Revision 14-0; Effective April 11 2014


Rules that apply to Section 2000 are located at 40 Texas Administrative Code (TAC), Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification.


2010 Licensing Process

Revision 14-0; Effective April 11 2014


Rule: 40 TAC, Chapter 19, Subchapter C, Nursing Facility Licensure Application Process


A facility must obtain a license to operate a nursing facility in Texas. An applicant must apply for a license and be determined by the (DADS) to meet the requirements for a license. All forms and instructions are available on the application webpage.


2020 Medicaid Contracting Requirements

Revision 14-0; Effective April 11 2014


DADS provides complete information and contract application forms on its How to become a nursing facility provider webpage.


2030 Medicaid and Medicare Certification Process

Revision 14-0; Effective April 11 2014


A facility may choose between offering private-pay only services (a facility with no certification), becoming certified for Medicaid or Medicare, or becoming dually certified. To become a Medicaid nursing facility (NF) provider, a facility must apply for a Medicaid contract and be certified as meeting the Medicaid requirements for participation and any additional DADS requirements.


2040 Facility Construction

Revision 14-0; Effective April 11 2014


Rule: 40 TAC, Chapter 19, Subchapter D, Facility Construction (§§19.300–19.344)


2041 Asbestos Survey and Abatement

Revision 14-0; Effective April 11 2014


Rule: 40 TAC, Chapter 19, §19.331, Construction Standards for Additions, Remodeling and New Nursing Facilities


An asbestos survey may be necessary before conducting renovation activities that pose a potential risk of asbestos exposure to residents, staff or visitors of a facility. See requirements at:

  • Texas Asbestos Health Protection rules in 25 TAC, Part One, Chapter 295, Subchapter C; and
  • National Emission Standard for Asbestos in the Code of Federal Regulations (CFR), National Emission Standards for Hazardous Air Pollutants, Title 40, Part 61, Subpart M.

On the Texas Department of State Health Services (DSHS) Asbestos Program website, there are links to the TAC and CFR references bulleted above. In addition, there is a link titled Locate Asbestos Licensees, which navigates to a public directory of licensed entities that can perform an asbestos survey and design an asbestos abatement project, if required. A plan for an asbestos abatement project must address preventing resident exposure to airborne asbestos or settled asbestos fibers that could be disturbed by normal facility operations.

For more information about the risks of asbestos as a carcinogen, providers may review the ASBESTOS CAS #1332-21-4 fact sheet issued by the Public Health Service Agency of Toxic Substances and Disease Registry of the U.S. Department of Health and Human Services, dated September 2001.

To find answers to questions about asbestos or how the asbestos rules may apply to a specific facility, providers are encouraged to contact DSHS at 512-834-6770 or 800-572-5548. For questions about this policy, please contact an architect in the DADS Architectural unit at 512-438-2371.