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Guide to Senior Living in Texas

Texas is a unique state in many ways, and the senior demographic is no exception. While the state is home to approximately 7% of the more than 52.5 million seniors in the United States, those aged 65 and older make up only 12.6% of the state’s population. By 2050, estimates say that the state’s senior population will increase to approximately 17.4%, which is well below the 20% predicted nationwide. However, with 5.9 million seniors projected to live in Texas by 2030, senior living facilities will undoubtedly become an increasingly attractive option for those seeking senior care.

The affordable cost of senior living in Texas may explain why seniors choose to live in the state. For example, the average monthly cost of assisted living is $3,750, which is $301 less than the national average. Even with more affordable options for senior living, many seniors may struggle to pay for needed care. Fortunately, a variety of programs exist that may reduce these expenses. This guide offers information about the cost of senior living in Texas, possible financing options, and agencies and programs in the state that offer support for seniors.

Covid-19 Rules and Restrictions for Texas Senior Living Facilities

The following rules and guidelines were obtained from the Texas Health and Human Services website, as well as other state-level government sites. Among others, these rules apply to nursing homes, assisted living facilities, and home and community-based services/group homes.

This data has been most recently updated on 7/2/20, but keep in mind that COVID-19 is a rapidly evolving crisis, so all of the below information can change at any time. For additional questions and up-to-date information, you can contact your loved one’s senior living facility or your local Area Agency on Aging

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?No
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?N/A
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Up to the facility’s judgment of the situation
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?No
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 and Group Activities

Are residents allowed to leave the facility for non-medical reasons?Yes, but it is not recommended
Are residents of senior living facilities who leave and return required to self-quarantine?Yes, in many cases
Are senior living facilities required to cancel all group outings?Yes
Are residents still eating together in the dining hall?Yes, in groups of 10 or less (staff included)
Are facilities still allowed to host group activities within the community?Yes, in groups of 10 people or less (staff included)

Safety Measures for Staff & Contractors 

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus?In cases of local outbreaks
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents 

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 (in case of local outbreaks)

Paying for Senior Living in Texas

The Cost of Senior Living in Texas

The quantity and level of care a senior needs often determines the cost they pay on a monthly basis, and there are several options available. Residential assisted living provides assistance with activities of daily living in a residential setting, and is less costly than comparable in-home care and home health care services. Around-the-clock care in a nursing home is surprisingly affordable in Texas, but is still the most expensive type of care available in the state, while adult day care services are the least costly option. Here are the average rates that seniors can expect to pay for each type of care:

$3750

Assisted Living

$3956

In-Home Care

$4004

Home Health Care

$704

Adult Day Care

$4867

Nursing Home Care

The Cost of Assisted Living in Texas

Assisted living in Texas is affordable compared to the national average. Genworth Financial’s Cost of Care Survey for 2019 reports an average cost of $3,750 for the state, and $4,051 nationwide. However, Texas is a bit more expensive than some neighboring states. Average rates in Arkansas, Oklahoma, and Louisiana are all less expensive at $3,175, $3,518 and $3,650, respectively. Only New Mexico is higher at $4,100. In general, seniors in the southwest can expect to pay a bit less than the national median, with some states averaging nearly $900 less.

$3750

Texas

$4051

United States

$4100

New Mexico

$3518

Oklahoma

$3175

Arkansas

$3650

Louisiana

The Cost of In-Home Care in Texas

Texans who aim to age at home may eventually need help with cooking, cleaning, and running errands, among other daily tasks. In-home care companies take care of these activities, so seniors can spend more time on doing what they love. This type of service costs $3,956 per month in Texas, $334 less than the U.S. average and border state New Mexico’s average. It’s also less than Texas’s northern neighbor Oklahoma by about $240, but higher than both its eastern neighbors Arkansas and Louisiana by $333 and $738, respectively.

