St. Joseph Medical Center is a 792 bed senior housing facility. It is located in the Midtown neighborhood of Houston, Texas. The facility is in a generally upper class area, with a median household income of $75,332. ...
Nursing Homes in Texas
- SeniorAdvice's Guide to Nursing Homes in Texas
- Nursing Care Directory for Texas
- Nursing Care Costs in Texas
- Financial Assistance for Nursing Homes in Texas
- Texas Nursing Care Rules and Regulations
- Free Nursing Care Resources in Texas
The Lone Star State is a phenomenal retirement destination with 25 metropolitan areas and dozens of regional cities each offering its own brand of Southwestern flair. Nine cities, including Austin, Dallas, Kerrville and San Antonio, have already joined AARP's Network of Age-Friendly States and Communities by expressing their commitment to strengthening their services for older adults. Texas has nearly 29 million residents, and seniors represent about 13%, or 3.7 million, of the total population. This isn't surprising since the cost of living is about 6% lower than the national average, and Texans save a significant amount of housing and long-term care. Seniors also benefit from a mild climate with very little snow and warm, sunny weather during much of the year. Thanks to the state's strong economy and diverse businesses, residents enjoy easy access to world-class medical care, top-rated cultural attractions and many community-based resources for aging well.
The state's healthcare system includes more than 1,200 skilled nursing facilities that specialize in caring for adults who have multiple disabilities or complex medical needs. This guide explores long-term care costs, nursing home regulations and government-sponsored financial assistance programs that can help seniors pay for care.
SeniorAdvice's Guide to Nursing Home Care in Texas
Texas is a smart choice for nursing home residents, according to research from SeniorAdvice. The state's SeniorScore of 75 is three points higher than the national score. This rating is based on more than 100 items related to topics, such as Finances, Recreation & Leisure, Health & Safety and General Quality of Life.
Recreation & Leisure was the state's lowest-scoring category. It earned just 59 points despite having an average number of seniors, nearly 800 golf courses and more than 6,400 churches and religious institutions. Seniors also have access to a large number of parks and recreation areas. Texas earned a Health & Safety score of 63. Positive ranking factors include a high number of hospitals, doctors and senior living facilities, which compensated for the state's high crime rates.
Finances earned an average rating of 66. Property and sales taxes are high across the Lone Star State, although there's no income tax. Rankings were boosted by competitive prices for nursing homes and other forms of long-term care, as well as the state's moderate cost of living. Texas scores very well in General Quality of Life with 76 points, thanks to average rainfall and very pleasant year-round temperatures.
Top Nursing Care in Texas
The Belmont at Twin Creeks is a 112 room senior care facility. It is located at 999 Raintree Cir in Allen, Texas. With around 31,000 individuals living in the zip code of 75013, the encompassing area has a ...
San Remo is a 112 room senior care community situated within the Woods of Spring Creek II area of Richardson, Texas. The encompassing area has a dense population, with about 22,000 individuals living in the zip code of 75082. ...
Sagebrook Health Center is located at 901 Discovery Blvd in Cedar Park, Texas. It is a 124 unit nursing facility. The facility is in a predominantly wealthier area, with a median per-household income of $77,679. It is ...
Located at 11855 Lebanon Rd in Frisco, Texas, Stonemere Rehabilitation Center is a 136 unit nursing facility. The surrounding area is heavily populated, with approximately 49,000 individuals residing in the zip code of 75035. It is a predominantly ...
Situated in the Fossil Park neighborhood of Fort Worth, Texas, Remarkable Healthcare of Fort Worth is a 120 unit nursing care facility. The neighboring area is heavily populated, with about 56,000 people residing in the zip code of 76137. ...
Heartland Health Care Center-San Antonio is a 162 bed nursing facility located in the High Country area of San Antonio, Texas. The community is in a largely middle income area, with a median per-family income of $69,077. It ...
Villages of Lake Highlands is located nearby the Towngate neighborhood of Dallas, Texas. It is a 92 unit senior housing facility. The community is in a primarily middle class area, with an average family income of $61,572. ...
Brookdale Westlake Hills is located in the Barton Hills area of Austin, Texas. It is a 90 unit senior community serving people over the age of 55. With a median family income of $144,895, the community is in ...
The Carlyle at Stonebridge Park is a 99 bed senior care community located in Southlake, Texas. The encompassing area is densely populated, with approximately 28,000 people residing in the 76092 zip code. With a median per-household income of ...
Beacon Hill is a 150 unit senior community. It is located at 3515 S Park Ave in Denison, Texas. The community is in a predominantly middle income area, with a median per-family income of $45,400. It is ...
