Harris County unveils backup power mandate for nursing homes, assisted living facilities

Assisted living facilities and nursing homes in the unincorporated areas of Harris County now are required to install backup power generators to keep heating and cooling systems operational during electrical outages, making the county among the first in Texas to implement such a mandate. 

The mandate, included in the county’s revamped fire code, comes after the derecho in May, followed by Hurricane Beryl in July, that left more than 2 million households and businesses without power during sweltering temperatures. During the hurricane, at least 14 nursing homes and 30 assisted living facilities in Harris County lost power for multiple days.

“This is for all of our families, whether it’s our parents, our grandparents, our great grandparents, all of us. We’re all aging, and this could be us,” Precinct 4 Commissioner Lesley Briones said at a Wednesday news conference to announce the new requirement. 

At least 120 facilities throughout unincorporated Harris County will be required to have secondary power systems that switch on within three hours after an initial power loss. The updated code also requires facilities to implement emergency communication systems for rapid response, provide power for essential medical equipment and secure evacuation measures through powered doors and elevators. 

Briones proposed the mandate be added to the county fire code at  Commissioners Court’s Nov. 12 meeting. It passed unanimously.

Wednesday’s announcement sent at least one statewide association of assisted living facilities scrambling for answers. 

Carmen Tilton, Vice President of Public Policy at the Texas Assisted Living Association, said that she did not learn about fire code change until it was enacted Jan. 1. 

She said the association has been trying to find out details about the changes — the most she has heard from Harris County officials was at Briones’ news conference touting the mandate — and the organization already is fielding questions from assisted living facilities that are impacted. 

“I wish we had been brought in on these conversations because I think we could have helped,” she said. “Right now, I have a whole lot more questions and answers.”

County officials said facilities will have until Jan. 1, 2026, to comply with the new requirements, which they said they hoped will be enough time to prepare and implement changes.

Harris County Fire Marshal Laurie Christensen said she recognized there likely will need to be some flexibility with that date because some facilities could face delays securing permits or generators. 

Tilton said that while she appreciated the acknowledged need for flexibility, Texas nursing and assisted living facilities must pass an annual fire inspection to keep their state operating licenses.

Including the mandate in the county’s fire code raises questions about whether their licenses would be in limbo if they do not have a generator by the county’s deadline, Tilton said. 

The revamped Harris County fire code also uses a different definition for assisted living facilities compared to the state, Tilton noted. The county, she said, defines an assisted living facility as one having 16 or more occupants; state law puts it at four.

“It just doesn’t align,” she said. “If we’re using the same words but we’re not using the same definitions or identifying the groups of larger versus small the same way then that opens up areas of confusion.” 

Tilton said she was not necessarily opposed to the new mandate, but is “trying to be practical” about how association members will properly comply with the regulations. 

“There are just lots of logistics that we need to figure out,” she said. 

Christensen said her team, along with other local officials and the Texas Department of Health and Human Services will collaborate to notify and educate facilities about the new backup power requirement. She added she is cognizant the new regulation likely will come with a steep price tag.

The Texas Health and Human Services Commission in 2021 estimated the cost of installing a new generator capable of supporting certain air temperatures could range from $20,000 for a new and smaller facility to $720,000 or more for an older and larger facility, according to the Texas Tribune. 

The fire marshal’s office already conducts annual inspections on nursing homes and assisted living facilities to ensure they are in compliance with state regulations for their licenses, making the new mandate “another box we need to check,” Christensen said.

A failure to comply with the new requirement could result in citations, but Christensen said the fire marshal’s office likely will try to steer facilities toward compliance.

“When you look at our fire code, a lot of people think of it as enforcement,” Christensen said. “It’s not about enforcement — it’s about education. Our goal is to prevent a fatality before it happens, whether it be by fire, heat or cold.”

Texas law requires all new nursing homes to have a backup generator that can power safety features, such as emergency lighting and exit signs, fire alarm systems, nurse call systems, telephones, medication and life-saving equipment since 1996. Assisted living facilities are not required to have a generator by state law. 

The state law does not require those generators be capable of powering air conditioning or heating systems.

State lawmakers have tried to implement a requirement for backup generators at assisted living facilities and nursing homes but each attempt has stalled. Other states, including Florida and Maryland, have enacted stricter laws.

Andrea Earl, associate state director of advocacy and outreach at AARP Texas, said she was aware Harris County officials had been sounding the alarm to state lawmakers about the need for enhanced requirements at assisted living and nursing homes.

Progress is better than no progress, Earl said, but real change will require a policy adopted by the Texas Legislature. 

“We applaud Harris County but what you see in a lot of these areas is that once the issue is addressed, the problem just moves,” she said.  

Local fire codes are not subject to the same potential civil and criminal penalties that could be enacted with a state law, she added. 

The new regulations will not apply to independent living facilities, which also have struggled with power issues during natural disasters. Unlike nursing homes and assisted living facilities that provide higher levels of care, independent living facilities are not certified by the state, do not require state licenses and face scant oversight from regulators in comparison.  

Houston Mayor John Whitmire said he wanted to tighten accountability on landlords who failed to prepare for disasters or provide adequate relief to their tenants. In August, the city’s housing director said Houston could shift the way it funds independent senior living facilities to encourage better disaster plans.

The mayor’s office and Housing and Community Development Director Mike Nichols did not immediately respond to requests for comment about the status of their accountability efforts.

Houston Landing reporter Hanna Holthaus contributed to this story. 

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