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Nursing Homes in Texas
As the second-largest state in the country, Texas offers an abundance of care options for 3.7 million adults aged 65 and over, including world-class hospitals, luxury assisted living communities and home care services. About 2.4% of these seniors reside in nursing home facilities due to physical or cognitive conditions that require round-the-clock care. While this type of care can be expensive, there are assistance options available.
According to the Genworth Cost of Care Survey for 2020, a private room in a nursing home in Texas costs an average of $6,388. A semi-private room costs an average of $5,019 per month. Nursing homes are institutions that provide medical care from licensed nurses as well as social services, over-the-counter medications, medical supplies, personal items and room and board.
Seniors can find more detailed information about nursing homes in Texas, including costs, financial assistance, regulations and other resources further along in this guide.
The Cost of Nursing Home Care in Texas
Texas is more affordable than any other neighboring state for nursing home care at an average of $5,019 per month for a semi-private room. Oklahoma is the next least expensive state at $5,323. New Mexico is the most expensive neighbor state to Texas at $7,406, but it’s still cheaper than many other states in the nation. Louisiana and Arkansas both cost less than $6,000 per month. All of these states are less expensive than the national average for care, which is $7,756 per month.
While Texas is a large and diverse state, most of the major cities have similar nursing home care costs which hover around the state average of $5,019 per month. The state capital of Austin has an average cost of $5,201 while the largest city, Houston, costs $5,627. Beaumont and El Paso are more than 800 miles apart but cost $5,262 and $5,232 respectively. The least expensive city in the state is Longview with a monthly average of $4,091. The most expensive city, which has an average cost of $6,350 per month, is Brownsville, located at the southern tip of Texas. Dallas and Amarillo share the same monthly average of $5,171.
Amarillo
$5171
Austin
$5201
Beaumont
$5262
Brownsville
$6350
Dallas
$5171
El Paso
$5232
Houston
$5627
Longview
$4091
In addition to nursing homes, seniors in Texas have access to many other types of care that can make their lives easier. Adult Day Care is the least expensive form of assistance at just $698 per month. Seniors who want to live in an assisted living community can expect to pay around $3,998 per month. Those who want to remain independent in their own homes will pay an average of $4,195 per month for both homemakers services and home health care.
Nursing Home
$5019
Adult Day Care
$698
Assisted Living
$3998
Home Care
$4195
Home Health Care
$4195
Does Medicaid Cover Nursing Home Care in Texas ?
Texas is one of the nation’s largest states by area, and its Medicaid program covers more than 4.5 million residents, which ranks it third in the nation after California and New York. Almost one in five residents qualifies for Medicaid or CHIP, and approximately 63% of nursing home residents receive financial assistance through this program.
Medicaid is an important source of long-term care funding. In fact, elderly and disabled beneficiaries account for almost two-thirds of the state’s Medicaid spending. According to the Texas Health Care Association, the Lone Star State has 1,215 nursing facilities that serve approximately 90,000 individuals. Adults who have significant medical needs and limited resources can qualify for Medicaid Long Term Services and Supports. The state also offers several waiver programs, such as STAR+PLUS, that can help residents stay in the community and avoid institutional care if they prefer.
Medicaid Eligibility in Texas
Traditionally, Medicaid is a safety-net program available to residents who have limited income and resources. However, if you require nursing home care, you can qualify through expanded eligibility pathways. Single seniors who need institutional care can earn up to $2,742 per month compared to $914 to $1,215 per month for those on regular Medicaid. Income limits for nursing home care are based on 300% of the federal benefit rate for Supplemental Security Income.
2022 Medicaid Income Limits for Seniors in Texas
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two Person | 1 | $32,904** | $2,000 | $148,680 |
| Two Person | 2 | $65,808 | $2,000 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
Before you’re approved for Medicaid, you must submit documentation and complete a personalized needs assessment to determine the type of care you require. To qualify for long-term care benefits, applicants must be:
- Aged 65 or older or disabled
- A U.S. citizen or legal resident
- A resident of Texas with a permanent address
How to Apply for Medicaid in Texas
If you believe that you’re eligible for Medicaid based on your income or medical status, contact the Department of Health and Human Services at (800) 252-8263, or get in touch with your regional Aging and Disability Resource Center by calling (855) 937-2372.
The state provides an online application portal at YourTexasBenefits.com where you can apply for medical coverage and other benefits. You may be asked to include documentation with your application. The Texas Health and Human Services Commission provides a list of acceptable items.