Park Manor of Mckinney is a 101 room senior care community. It is located at 1801 Pearson Ave in Mckinney, Texas. The encompassing area is heavily populated, with approximately 35,000 residents in the 75069 zip code. With ...
Located at 2460 Marsh Ln in Plano, Texas, Prestonwood Rehabilitation is a 132 room nursing care facility. The community is in a largely affluent area, with a median household income of $106,348. With about 48,000 poeple living ...
Prairie Estates is a 180 unit senior housing facility situated in Frisco, Texas. The community is in a primarily affluent area, with a median family income of $108,417. It is heavily populated, with about 74,000 individuals living in ...
Hearthstone Health and Rehabilitation is situated around the Brushy Creek neighborhood of Round Rock, Texas. It is a 120 unit nursing home facility. The facility is in a mostly upscale area, with an average household income of $91,674. ...
Located at 11353 Sugar Park Ln in Sugar Land, Texas, The Crescent is a 112 unit senior housing community. The community is in a generally affluent area, with a median household income of $87,196. It is densely populated, ...
The Harrison at Heritage is located in the Heritage area of Fort Worth, Texas. It is a 120 bed senior care community. The facility is in a generally upper class area, with a median family income of $87,964. ...
Park Manor of The Woodlands is a 124 unit senior care facility situated in The Woodlands, Texas. The community is in a generally well-to-do area, with an average family income of $87,350. With roughly 13,000 people residing in ...
Park Valley Inn Health Center is situated in the Brushy Creek neighborhood of Round Rock, Texas. It is a 128 unit nursing care facility. The surrounding area is heavily populated, with about 52,000 individuals living in the 78681 ...
Wedgewood Nursing Home is situated within the Park Palisades neighborhood of Fort Worth, Texas. It is a 93 unit nursing home facility. The community is in a primarily middle class area, with an average per-household income of $51,414. ...
The Cost of Nursing Home Care in Texas
Older adults in Texas benefit from very competitive nursing home costs. Median monthly rates of $5,019 are $2,737 lower than the national average, a savings of 35%. Texans save $2,387 compared to their counterparts in New Mexico, which is the most expensive state in the region. In Arkansas, nursing homes charge $5,931 per month, about $912 more. Median rates are $517 higher in Louisiana at $5,536, and seniors in Oklahoma pay $304 more per month.
- Texas: $5,019
- United States: $7,756
- New Mexico: $7,406
- Oklahoma: $5,323
- Arkansas: $5,931
- Louisiana: $5,536
The Cost of Nursing Home Care in Texas' Top Cities
Nursing homes in major cities across the Lone Star State charge anywhere from $5,171 to $5,962 per month. Median rates are highest in Laredo, followed by Houston, Corpus Christi and San Antonio at $5,627, $5,519 and $5,338, respectively. Prices in Lubbock, El Paso and Austin average between $5,201 and $5,293, and rates are lowest in Dallas and Amarillo.
- Houston: $5,627
- San Antonio: $5,338
- Dallas: $5,171
- Austin: $5,201
- El Paso: $5,232
- Corpus Christi: $5,519
- Laredo: $5,962
- Lubbock: $5,293
- Amarillo: $5,171
Senior Care Cost Comparison in Texas
Nursing homes in Texas are competitively priced, even when compared to other forms of long-term care. Skilled nursing costs just $1,021 more than assisted living at $3,998 and $21 more than memory care at $4,998. Home care agencies that help with chores, errands and medications charge $4,195 per month, about $824 less. Community-based adult day care programs are available in some cities for an average cost of $698.
- Memory Care: $4,998
- Assisted Living: $3,998
- In-Home Care: $4,195
- Home Health Care: $4,195
- Adult Day Care: $698
- Nursing Home Care: $5,019
Financial Assistance for Nursing Home Care in Texas
As you can see above, Nursing Home Care is often the most expensive senior care option – sometimes even 2-3 times the cost of other types of senior living. The primary reason for this is the 24/7 skilled nursing and other medical services that are provided. Thankfully, most people aren't forced to pay for skilled nursing care entirely out-of-pocket. Rather, many qualify for financial assistance programs to help cover the cost of nursing care.
Medicaid is the most comprehensive financial assistance program – but, not all seniors are eligible for Medicaid due to strict medical and financial eligibility requirements. 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.
