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Texas Assisted Living:
Type A or Type B?
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In Texas, assisted living residences that care for
three or more unrelated people must be licensed. This licensing is
defined at two levels: Type A and Type B.
TYPE A assisted living facilities may only accept and care
for individuals who can evacuate the residence without assistance
and who can follow directions in an emergency. Residents must not
need routine assistance during nighttime sleeping hours. The
caregivers in these residences might not be awake and immediately
available at night.
If a resident needs help to get in and out of bed, then a Type A
facility is not appropriate because the resident could not
evacuate independently in an emergency.
If the person is confused and could not follow directions in an
emergency unless a caretaker remains with him or her, then that
person is not a good candidate for a Type A home.
TYPE B assisted living facilities may accept residents who
don't qualify for a Type A facility because they will either need
personal assistance to evacuate the building or they cannot follow
directions on their own in an emergency…or both. Type B residences
are permitted to accept applicants who need assistance to get in
and out of bed. However, they cannot accept residents who are
permanently bedfast.
Type B facilities are more likely to have a caregiver who is on
duty and can check on residents throughout the night. However, it
is not a requirement that there be caregivers awake and on duty
all night. It is, however, a requirement that a sufficient number
of employees be in the building and available to assist residents
at night during an emergency.
If the potential resident has a condition that will probably get
worse, such as Alzheimer's disease, Parkinson's disease, multiple
sclerosis, ALS or other so-called degenerative diseases, then it
makes sense to choose a Type B assisted living facility at the
outset. Otherwise, it will probably be necessary for the resident
to move again to a Type B facility when the condition progresses.
Moving is difficult even for young and healthy people. It is so
difficult for many ill, frail, or elderly people to move that the
consequences of "relocation trauma" have been compared to
post-traumatic stress symptoms. Choose a Type B assisted living
residence and the need to move again to a higher level of care
might be postponed, or avoided altogether.
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