Does Texas require assisted living facilities to carry liability insurance or workers compensation?

Neither the Texas assisted living licensing rules nor the licensing statute requires Type A or Type B facilities to carry liability insurance. Texas does cap some damages in health care liability claims and requires an early expert report, which narrows some claims, but it does not cap defense costs, and a single serious claim can still exceed what a small facility can pay.

Your landlord, lender, Medicaid contract or referral sources will usually require coverage even though the license does not.

Texas is the only state where private employers may choose not to carry workers compensation (Labor Code section 406.002). A facility that does not carry it must notify the Texas Division of Workers Compensation in writing (section 406.004), tell each new employee at hiring, post notices at the workplace, and notify employees within 15 days when coverage is obtained or ends (section 406.005).

A non-subscriber also gives up common law defenses in employee injury lawsuits, and caregiver injuries from lifting and transfers are frequent in this class. Many non-subscribers buy an occupational injury benefit plan and employer liability coverage instead; whether that is cheaper than workers compensation depends on payroll and claims history.