Information You May Need:
- A valid government-issued ID
- Financial statements
- Property tax assessments
- Proof of income, including Social Security benefits
- Proof of citizenship or legal residency
- Public assistance award letters
- Recent tax returns
- A list of vehicles
- Rental agreements or checks
- Insurance information
- Utility bills
Additional Medicaid Support & Resources in Texas
Applying for Medicaid is a complex process. For help, you can contact Texas Medicaid directly or reach out to public service agencies, such as pro bono law firms. Learn more about some of these options below.
| Resource | Contact | Services |
|---|---|---|
| Texas Medicaid Long-Term Care Services | (800) 252-8263 | The Texas Department of Health and Human Services administers the state's Medicaid program and long-term care benefits. You can contact this agency for help with your application or to learn more about ways to pay for nursing home care. |
| Your Texas Benefits | (512) 438-4313 | Your Texas Benefits is an online application portal for residents who may qualify for Medicaid, home- and community-based services and other financial assistance programs. Applicants are screened for health care, food stamps and related programs. The state also offers a convenient prescreening tool to check your eligibility. |
| Texas Legal Services Center | (512) 477-6000 | This statewide legal aid society is a key partner in the state's Health Information, Counseling and Advocacy Program (HICAP). It also helps residents who are having trouble accessing housing, health care and other essential services. |
Does Medicare Cover Nursing Home Care in Texas ?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Texas
Seniors who need help understanding Medicare nursing home benefits can contact the state or federal government for assistance. The Social Security Administration handles initial enrollment, and many related benefits and helpful services are offered at the state level.
| Program | Contact | Service |
|---|---|---|
| Texas Department of Insurance | (800) 252-3439 | The Texas Department of Insurance manages the state's Health Information, Counseling and Advocacy Program, which provides information about Medicare and long-term care insurance. It publishes detailed consumer guides on a variety of other insurance-related topics and provides a directory of helpful resources. |
| Texas Senior Medicare Patrol | (888) 341-6187 | The Senior Medicare Patrol program provides a variety of informational resources to help beneficiaries prevent and detect fraud and billing errors. The program works with Area Agencies on Aging and other partners to provide education and individual counseling. Seniors can call the SMP hotline to report any concerns. |
| Kepro Quality Improvement Organizations | (888) 315-0636 | Kepro is a government-designated organization that's dedicated to improving the quality of care for Medicare beneficiaries in Texas and 28 other states. Beneficiaries who have comments or concerns about the quality of care they've received at the state's hospitals and long-term care facilities are encouraged to contact Kepro for assistance. |
Other Financial Assistance Options for Nursing Home Care in Texas
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Texas
There are many resources in Texas that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Area Agencies on Aging | In Texas, seniors aged 60 and older can access a variety of supportive services through the state's 28 Area Agencies on Aging. These agencies can help with issues including benefits counseling, caregiver education and support and legal counseling, and they can connect seniors to their local Ombudsman program. AAAs can also assist seniors with more practical care concerns, connecting them with local resources, such as meal and nutrition programs, transportation services and respite and in-home care services. |
Cash Assistance Programs
Cash assistance programs in Texas provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Lifeline Program | 512-936-7000 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
| Texas Fleetwood Memorial Foundation | 817-877-0702 | If you're a retired Texas police officer or firefighter who was injured in the line of duty, you can get a grant to cover the costs of mobility equipment. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, Texas seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Health and Human Services | 855-937-2372 | Texas HHS provides a range of services to older Texans who require long-term assistance. HHS staff can connect seniors with personal care, medical assistance, transportation and other services. Some programs are available to anyone 60 and older, while others have eligibility requirements based on income or need. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Texas seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Meals on Wheels | Texas Meals on Wheels is part of the national network of Meals on Wheels providers. MOW is not a direct provider of food but can help Texas seniors find free food pantries through its online search database. Many pantries and food distribution points that partner with Meals on Wheels offer delivery services for homebound seniors; these services often include a welfare check. Congregate meal sites are usually available for seniors interested in a social dining experience. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Texas collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Ramp Project | 214-558-0339 | Your primary care provider or social worker can apply for medical equipment from the Texas Ramp Project on your behalf. The team builds a free wheelchair ramp so you can leave and reenter your property at your leisure |
Health Insurance & Prescription Drug Coverage for Seniors
