RALNA Regulatory Update December 14, 2021

The Texas Health and Human Service Commission (HHSC) is proposing new permanent rules based on lessons learned from the current pandemic. Assisted Living Facilities in Texas must pay attention to these new proposed rules because, if adopted, ALFs will need to update their policies and procedures to comply.

The rules have been published for comment in the Texas Register and are expected to go into effect in January 2022.


The proposed rules provide that during a “contagious disease outbreak, epidemic, or pandemic” – whether or not a public health emergency has been declared — an ALF must regularly check federal, state, and local guidance.

Infection control measures must be maintained when sheltering in place if an evacuation is necessary, and when receiving residents from another ALF that has positive cases of the disease that is the basis of the outbreak. ALFs must have a transportation plan in place in case evacuation is necessary, and must maintain a 90-day supply of PPE.

Every ALF must maintain infection and control measures that include:

  • Having a protocol for receiving deliveries;
  • Developing communication plans with current and prospective residents, resident representatives, and staff;
  • Conducting testing and monitoring activities;
  • Reporting new positive cases of the disease that is the basis of the outbreak, epidemic, or pandemic;
  • Carrying out screening of staff, visitors, and residents;
  • Maintaining adequate staffing and having a staffing plan to ensure that staff are trained and supervised. At least one staff member must be responsible for infection control procedure;
  • Changing visitation policies and procedures in response to direction from state agencies. However, Texas law mandates that certain visitations be allowed, such as for clergy, end-of-life visits, and designated essential caregivers.

The new rules are extensive and every ALF in Texas should review them carefully. The full text of the proposed rules can be found here.

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