How to choose senior living in Texas
Most families start this search in a hurry, after a fall or a hospital stay. This is the short version of what we wish someone had told us: what the Texas license types mean, what the ratings measure, and who pays for what.
1. Match the type of care to the need
- Independent living: apartments with meals and activities, no hands-on care. Not licensed as care in Texas.
- Assisted living: help with bathing, dressing, medications and meals. Licensed by Texas HHSC as Type A or Type B.
- Memory care: assisted living with a Texas Alzheimer certification, secured areas and dementia-trained staff.
- Small care homes: licensed assisted living in a house with 16 or fewer residents. Often more personal and less expensive.
- Nursing homes: 24-hour skilled nursing, rehab after a hospital stay, or long-term care for complex medical needs.
2. Read the Texas license: Type A or Type B
Type Aresidents can get out of the building on their own in an emergency and don't need routine help at night. Type B residents may need staff to help them evacuate, may need care overnight, or may not be able to follow directions in an emergency. If your parent uses a wheelchair, needs help getting out of bed, or wanders at night, you are looking for Type B.
3. For dementia, look for the Alzheimer certification
Any assisted living facility in Texas that advertises Alzheimer's or dementia care must be certified for it. On each listing we show whether a facility holds that certification and how many memory care beds it has. Ask how the unit is secured and what training staff get.
4. For nursing homes, read past the overall star rating
Medicare rates every certified nursing home 1 to 5 stars overall, plus separate stars for health inspections, staffing and quality measures. Staffing is the one families feel most, so look at nurse hours per resident and turnover too. Fines and abuse citations are on each listing.
5. Know who pays for what
- Medicare covers short-term skilled nursing and rehab after a qualifying hospital stay. It does not cover assisted living or long-term custodial care.
- Medicaid pays for long-term nursing home care for people who qualify, and some assisted living through Texas STAR+PLUS at facilities that contract for it.
- Veterans and surviving spouses may qualify for the VA Aid and Attendance pension, which can help with assisted living costs.
- Long-term care insurance often pays for assisted living. Ask each community whether they bill the insurer directly.
6. On the tour, ask about money and staffing
- What's the base monthly rate, and how are levels of care priced on top of it?
- How many caregivers are on duty during the day and overnight?
- What happens to the price, and to my parent, if their needs increase?
- Can I see your most recent state inspection report?
Common questions
What is the difference between Type A and Type B assisted living in Texas?
Type A facilities serve residents who can leave the building on their own in an emergency, follow directions, and don't need routine care overnight. Type B facilities can serve residents who need help evacuating or need staff during the night. Most Texas assisted living facilities hold a Type B license.
Does Medicare pay for assisted living?
No. Medicare doesn't pay for assisted living or long-term custodial care. It can cover a short skilled nursing stay after a qualifying hospital stay. Some Texas assisted living facilities accept Medicaid through the STAR+PLUS program.
What does an Alzheimer certification mean?
Texas requires an assisted living facility that advertises Alzheimer's or dementia care to hold an Alzheimer certification, which comes with extra standards for staff training and secured areas. Our listings show which facilities hold one and how many memory care beds they have.
How do I check a facility's inspection history?
For assisted living, search the facility on the Texas HHS long-term care provider search to see inspection results. For nursing homes, Medicare Care Compare shows star ratings, inspection reports, staffing and fines.
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