Medicaid in Texas
Medicaid is a health insurance program available to low-income adults and children. It covers primary and acute medical care and many long-term services and supports, including skilled nursing. Since Texas expanded its Medicaid eligibility in 2013, enrollment has increased by 13%. Today, it covers 4.4 million Texans or about 17% of the state's population. Medicaid is also the primary source of funding for about two-thirds of the state's 90,000 nursing home residents, and the vast majority of the state's 1,200 skilled nursing facilities accept this type of coverage.
Medicaid Eligibility in Texas
STAR+PLUS is the state's Medicaid program for seniors and disabled adults. To qualify for long-term care benefits, applicants must meet financial and personal needs criteria. Here are some of the basic requirements.
- Applicants must earn no more than $2,382 per month if applying individually or $4,764 if applying as a couple.
- Assets are capped at $2,000 for individuals or $3,000 for couples, although personal property, such as a home or vehicle, is excluded.
- Beneficiaries must use all of their income for personal care, except for a $60 personal needs allowance.
- Nonapplicant spouses may be entitled to a minimum monthly maintenance needs allowance of up to $3,259.50. They're also allowed to keep up to $130,380 in nonexempt assets.
- Applicants must be a resident of Texas and a U.S. citizen or qualified noncitizen, such as a legal permanent resident, refugee or alien.
- As part of the application process, seniors must complete a functional needs assessment to verify that they require a nursing home level of care.
Applications for Medicaid are handled by the Department of Health and Human Services Commission. Individuals who meet these requirements qualify for health coverage and nursing home benefits, as well as Medicaid waivers that pay for noninstitutional alternatives, such as private duty nursing and home health care. Seniors can visit the official government website at YourTexasBenefits.com or call HHS at (855) 937-2372 to begin the application process.
Additional Financial Assistance Options
- Medicare: For the first 20 days in a skilled nursing facility, Medicare will cover the entire cost of care, and a portion of the costs up until day 100. After 100 days, Medicare won't cover any of the costs. Importantly, seniors must also have a "qualifying hospital stay" that lasts 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
- Aid and Attendance: Aid and Attendance may be available to veterans who receive a VA pension. This benefit is a monthly cash allowance that veterans receive in addition to their standard pension amount. It is intended for veterans in need of long-term care services and may be used to pay for skilled nursing care.
- Reverse Mortgages: For those who own a home, 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. It's often a good fit for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Keep in mind that reverse mortgage loans do need to be repaid (with interest), typically within 12 months of receiving the loan.
- Long-Term Care Insurance: For seniors who already have long-term care insurance, the cost of skilled nursing care may be covered. Most policies cover at least a portion of the costs, but it depends on the specific policy terms. It's important to note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a long-term care insurance policy.
Texas Nursing Home Care Rules and Regulations
Licensed and Medicaid-certified nursing facilities in Texas are regulated by the Health and Human Services Commission. In addition to licensing nursing facilities and skilled nursing facilities, it maintains the state's Nurse Aide Registry, approves training courses, licenses administrators and creates regulations for establishing and maintaining licensed nursing facilities. Here are some of the requirements that Texas nursing homes must follow.
Scope of Care | Nursing facilities provide 24-hour medical care to ensure residents' physical, mental and emotional well-being. They employ registered nurses, nurse aides, licensed administrators, pharmacists and rehabilitative therapists. Nursing homes may also apply a voluntary certification to care for individuals who have Alzheimer's disease, dementia or cognitive decline. A physician, physician's assistant or advanced practice registered nurse must approve each admission and provide orders for the residents' care. |
Care Planning | Facilities must complete a comprehensive needs assessment for each resident within 14 days of admission. The state requires a comprehensive reassessment every 12 months with quarterly reviews. Assessments may also be ordered following a significant change in the resident's health or behavior. These results are used to develop a comprehensive care plan that's approved by an interdisciplinary team. |
Pharmacy Services | Medicaid-certified nursing homes must provide all emergency and routine medication that residents require in-house or through a contracted provider. Licensed-only nursing facilities must provide emergency medications and offer services to help residents obtain their regular prescriptions. Nursing homes must employ or consult a licensed pharmacist who is responsible for maintaining appropriate records. Facilities are also responsible for reviewing residents' medication regimens monthly. |
Staff Screening | Texas Health and Human Services maintains a registry of certified nursing aides. Nursing facilities must conduct a comprehensive criminal background check on all direct-care workers within 24 to 72 hours of employment, depending on the facility's classification. Registry records must be reviewed annually for all applicable employees. |
Staff Training | In Texas, certified nurse aides must complete 100 hours of training and undergo a competency evaluation through a program that's approved by the Department of Aging and Disability Services. The state requires nurse aides to complete at least 24 hours of in-service training every two years with an emphasis on geriatrics and/or dementia to renew their registration. |
Medicaid Coverage | Texas Medicaid covers nursing facility care through its STAR+PLUS program, which serves seniors and disabled adults who meet income and asset requirements. Applicants must complete a function needs assessment to confirm that they require a nursing home level of care. |
Reporting Abuse | Instances of suspected abuse or neglect occurring in nursing homes and other licensed long-term care facilities should be reported to Texas Health and Human Services by calling (800) 458-9858. The Health and Human Services Commission's Provider Investigations department reviews complaints and follows up on all reports. |
Free Nursing Home Resources in Texas
The Texas Health Care Association is dedicated to representing members of the state's long-term care industry. It engages in advocacy and lobbying to increase funding and enhance the overall quality of care. Its Commitment to Care initiative tracks patient satisfaction ratings at the regional level and promotes best practices for improving long-term outcomes. The THCA offers professional training courses and provides a variety of resources for consumers who want to learn more about the state's nursing homes and alternative forms of long-term care.