Texas seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas BenefitsCheckUp | 800-252-3439 | Texas BenefitsCheckUp allows seniors in the state to find benefits available within their zip code, including forms of assistance that cover medications, nutrition, home energy and disability services. Seniors using the service can gain information about long-term care, social security income and taxes, helping them plan their retirement and budget for future expenses. The website may also provide contact information for elder abuse or crisis hotlines operating in the designated area. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Texas have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Section 504 Home Repair Program | 254-742-9700 | Seniors in rural Texas can access combined funding of $50,000 in grants and loans from the USDA Single Family Housing Repair fund. You can use loans to modernize, repair or improve your home or remove hazards to health and safety, while grants are exclusively for removing health and safety hazards. |
Legal Resources
Many organizations offer free or low-cost legal services to Texas seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Office of the Long-Term Care Ombudsman - Alvin, TX | 800-252-2412 | The Long Term Care Ombudsman office represents the interests and care of those in long-term care communities. Agents of this organization can help seniors and their families find the right fit for senior living, helping them determine what level of service fits best and making recommendations for different communities based on the amenities of each. Other services the Ombudsman Office include investigating complaints filed by residents of these communities, or by family members of residents who cannot advocate for themselves. |
| Texas Legal Services Center | 512-477-6000 | Low-income citizens, including seniors with limited means, can obtain free legal advice from Texas Legal Services Center. Areas of law include elder, consumer, pensions and benefits. |
| Legal Hotline for Texans | 800-622-2520 | The Legal Hotline for Texans is operated by the Texas Legal Services Center. It operates statewide, providing free civil legal information and assistance to seniors who are at least 60. Topics include long-term care, public benefits, Medicare, consumer rights, guardianship, powers of attorney and advance directives. The hotline is staffed during business hours on weekdays. |
| Texas Legal Services Center | 800-443-2528 | The Texas Legal Services Center is a nonprofit organization that serves those aged 60 and over throughout the state. Seniors can contact the center to get assistance with applying for public benefits or veterans' benefits or for help with pension recovery and end-of-life or loss-of-health planning. |
| Texas Office of the Independent Ombudsman for State Supported Living Centers | 877-323-6466 | The Office of the Independent Ombudsman for State Supported Living Centers protects the rights of long-term care residents across the state, including individuals who need memory care. Staff advocate for residents and their families, investigate complaints, monitor compliance and provide free information about quality and regulations related to long-term care. |
Senior Centers
Senior centers in Texas bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Alzheimer's Association Texas Chapter | 800-272-3900 | The Alzheimer's Association is a nationwide organization that helps fund Alzheimer's research and provides services and supports to those affected by the disease. It operates six chapters in Texas, including the Capital of Texas Chapter, the Dallas and Northeast Texas Chapter, the Houston and Southeast Texas Chapter, the North Central Texas Chapter, the San Antonio and South Texas Chapter and the West Texas Chapter. Through their local chapter, individuals can participate in support groups, become involved in community awareness and education programs, receive care consultations and access online tools to help find support groups and health care services. For information regarding eligibility for various programs, individuals should contact their local chapter or call 800-272-3900. |
| Texas 2-1-1 | Available 24 hours a day, seven days a week, 2-1-1 Texas operates a free hotline and website to easily connect Texans, including seniors, with a range of services and provide accurate information from local and statewide health and human services departments and programs. |
Senior Engagement
Senior engagement resources and programs in Texas help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Alzheimer's Texas | 800-367-2132 | Alzheimer's Texas is a nonprofit organization that provides referrals, information and support programs for Texans with Alzheimer's and other forms of dementia. Its services include consultations, educational classes, early-stage support, caregiver support groups and community respite development. Its community-based respite care program provides three to four hours of free care per week for participants, and its early-stage engagement program enables seniors to enjoy fun activities and social events. To learn about eligibility requirements, individuals should contact the 24/7 helpline at (512) 241-0420 or (800) 367-2132. |
| Texas Alzheimer's Disease Program | 888-963-7111 | The Alzheimer's Disease Program is a state-funded initiative that provides information and resources to those living with the disease and their family, friends and caregivers. Through this program, individuals can learn more about Alzheimer's disease, including warning signs and the next steps to take if a loved one has symptoms. It also provides a way for individuals to connect to the MedicAlert + Alzheimer's Association Safe Return emergency response service, which can help locate those who wander away or have a medical emergency, along with a variety of resources for caregivers. All resources are available in English and Spanish and are available to everyone. |
