How to file an HHSC complaint against a Texas assisted living facility, who to call first, and what DFW families should document before they pick up the phone.
By Dallas Senior Advisor Care Team · August 6, 2026
If you want to know how to file an HHSC complaint against a Texas assisted living facility, the short answer is that you call one number: the Texas Health and Human Services Commission's Complaint and Incident Intake line at 1-800-458-9858, which is staffed for long-term care reports. You do not need a lawyer, you do not need the facility's permission, and you do not need to have exhausted the community's internal grievance process first. HHSC's Long-Term Care Regulation division licenses every assisted living facility in Dallas, Collin, Denton, Tarrant, and Rockwall counties under Texas Health and Safety Code Chapter 247 and 26 Texas Administrative Code Chapter 553, and the same division investigates complaints against them. Intake will ask for the facility's name and city, the resident's name, what you observed, and when it happened. You can file anonymously, though naming yourself makes it far easier for a surveyor to follow up on details only you know. Families in DFW often reach this point after a hospital episode, when a discharge planner at Baylor University Medical Center or Texas Health Presbyterian Dallas asks a question about the resident's condition that the community cannot answer.
It helps to understand what you are actually triggering. A complaint does not schedule a conversation between you and the administrator. It opens a regulatory file that may result in an unannounced on-site survey, staff interviews, a records review, and, if violations are cited, a plan of correction the facility must complete. That is a heavier instrument than a phone call to the executive director, and it is the right one when the issue involves resident safety, medication handling, staffing levels, or a pattern that has not improved after you raised it directly. HHSC triages incoming reports by severity, so the way you describe the problem matters: concrete, dated, specific allegations move differently than general dissatisfaction.
Not every frustration is a licensing violation, and knowing the line saves families weeks. HHSC's authority covers the things written into Chapter 553: whether the facility is operating within its license type, whether staffing and training meet the rule, how medications are stored and administered, whether the building meets life-safety and evacuation requirements, whether residents' rights are honored, and whether the community's service plan actually matches the care a resident needs. The license type matters more in Texas than most families realize. A Type A license covers residents who can evacuate the building without staff assistance. A Type B license covers residents who need staff help to evacuate, which is where nearly all memory care in Texas sits, because Texas has no separate memory-care license at all. If your parent's needs have progressed past what a Type A community is licensed to serve and the facility has not addressed it, that is squarely an HHSC matter, not a customer-service one.
What HHSC generally will not resolve for you is a billing dispute, a rate increase, a dining-room preference, or a personality conflict with a particular aide. Those are real problems, but they belong to the ombudsman, to the corporate operator, or to your contract. The distinction shows up constantly across the metro: a family in Preston Hollow unhappy with a second rate increase in eighteen months and a family in Lake Highlands who found a parent's blood pressure medication uncharted for three days are in very different regulatory territory, even though both are frustrated with the same building.
The single biggest difference between a complaint that produces a citation and one that closes with no findings is documentation. Before you call, write down a timeline: dates, times, what you saw or were told, and who told you. Photograph what can be photographed, including a pressure injury, an unsafe transfer setup, a room condition, or a medication administration record if you are authorized to view it. Keep the emails and texts from the community, and note the names and titles of anyone you have already raised the issue with. If your parent was seen at UT Southwestern, Medical City Plano, or Texas Health Arlington Memorial and a clinician documented something that contradicts what the facility told you, that hospital record is often the most useful single item you can reference. Ask the physician's office for the discharge summary or after-visit note rather than relying on memory. Intake staff will not collect this for you, and a surveyor arriving three weeks later cannot reconstruct what you never wrote down.
Also request a copy of the resident's current service plan and the admission agreement if you do not already have them. Texas assisted living facilities must maintain a service plan reflecting each resident's assessed needs, and a plan that has not been updated after an obvious decline is itself a documentable problem. Keep everything in one folder, digital or paper. If HHSC opens an investigation, you may be contacted for a follow-up interview, and having the timeline in front of you will make that conversation substantially more productive.
Texas gives families three distinct channels, and picking the wrong one costs time. HHSC Complaint and Incident Intake, at 1-800-458-9858, is the regulatory route for licensed facilities and is the one that can cite violations and require corrective action. The Texas Long-Term Care Ombudsman Program, reachable at 1-800-252-2412, is different in kind: ombudsmen are advocates, not regulators, and they work the problem with the facility on the resident's behalf, often faster and with less friction than a formal survey. For a care-plan dispute, a room transfer you believe is retaliatory, or a communication breakdown with an administrator, the ombudsman is usually the better first call. Texas Adult Protective Services, at 1-800-252-5400, handles suspected abuse, neglect, and exploitation and takes reports twenty-four hours a day. In a licensed facility, serious allegations frequently end up with both HHSC and APS involved, and you should not spend energy deciding which one technically owns it. Report it and let the agencies sort the jurisdiction.
Regionally, your Area Agency on Aging is a fourth resource that families underuse. The Dallas Area Agency on Aging, operated by The Senior Source, serves Dallas County. The Area Agency on Aging of North Central Texas, housed at NCTCOG, covers Collin, Denton, and Rockwall counties, and the Area Agency on Aging of Tarrant County serves Arlington and the rest of Tarrant. They connect to the local ombudsman staff and to benefits counseling, and Texas 2-1-1 will route you to the right one. Because the DFW metro spans four large counties and a family may be filing about a community in McKinney's Stonebridge Ranch while living in Oak Cliff, knowing which regional office is yours prevents a round of transferred calls.
Once a complaint is filed, HHSC assigns it a priority based on the alleged severity and immediacy of harm, and the most serious allegations are worked fastest. Ask intake what priority your report received and roughly when you can expect movement, since that answer varies with the nature of the allegation. Investigations are generally unannounced. You will typically be notified of the outcome, and survey findings for licensed Texas facilities become part of the provider's public record. You can look up a facility's licensing status and inspection history through the HHSC Long-Term Care Provider Search at apps.hhs.texas.gov, and if the community also operates a skilled nursing wing, Medicare's Care Compare adds federal survey data for that portion. Reading two or three years of history is more informative than reading the most recent visit, because a single citation in an otherwise clean record reads very differently from the same citation appearing repeatedly.
Filing does not obligate you to move your parent, and moving is genuinely disruptive, particularly in a metro this spread out. A relocation from a Las Colinas community to one near a daughter in Frisco can add forty minutes each way to a caregiver's routine, and in a car-dependent metro like DFW that change quietly determines how often anyone visits. Weigh the severity of the finding, whether the operator's plan of correction is credible, and whether comparable inventory exists near the family member who actually shows up. Sometimes the right outcome is a corrected facility and a family that now knows how to escalate. Sometimes the record tells you it is time to tour again.
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