Since 1977, TLSC has been serving seniors and low-income residents across the state. It helps with all types of civil legal issues ranging from pensions and retirement benefits to estate planning, long-term care access and nursing home admissions policies. This legal aid organization works to support the rights of seniors, veterans and disabled adults. Seniors can contact TLSC for free advice, self-help legal forms and assistance applying for government benefits, such as Medicare and Medicaid.
Texas Agencies
Texas Health and Human Services
Address: 4900 N. Lamar Blvd., Austin, TX 78751
Phone Number: (512) 424-6500
Website: hhs.texas.gov
Health and Human Services administers some of the state's most important public health programs for seniors, women and disabled adults. This agency manages the Department of Aging and Disability Services, which licenses nursing homes, assisted living facilities and healthcare administrators. It connects residents to Medicaid, long-term care services and supports, Medicare premium assistance and financial benefits, such as food stamps, through 11 regional offices.
Health Information, Counseling and Advocacy Program (HICAP)
Address: 4900 N. Lamar Blvd., Austin, TX 78751
Phone Number: (800) 252-9240
Website: hhs.texas.gov/services/health/medicare
Sponsored by the state's Area Agencies on Aging, the Health and Human Services Commission and the Texas Legal Services Center, HICAP provides free benefits counseling to Medicare and beneficiaries aged 60 and older. Counselors are trained to help with Medicaid, long-term care insurance and Medicare, including Medigap supplements, Part D prescription drug coverage and Medicare Saving Programs available to qualified beneficiaries who meet certain income and asset limits.
Texas Long-Term Care Ombudsman
Address: P.O. Box 13247, Austin, Texas 78711
Phone Number: (800) 252-2412
Website: hhs.texas.gov/news_info/ombudsman/search.cfm
The Office of the Long-Term Care Ombudsman operates through the state's network of Area Agencies on Aging. It educates seniors and members of the public about the rights of nursing home and assisted living residents. The ombudsman accepts confidential complaints, provides impartial advice and works with providers and state agencies to resolve disputes. It also communicates with legislators to strengthen the state's long-term care regulations. This independent agency serves nursing home residents and members of the public.
Area Agencies on Aging in Texas
Texas has 28 Area Agencies on Aging that support seniors and family caregivers in designated regions. AAAs fund a wide variety of programs that benefit adults aged 60 and older, including Medicare insurance counseling, delivered meals and in-home care. Staff members arrange needs assessments, handle benefits applications and work with families who have questions about long-term care planning. AAAs also direct seniors to local organizations that offer recreational activities, legal advice and accessible transportation. Seniors can call 211 or visit Health and Human Services to find their AAA.
Veteran Affairs Office in Texas
Senior veterans and their dependents can access a variety of benefits through the Texas Veterans Commission and the state's network of nationally chartered veterans service offices. Claims offices are located at VA facilities and public health centers in major cities throughout the state, and each county employs an accredited benefits expert. Officers can help with applications and appeals for health care, pension or disability benefits and long-term care, including access to the state's veterans' homes. Military families can visit TexVet.org to find a VSO in their county.
Social Security Offices in Texas
The Social Security Administration manages a number of programs that benefit disabled adults and older Texans. It handles Sociality Security disability and retirement benefits, as well as Medicare enrollment and survivor's payments. Some seniors who qualify for Supplemental Security Income may be eligible for a monthly stipend that can be used for room and board at long-term care facilities. For help applying for or managing benefits, seniors can contact their nearest Social Security office.
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