Texas · Assisted Living Facility (Type A / Type B)
Texas assisted living medication record requirements (26 TAC § 553.261)
In Texas, assisted living medication requirements sit in 26 TAC § 553.261 — a section titled “Coordination of Care,” which is why operators often struggle to find them. Subsection (a) covers medication end to end: who may administer (a)(1), what the medication profile record must contain (a)(1)(D), permitted supervision tasks (a)(2), monthly counselling for residents who self-administer (a)(3), documentation of missed doses and unusual reactions (a)(4), locked storage and diversion prevention (a)(5), and disposal (a)(6).
- Regulator
- Texas Health and Human Services Commission
- Governing chapter
- 26 TAC Chapter 553 — Licensing Standards for Assisted Living Facilities
What the rule requires
Only authorised personnel may administer
26 TAC § 553.261(a)(1)
Medications are administered according to physician orders, by personnel who are licensed, hold a medication aide permit, are properly delegated, or are RN-verified.
The medication profile record
26 TAC § 553.261(a)(1)(D)
Each resident has a medication profile record listing the drug, strength, dosage, directions, route, pharmacy, prescription number, and issue date.
What counts as medication supervision
26 TAC § 553.261(a)(2)
Supervision may include reminders, opening containers, pouring doses, returning medication to locked storage, and listing the medication on the profile.
Monthly counselling for self-administering residents
26 TAC § 553.261(a)(3)(A)
Residents who keep medication locked in their own rooms are counselled at least monthly, and a written record of that counselling is retained.
Missed doses and unusual reactions
26 TAC § 553.261(a)(4)
Unusual reactions are reported immediately, and any supervised or administered medication not received or taken as prescribed is documented.
Locked storage and diversion prevention
26 TAC § 553.261(a)(5)
Medication storage is locked, residents' medications are kept separate, refrigerated medications are protected, and the facility maintains controlled-drug diversion prevention policies.
Disposal and release at discharge
26 TAC § 553.261(a)(6)
Discontinued, expired, or post-death medications are separated and disposed of through a registered pharmacist. Centrally stored medications are released at discharge only against a signed receipt.
Questions operators actually ask
Why can't I find the Texas medication rules?
Because the section is titled “Coordination of Care,” not “Medications.” The medication requirements are subsection (a) of 26 TAC § 553.261. Searching the chapter for the word “medication” finds the content; searching the section titles does not.
Did the Texas medication rules move to § 553.267?
No. A December 2023 proposal would have repealed § 553.261 and relocated the medication rules to a new § 553.267, but HHSC withdrew that proposal. As of this page's verification date the medication rules remain in § 553.261, which was last amended effective 31 August 2021. Cite § 553.261.
Who is allowed to administer medication in a Texas ALF?
Under § 553.261(a)(1), a person holding a current license that authorises medication administration, a person holding a current medication aide permit acting under a licensed nurse's authority, or personnel operating under proper delegation or RN verification.
Does Texas require an electronic medication record?
No. § 553.261 specifies the information the medication profile record must contain, not the format. Paper and electronic records are both acceptable if the required fields are present and retrievable.
What this page does not cover
This page covers medication records only. Chapter 553 separately governs accident and injury response, staffing, resident assessment, and physical plant requirements.
How current this is, and its limits
Every citation above was re-verified against the current regulation on 2026-08-06. Regulations change, and this page is a plain-English summary — not legal advice, not a compliance determination, and not a substitute for reading the regulation or asking your licensing analyst. Always confirm the current text before relying on it in a survey.
Read the source: Texas Health and Human Services Commission
Subsection structure confirmed: (a)(1) Administration, (a)(2) Supervision, (a)(3) Self-administration, (a)(4) General, (a)(5) Storage, (a)(6) Disposal. The proposed relocation to § 553.267 was WITHDRAWN — citing § 553.267 would be wrong. The seed's § 553.261(b)(1) accident-response requirement is outside this page's scope and was not independently verified.
See how these records look on a screen
A twenty-minute walkthrough of the medication record, the controlled count, and the reports a surveyor asks for, using sample residents only. You keep the notes whether or not we ever work together.
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