$3956

Texas

$4290

United States

$4290

New Mexico

$4195

Oklahoma

$3623

Arkansas

$3218

Louisiana

The Cost of Nursing Home Care in Texas

To receive supervision and care 24/7 in a semiprivate room in a nursing home, Texans pay an average of $4,867, a startling savings of $2,646 per month, considering the national average for this type of care is $7,513. Comparisons with bordering states yield the same results: Nursing home care in New Mexico, Arkansas and Louisiana cost between $568 and $2,463 more than in Texas. The only exception is Oklahoma, which boasts the same low cost as The Lone Star State. 

$4867

Texas

$7513

United States

$7330

New Mexico

$4867

Oklahoma

$5505

Arkansas

$5435

Louisiana

Financial Assistance for Senior Living in Texas

STAR+PLUS
In 2015, Texas created the STAR+PLUS program to streamline care for seniors who need long-term supports. Under this Medicaid waiver program, seniors can opt to receive a variety of care and support services at home, but the program also pays some of the care costs associated with senior living. STAR+PLUS is a managed care program, where all services are organized through a single contact, much like an HMO.

To qualify for this waiver, seniors must be disabled or aged 65 or older. Applicants must also meet the Medicaid program’s financial eligibility requirements. Anyone who qualifies for Supplemental Security Income automatically qualifies for Medicaid.

Contact: Seniors interested in the STAR+PLUS program can send an email to [email protected] for more information or apply at YourTexasBenefits.com.

Community Care for Aged and Disabled
The Community Care for Aged and Disabled (CCAD) program offers financial assistance to seniors in an adult foster care home or senior living facility, along with a variety of in-home options for care. The CCAD program is not administered through Medicaid, although Medicaid guidelines are often used as part of the criteria to determine CCAD eligibility.

To qualify, applicants must be aged 65 or older and meet the program’s functional and income and asset guidelines. Seniors must need assistance with ADLs and have no Medicaid coverage for similar services.

Contact: Seniors must apply for the CCAD program through their local Aging and Disability Resource Center. Call the ADRC hotline at 855-YES-ADRC to discuss your options and the program requirements.

VA Aid and Attendance Program
Those who have served in the armed forces or a surviving spouse may qualify for financial assistance under the Aid and Attendance benefit program. This program provides a cash allowance, in addition to any pension currently received, that can be used to pay for some of the costs of a senior living facility. The funds can be used to help cover the cost of room and board, which is often excluded from Medicaid programs and waivers. As of 2020, the maximum pension amounts including the Aid and Attendance benefit are $27,194 for a married couple, $22,938 for an individual and $14,761 for a surviving spouse.

To qualify for this additional benefit, a former service member must have a clean record and an honorable or other qualified discharge, along with at least 90 days of service in the military, including at least one during wartime.

Contact: Veterans interested in applying for the A&A benefit should contact their local VA office. The process is often long and complex, but benefits may be paid retroactively.

Senior Living Laws and Regulations in Texas

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations. 

Texas Health and Human Services licenses all long-term care facilities throughout the state. Most Senior Living Facilities receive either an A or B license. The major difference is that those with a type A license can only accept residents who can self evacuate during emergencies, while a B license is for facilities that offer assisted evacuation. All senior living communities providing memory care must have a B license. Keep reading to find out more about the statutes and regulations that govern senior living facilities in Texas.

Scope of Care Provided

Senior living facilities offer a variety of assistance services including personal care and help with ADLs. General supervision is also part of the care offered at these communities. A Senior living facility must also offer a weekly activity or social program. Memory care units and facilities must also encourage socialization, physical activity and cognitive development in scheduled activities. Activities must be provided for memory care residents on a daily basis.

A Senior Living Facility cannot provide ongoing skilled nursing services similar to the level of care offered in a nursing home, although temporary services can be offered for up to 30 days following an illness or injury.

Care Plan Requirements

Within 14 days of admission, senior living facilities must complete a comprehensive evaluation and develop an individualized service plan for each resident.

Medication Management 

Medication management is typically limited to supervision and reminders for residents capable of self-administration. Staff may assist with opening containers and pouring out appropriate dosages, and returning medications to secured areas after each dose. Some residents may choose to keep medications secured in their rooms, but staff must assess those residents at least once a month to determine their continued capability.

