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

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. Seniors who need institutional care can earn up to $2,523 per month compared to $841 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

 

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household
(One Spouse Applying)

$30,276

$2,000 for applicant
$137,400 for nonapplicant

Two-Person Household
(Both Spouses Applying)

$60,552

$3,000

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

Service

(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.

(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.

(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.

Resource

Contact

Service

(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.

(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.

(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.

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

A number of government organizations and private agencies are available to help Texans who have questions about nursing home care. The following resources can help seniors locate and pay for skilled nursing services.

Resource

Contact

Service

(800) 252-9240

Texas has 28 Area Agencies on Aging that work with the Department of Texas Health and Human Services to administer long-term care benefits and healthy aging programs. Staff members provide personalized needs consultations and connect residents to resources in their community, including in-home care, legal assistance, meals and transportation.

(800) 252-2412

This state office represents a network of paid and volunteer ombudsmen who advocate for seniors living in nursing homes and other long-term care facilities. They provide free, confidential services to help seniors understand their rights, and they work with residents and facility managers to ensure that services meet appropriate standards.

(800) 698-2411

The U.S. Department of Veterans Affairs provides an extensive array of benefits to service members and their spouses, including health care, pensions and Aid and Attendance stipends. Outpatient clinics and nonmedical counseling centers are located in most midsize cities, and Texas has five VA medical centers. Confidential benefits consultations are also available through state-operated veterans services offices in each county.

(855) 937-2372

Texas' Aging & Disability Resource Centers assist seniors and disabled adults in all 254 counties. Services are also available to family caregivers, friends and neighbors. ADRCs are a comprehensive resource for information about long-term care and community-based supports. The local ADRC can help with intake, applications and eligibility screenings for nursing home care.

(512) 424-6500

Own Your Future is the official website of the Texas Long-Term Care Partnership. This service helps residents estimate potential long-term care costs and provides information about participating insurance providers. Approved long-term care insurance plans can help seniors protect their assets, and part of the premiums may be tax-deductible.

COVID-19 Rules for Nursing Homes in Texas

The following information is based on research done on several government websites, including hhs.texas.gov. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Texas Communities

Can I visit my relative in person if he/she wants emotional support from me?

Yes (Conditions Apply)

Can I visit my relative in person for end-of-life compassion care?

Yes

Will my loved one be required to self-quarantine after I visit him or her?

No

Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?

Yes

Are Hairdressers and other non-medical contractors still allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors being screened for elevated temperatures?

Yes

Are visitors being asked questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Texas Communities

Are residents allowed to leave the facility for non-medical reasons?

Yes

Are residents of senior living facilities who leave and return required to self-quarantine?

No (Conditions Apply)

Are senior living facilities required to cancel all group outings?

No

Are residents still eating together in the dining hall?

Yes (Conditions Apply)

Are facilities still allowed to host group activities within the community?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Texas Communities

Are staff members and contractors being screened for elevated temperatures?

Yes

Are staff members and contractors being tested for Coronavirus?

Yes (Conditions Apply)

Are staff members and contractors being asked questions about health, travel, and potential virus contact?

Yes

Are staff members required to regularly screen residents for coronavirus symptoms?

Yes

Are residents relied on to screen themselves and self-report potential coronavirus symptoms?

No

Are staff members required to take residents’ temperatures?

Yes

Are residents being tested for coronavirus?

Yes (Conditions Apply)

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 Nutrition Services Requirements
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
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 Coverage
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.

Nursing Homes Facilities in Texas (237)