Nursing homes and assisted living in Texas

Texas is a huge state, and the care options change a lot from one city to another. Here we explain the names you will hear, how Medicaid helps, and who to call.

What care settings are called here

In Texas, the licensing agency is the Texas Health and Human Services Commission (HHSC). These are the main types:

• Assisted Living Facility (ALF): a residence with a homelike setting where the person gets personal care based on what they need. It can be an apartment-style building or a house with just a few residents.
• Type A ALF: for residents who do not need routine care during the night and who can follow directions in an emergency.
• Type B ALF: for residents who may need help from staff at night or to get out of the building in an emergency.
• Nursing facility or nursing home: offers 24-hour nursing care for people with greater medical needs or who are recovering after a hospital stay.
• Day Activity and Health Services (DAHS) and adult day centers: the person spends the day with activities and care, and goes back home to sleep.

How Medicaid helps in Texas

The main program for older adults is STAR+PLUS, the Medicaid managed care program for people 65 or older and adults with disabilities. It includes a service coordinator, personal care at home, and adult day centers. People who already live in a nursing home with Medicaid are also part of the program. Having Medicare usually does not keep you from enrolling.

For people who need a nursing home level of care but would rather stay at home or in the community, there is STAR+PLUS HCBS, which used to be called a waiver. Its services include assisted living, adult foster care, home-delivered meals, respite care, and help leaving a nursing home to move back into the community.

Some of these services use an interest list. Spots are given out in the order people sign up and based on the funding available. To sign up for the interest list for waiver programs (except HCS and TxHmL), HHSC says to call 1-877-438-5658.

Where to apply for Medicaid: at YourTexasBenefits.com or by calling 2-1-1. The income and asset rules are technical, so check your situation with HHSC or a professional before making decisions.

How much care costs in Texas

According to the CareScout Cost of Care Survey 2025 (data collected from July to November 2025, tables published in March 2026), the median costs in Texas are:

• Non-medical in-home caregiver: $30 an hour.
• Adult day center: $90 a day.
• Assisted living: $5,666 a month.
• Nursing home, semi-private room: $5,627 a month.
• Nursing home, private room: $7,604 a month.

These are medians: the real price depends on the city, the room, and the level of help. Ask for prices in writing.

Who to call

• Texas Long-Term Care Ombudsman: 1-800-252-2412. A free, confidential service that supports residents of nursing homes and assisted living.
• Aging and Disability Resource Centers (ADRC): 1-855-937-2372 (855-YES-ADRC). They give guidance on long-term services in all 254 counties of the state.
• Eldercare Locator (national helpline): 1-800-677-1116, to find the Area Agency on Aging in your area.

Tips for your family

• Check the license. In the HHSC long-term care provider search (TULIP), you can look up each place's license. If you have questions about any of the information, the residence itself or HHSC can clear it up for you.
• Ask what type of ALF it is. If your loved one needs help at night or has dementia, make sure the residence has a Type B license.
• Get on the interest list early. If you think your loved one might need STAR+PLUS HCBS later on, call as soon as you can; your place in line counts.
• Ask about language. Before you decide, ask whether there is Spanish-speaking staff on every shift, including nights and weekends.

On hogaresparamayores.com you can see licensed places in Texas and compare options near your family.