from 2025 or 2026. Treat the record as a snapshot of recent findings, not a lifetime file.

Correction dates

After a citation, the facility submits a plan of correction, and the state records when each problem was corrected. On our facility pages, each cited visit shows the date its last citation was corrected. Among visits that have correction dates, the median gap between the visit and the last correction was 22 days for Health visits and 30 days for LSC visits. A recent visit with no correction date yet usually just means the paperwork is still in progress. A visit from long ago with no correction date is worth asking about.

Enforcement actions

When a violation is serious or keeps coming back, HHSC can go beyond a citation. Every enforcement action in our Texas data is an administrative penalty, which is a fine: 354 penalties at 276 facilities, imposed between Nov 3, 2023 and Oct 29, 2026. Each one lists the rules it was based on, so a reference like 26 TAC §553.267(a)(3)(E)(ii) points to the exact standard. That one is the right to be free from abuse, neglect and exploitation, and it's the most common rule in Texas penalties. See the most common violations for the full breakdown.

Under §553.751, HHSC weighs the seriousness of the violation, the facility's history, its efforts to correct, and its size when it sets a penalty. The license holder can ask for a hearing, so an imposed amount isn't always what ends up being paid. Treat the amount as what the state imposed.

Read the original

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

Putting it together

Start with the Health citations and any enforcement actions. They say more about daily care than the building items do.
Check the dates. Recent findings matter more than old, corrected ones.
Look at the rule numbers on any penalty. Abuse, neglect, staffing and medication rules deserve a direct question on your tour.
Open TULIP and read what the inspectors actually wrote.
Take your questions to the tour. Our tour question list is organized around the same rules.

How we got these numbers

The citation counts are totals of the Health and Life Safety Code citations TULIP lists for each facility. The "per cited visit" figures divide those citations by the number of distinct visits (exit date and visit type) that produced at least one citation. The correction-gap medians use only visits that have a recorded correction date. Enforcement counts include every action TULIP lists for a facility.

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.