A DFW family's walkthrough of what to look for before signing a Texas assisted living residency agreement, from level-of-care pricing tiers to discharge language.
By Dallas Senior Advisor Care Team · September 5, 2026
By the time most Dallas-Fort Worth families are handed a residency agreement, the hard part feels over. You have toured four or five communities across Preston Hollow, Richardson, and maybe out toward Frisco, you have compared studio sizes and dining rooms, and someone at the front desk has just said the room is available Monday. The contract lands on the table as a formality. It is not. In Texas, the residency agreement is the single document that determines what you pay, what care your parent is actually promised, what happens when their needs change, and under what conditions the community can ask them to leave. Everything a marketing director said on the tour is conversation; this is the part that binds. Knowing what to look for before signing a Texas assisted living residency agreement is the difference between a placement that holds for years and one that unravels in month four with a rate increase nobody saw coming.
Assisted living facilities in Texas are licensed by the Texas Health and Human Services Commission (HHSC), Long-Term Care Regulation, under Texas Health and Safety Code Chapter 247 and 26 Texas Administrative Code Chapter 553. HHSC requires a written agreement between the facility and the resident, and it requires the facility to disclose the services it provides and the basis on which it charges for them. What the rules do not do is standardize the contract. A community off Walnut Hill Lane in Dallas, one on Preston Road in Plano, and one near Texas Health Arlington Memorial can each use entirely different paperwork, with different fee structures, different notice periods, and different definitions of the same word. There is no state form. That means the burden of comparison falls on the family, and it falls at the worst possible moment, usually within a few days of a hospital discharge from Baylor University Medical Center or Medical City Dallas when everyone is exhausted.
Almost every DFW assisted living contract splits the monthly bill into at least two pieces: a base rate tied to the apartment itself, and a care charge tied to how much help your parent needs. The base rate is the number quoted on the tour. The care charge is the number that moves. Ask the community to show you, in writing and inside the agreement, exactly how care levels are assigned, how many levels exist, what each one costs, and who performs the assessment. Some communities in Collin County use a five-tier system with $400 to $700 between steps; others use a points system where each task, such as two-person transfer assistance or a nightly check, adds a dollar amount. Both are legitimate. What is not acceptable is a contract that says care charges are determined at the facility's discretion with no schedule attached. If the level-of-care pricing sheet is not part of the signed agreement, ask for it to be attached as an exhibit.
Then look for the one-time charges. Community fees, sometimes called move-in fees, commonly run from one to two times the monthly rate across the DFW market, and the agreement should state plainly whether any portion is refundable and on what timeline. A family in Lake Highlands who moves a parent in on September 1 and loses them to a stroke on September 20 should know before signing whether that fee comes back. Also check the rate-increase clause. Most Texas agreements permit an annual base-rate increase with 30 days' written notice, but the more important question is whether care-level increases require the same notice or can be applied immediately after a reassessment. Given 2026 DFW assisted living costs generally running $3,800 to $5,800 a month, and memory care $4,800 to $7,000, a single unannounced tier bump can move a family's budget by thousands a year.
Texas facilities assess residents before admission and periodically after, and that assessment drives both the care plan and the price. Read how often reassessment happens, what triggers an off-cycle reassessment, and whether you are entitled to be present or to receive a copy. Families frequently discover that a parent who came in from rehab at Methodist Dallas Medical Center was assessed on a good day, at a point when hospital physical therapy had them at their strongest, and that the level bumps within eight weeks as the post-rehab gains fade. That is a normal clinical trajectory, not a bait and switch, but a contract that gives you notice rights and an appeal path makes it manageable rather than adversarial.
The service plan itself should be specific. Vague promises to provide assistance with activities of daily living as needed are not much use if your mother needs a two-person transfer, insulin drawn and administered, or escort to the dining room at every meal. Under Texas rules, an assisted living facility must be able to meet the needs it accepts a resident with, and the license type matters here: a Type A license covers residents who can evacuate the building without staff assistance, while a Type B license covers residents who need staff help to evacuate, which is where most memory care and most higher-acuity residents belong. If your parent is borderline and the community holds only a Type A license, the contract should tell you what happens when they cross that line. It usually means a move.
The most consequential paragraph in a DFW assisted living agreement is often the one nobody reads: the involuntary discharge section. Texas assisted living facilities are generally required to provide 30 days' written notice before an involuntary discharge, with limited emergency exceptions, but the grounds listed in the contract vary widely. Look for language about needs exceeding the facility's licensed capacity, nonpayment, behaviors affecting other residents, and required hospitalization thresholds. Some agreements state that a resident who is hospitalized beyond a set number of days forfeits the apartment unless the family continues paying to hold it. Families whose parent is admitted to Texas Health Presbyterian Dallas for a two-week pneumonia course need to know that answer in advance, not from a voicemail on day twelve.
Just as important is the voluntary move-out clause on your side. Thirty days' notice is standard, but confirm whether notice must be given on the first of the month, whether a partial month is prorated, and whether the community keeps the last month's payment if a resident dies. This is a genuinely common source of DFW family disputes. Given how far apart these communities sit across four counties, a family in Rockwall who decides after five months to move a parent closer to a daughter in Flower Mound should not be surprised by a 60-day financial tail. If a term reads ambiguously, ask for it to be clarified in writing before signing rather than trusting a verbal assurance from a salesperson who may not be there in a year.
If there is any chance your parent will eventually need Texas Medicaid long-term care support, the agreement should be read with that in mind now, not later. Texas STAR+PLUS managed care and the STAR+PLUS Home and Community Based Services (HCBS) waiver can pay for personal and attendant care delivered in an assisted living setting, but the waiver does not pay room and board. That distinction only works in practice if the community participates with a STAR+PLUS managed care organization operating in the DFW service area, such as Molina Healthcare, UnitedHealthcare Community Plan, Superior HealthPlan, or Aetna Better Health, and if the contract does not require a minimum number of private-pay months. Many DFW communities do impose such a requirement, and some do not accept waiver residents at all. Ask directly, and ask for the answer in the agreement.
Finally, look at what the contract says about outside providers. Families routinely bring in a private companion for a few hours a day, a home health agency for wound care after a Parkland Health discharge, or hospice at the end. The agreement should state whether third-party providers are permitted, what credentialing the community requires, and whether any additional fee applies. Also confirm who holds decision-making authority on file, since a durable power of attorney for health care and a financial power of attorney are different instruments and the community will want both. Before signing, run the facility through the HHSC Long-Term Care Provider Search at apps.hhs.texas.gov to confirm the license type and review recent survey history, and take the unsigned agreement home overnight. Any DFW community that will not let you leave with a copy to read has told you something useful.
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