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. 

$5019

Texas

$7756

The United States

$5323

Oklahoma

$7406

New Mexico

$5536

Louisiana

$5931

Arkansas

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.

$5171

Amarillo

$5201

Austin

$5262

Beaumont

$6350

Brownsville

$5171

Dallas

$5232

El Paso

$5627

Houston

$4091

Longview

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. 

$5019

Nursing Home

$698

Adult Day Care

$3998

Assisted Living

$4195

Home Care

$4195

Home Health Care

Financial Assistance for Nursing Home Care in Texas

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Texas.

Texas’s Medicaid Program

The Texas Medicaid and CHIP system is operated by the state’s Health and Human Services Department. As of September 2020, 4,356,699 Texans were enrolled in the system, but only 374,473 of those enrollments were Aged and Medicare-Related. These seniors are eligible to receive benefits for several different long-term care services, including assisted living, home health care and nursing home care. There are several waiver programs that may be able to pay for skilled nursing, including Community Living Assistance & Support Services, Community Based Alternatives and the HCBS Program.

Doctors may recommend that seniors with extensive medical needs receive full-time care in a nursing home, and Medicaid can cover those costs for some residents. Other than hospitals, nursing homes provide the highest level of care. They also assist seniors with mobility, feeding, grooming, bathing and other daily activities. Seniors who need these services on a temporary basis may require an alternative setting or may not be eligible for Medicaid assistance. There are 1,214 nursing home facilities in Texas that serve more than 90,000 people every year. 

To apply for Texas Medicaid, seniors can visit www.yourtexasbenefits.com or call (737) 867-7700. Changes to applications, renewals and other services are also provided online. People who need assistance applying can contact their local Area Agency on Aging or local Aging and Disability Resource Center. 

Medicaid Eligibility in Texas

Seniors, legally adults aged 65 and over, in Texas who need financial assistance with health care or health insurance may be eligible for Medicaid. These seniors must meet certain income requirements, which can be found on the table at this website. The maximum income for a household of one is $25,265. Applicants must also be at least one of the following:

  • Resident of the state of Texas
  • U.S. national
  • U.S. citizen
  • Permanent resident
  • Legal alien

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Texas

Texas has several private and government-run organizations that aim to help seniors with nursing home issues. Families can use these free and low-cost resources to locate licensed facilities, find financial aid and learn more about the basic operation of nursing homes throughout the state. 

ResourceContactService
Texas Area Agencies on Aging(800) 252-9240In conjunction with Texas Health and Human Services, local Area Agencies on Aging (AAAs) throughout the state are available to help seniors and families locate nursing services. They can also help people with Medicaid and other government resources as well as other benefits available in their community. Any adult in Texas who is aged 60 and over is eligible for help, and priority is given to people in rural areas, people with low incomes or with limited language skills, and those with Alzheimer’s or other forms of dementia.
Alzheimer’s Texas(800) 367- 2132Seniors who have Alzheimer’s disease or other forms of dementia can find out if a nursing home is an appropriate living option with the services available from Alzheimer’s Texas. The Texas chapter of this nonprofit organization assists individuals and families with planning for the future and finding education and support within the community. It also works with communities to develop respite programs that can help families relieve stress.
Veteran’s AffairsList of LocationsVA benefits can help pay for the nursing home care for a veteran or their surviving spouse as well as other long-term care services through the Aid & Attendance program. In order to access certain services, beneficiaries must be signed up with the VA health system, go through a screening process to determine specific needs, and have access to needed services near their current location. There may be a co-pay for certain services.
Aging & Disability Resource CenterList of LocationsAging & Disability Resource Centers are located throughout the state of Texas to help individuals and families with a wide range of issues related to elderly care, including nursing homes. Their representatives can provide one-on-one counseling that points people who may need nursing home care towards effective, affordable care options among a full range of long-term services. All adults in Texas aged 60 and over are able to take advantage of this resource.

Nursing Home Laws and Regulations in Texas

Licensing RequirementsAll nursing facilities in Texas are licensed by the Department of Aging and Disability Services. In addition to a licensing fee, the applicant for a facility must demonstrate that their location meets:Minimum standards of medical care, nursing care and financial conditionStandards of the Life Safety CodeMinimum construction standardsConditions to pass an on-site survey
Staffing RequirementsNursing facilities in Texas must always have licensed nurses or nurse aides available 24/7 to meet the needs of residents. There must also be a registered nurse who serves as a director of nursing on a full-time basis. On-duty nurses are responsible for assessing, evaluating, planning, and implementing resident comprehensive care plans according to admissions evaluations and reviews. While there is no legal resident-to-staff ratio in Texas, facilities are required to have enough staff to meet all the daily needs of residents.
Staff Training RequirementsNurses at nursing homes must complete a training and competency evaluation program that adheres to state law. This applies to both permanent and temporary employees. Individuals who have not practiced nursing for 24 consecutive months must go through new training and a competency evaluation program. Nurse aides must go through a performance review every 12 months.
Admission RestrictionsNursing homes in Texas are unable to admit seniors who have not been screened by a physician or who don’t meet residency requirements. The admitted party cannot have any conditions or medical requirements that the nursing staff is not equipped or trained to handle. 
Care Planning RequirementsEach nursing facility needs to create a comprehensive care plan for each resident that’s admitted to their location. This plan needs to establish short- and long-term goals, create care priorities, establish specific solutions to resident problems and help develop coping mechanisms. Each plan should coincide with the objectives of the resident’s physician. All of the critical needs of the resident need to be addressed, including:ActivityDietaryMedicalNursingPsychosocialRehabilitative
Dietary and Nutritional Services RequirementsEach nursing facility is required to provide palatable, nourishing and well-balanced meals to each resident according to their unique tastes and dietary needs. To ensure this objective is met, each facility needs to hire a dietary consultant for eight hours per month for the first 60 residents and an additional four hours for each group of 30 or more residents past that.
Specialized Rehabilitative ServicesWhenever a resident of a nursing home is prescribed specific rehabilitative services by their physician, the facility is required to provide the required services themselves or obtain the required services from an outside resource. Rehabilitative services must adhere to the physician’s plan and be documented by the facility. 
Medication and Pharmaceutical ServicesNursing homes in Texas are required to obtain routine drugs and biologicals and make emergency drugs readily available. Unlicensed medical professionals, such as students, are only permitted to administer drugs with the appropriate permit and under the supervision of a licensed nurse. In order to ensure the accurate administration of drugs, facilities must also employ or obtain the services of a licensed pharmacist. 
Activities RequirementsFacilities are required to offer ongoing individual and group activities that fulfill the interests of residents. These activities should be part of a program that promotes the physical, mental and psychosocial well-being of residents. The program must be run by a qualified therapeutic recreation specialist or activities professional.
Infection Control RequirementsNursing homes in Texas are responsible for preventing and controlling infections by establishing a program that provides safe, sanitary and comfortable conditions. This Infection prevention and control program (IPCP) must include effective policies for preventing the spread of disease among residents, staff and guests, and must include written policies, procedures and standards.  All incidents of infection of a reportable disease must be sent to local health officials. 
Medicaid CoverageIndividuals who meet certain requirements can get funds for nursing home care from the Texas Medicaid system. In addition to satisfying several income and residency conditions, beneficiaries of Medicaid must get approval from a physician who believes the beneficiary requires around-the-clock skilled nursing care.

Nursing Homes Facilities in Texas (225)