Social Security Offices
Social Security offices in Texas help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Texas resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Property Tax Exemptions | 888-334-4112 | The Homestead exemption, School District Property Tax Freeze and Senior Property Tax Deferral are available. Homestead reduces property value by at least $25,000, with an additional $13,000 deduction for seniors. SDP tax freeze prevents tax increases after age 65. Property taxes can be deferred until your estate is settled after death. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Texas retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas Comprehensive Energy Assistance Program (CEAP) | 877-399-8939 | The CEAP program provides financial assistance for low-income Texans to help them cover the costs of heating and cooling their homes. You can use the program to cover a maximum of eight utility bills per year. |
Veteran's Services
Texas retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Texas VA Benefits and Health Care | Texas' VA Benefits and Health Care services are available at facilities throughout the state, including medical centers in Bonham, Dallas, Houston, Kerrville and Waco and outpatient locations in several outlying areas. In addition, community-based sites and Regional Benefits Offices are available to provide social services for qualified senior veterans ages 65 and older or those with service-related disabilities. Programs available include Aid and Attendance, an increase in monthly pensions to assist with daily living activities or skilled nursing costs. | |
| TexVet | 800-273-8255 | Funded by Texas Health and Human Services, TexVet is a valuable resource for anyone who served in the U.S. military. Seniors can obtain advice and resources related to areas including veteran benefits, housing, mental health and transportation. |
Nursing Home Laws and Regulations in Texas
| Nursing Home Laws and Regulations in Texas | |
|---|---|
| Licensing Requirements | All nursing home facilities must be licensed by the Agency for Health Care Administration to operate in Florida. Separate licenses are required for facilities managed in different sites, even if operated by the same management. |
| Staffing Requirements | Each nursing home must have a designated director of nursing and an assistant director of nursing in a facility with more than 120 residents. The facility must also have sufficient nursing staff on a 24-hour basis.Nursing staff cannot be scheduled for more than 16 hours within 24 hours unless there's an emergency.Each nursing home facility must also have a licensed physician to serve as medical director. In facilities with less than 60 residents, a physician can serve as a medical consultant instead. |
| Staff Training Requirements | Each nursing facility must have staff education in HIV/AIDS training and at least one-hour of training for Alzheimer's disease or related disorders. Staff education must also include prevention and control of infection, fire prevention and disaster preparedness, accident prevention and residents' rights. |
| Admission Restrictions | Residents suffering from an infectious disease cannot be admitted to a nursing facility unless there are adequate isolation measures in place to control the transmission of the disease. Residents who need services beyond what the facility is licensed or able to provide may not be retained in the facility. |
| Care Planning Requirements | Residents admitted to a nursing facility must have a care plan. The care plan must contain a preliminary nursing evaluation, an assessment of each resident's functional capacity, and physician's orders, diagnosis, medical history and rehabilitative potential. The facility must also create a comprehensive care plan that describes the services provided for the resident. The care plan must be completed within seven days after completion of the resident assessment. |
| Dietary and Nutritional Services Requirement | Nursing facilities must have a designated full-time director of food services (DFS). The DFS must be a qualified dietitian or the facility must receive consultation from a qualified dietitian. A facility must also maintain a one-week supply of non-perishable food and supplies. |
| Specialized Rehabilitative Services | Each facility must provide residents access to rehabilitative services, and residents have the right to receive therapeutic and rehabilitative services in accordance with their care plan. |
| Medication and Pharmaceutical Services | Nursing homes must either employ or obtain the services of a state-licensed consultant pharmacist. The consultant pharmacist is tasked with creating a drug record system and ensuring it's accurate and in order. Prescription and nonprescription drugs that require refrigeration must be locked and only accessible to licensed staff. |
| Activities Requirements | Nursing facilities must allow residents access to recreational and other health-related services that may not be directly provided by the facility.Residents must also have the right to participate in social, religious and community activities, receive planned recreational activities and join in community-based activities programs. |
| Infection Control Requirements | Nursing facilities must keep the premises and equipment sanitary and implement infection control policies and procedures. Facilities must also provide willing residents with influenza vaccinations. |
| Medicaid Coverages | Medicaid covers nursing home care for qualified Floridians. Seniors must be 65 years and older, require a nursing home level of care and meet the income requirements. |
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