Senior living facilities can work with residents who are not able to self-administer medication. The staff member providing medication management must hold a current license to administer medication, have a medication aide permit and act under the supervision of a licensed nurse. Alternatively, the staff member must be delegated and trained in the task by a staff nurse.

Staff Requirements

Senior living facilities must maintain comprehensive staff records that document the completion of a criminal background check prior to hiring, an annual employee misconduct registry check and an annual nurse aide registry check. Staff files must be provided to the Texas Health and Human Services Department upon request.

All Senior Living Facility staff must complete a four-hour orientation upon hiring. Direct care staff must complete an additional 16 hours of on-the-job training. Each year, staff must complete at least six hours of continuing education, with some positions requiring more.

Report Abuse or Neglect

The Health and Human Services Department investigates all claims of abuse or neglect in licensed senior living facilities in Texas. To report an incident, call 1-800-458-9858.

Texas Senior Living Free Resources

Texas Agencies

Texas Health and Human Services

Texas Health and Human Services is the state government department that administers many of the publicly funded programs designed for seniors. While calls may be referred to a local office, HHS provides comprehensive information about available services statewide and is a resource for seniors and caregivers looking for financial assistance.

Contact: To find out more about programs that may be available in your area, call 1-877-541-7905.

Area Agencies on Aging in Texas

Area Agencies on Aging provide a variety of assistive services ranging from case management to eligibility determinations for Medicaid waiver programs. All services provided by AAAs are free of charge, and seniors are encouraged to call for more information about specific options, financial assistance and available local programs.

Veterans Affairs Offices in Texas

Those with a history of military service and their spouses may be eligible for benefits through VA programs. The Aid and Attendance benefit is one option that provides funds for senior living. To learn more, contact the nearest VA office.

VETERANS OFFICEADDRESSPHONE NUMBER
Houston Regional Benefit Office6900 Almeda RoadHouston, TX 77030Beneficiaries in receipt of pension benefits: (877) 294-6380Other benefits-related inquiries: (800) 827-1000
Waco Regional Benefit Office701 Clay AvenueWaco, TX 76799Beneficiaries in receipt of pension benefits: (877) 294-6380Other benefits-related inquiries: (800) 827-1000
Houston Regional Loan Center6900 Almeda RoadHouston, TX 77030(800) 827-1000
Veterans’ Crisis LineReach them by phone.(800) 273-8255
VA Pension Management Center1 Federal DriveSt Paul, MN 55111(800) 827-1000

Social Security Offices in Texas

Social Security benefits are earned throughout a senior’s working life and can be used to pay directly for senior living care. In specific, these funds may be used for room and board which is often excluded from other funding options. For more information, contact your local Social Security office or check online.

Frequently Asked Questions

How much does assisted living cost in Texas?

The cost of assisted living is closely tied to location. There are areas in Texas where costs exceed $5,300 and other areas where costs are as low as $2,000 per month. The average across the state is $3,750.

Does Texas Medicaid pay for assisted living?

While standard Medicaid does not pay for assisted living, those who qualify may receive financial assistance through the Texas Medicaid STAR+PLUS waiver program.

Does Medicare pay for assisted living?

Medicare does not offer coverage for care services provided in assisted living facilities, however, it does offer limited coverage for nursing home stays.

What types of services are available in assisted living?

Assisted living facilities typically offer personal care, help with ADLs, meals, social opportunities and entertainment. Planned activities and exercise classes are also common offerings, along with access to primary medical care, podiatry and dentistry services.

What is the difference between assisted living and nursing homes?

In Texas, a nursing home provides round-the-clock care from registered nurses, while assisted living facilities do not. Depending on the level of care required, a nursing home may not offer as many amenities as an assisted living facility and may also have a more limited calendar of activities.

The Top Cities for Senior Living in Texas

Learn more about the cost of senior living in the top Texas cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.

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