Nursing Homes and Senior Care in Texas

Nursing Homes by City in Texas

The Texas cities with the most CMS-certified nursing homes. All 440 cities are listed below the table. Homes in Texas average 3.4 hours of nursing care per resident per day; the national median is 3.7 hours.

5-Star Nursing Homes in Texas

Homes with CMS's top overall rating, ordered by inspection rating. See all highest-rated nursing homes in Texas.

Assisted Living in Texas

Texas Health and Human Services Commission (HHSC), Long-term Care Regulation licenses assisted living in Texas. License types: Assisted Living Facility Type A and Assisted Living Facility Type B. Use the state's search to check a community's license and inspection history.

• Texas assisted living facility search
• Texas assisted living rules
• Texas assisted living licensing (Texas Health and Human Services Commission (HHSC), Long-term Care Regulation)

Memory Care Rules in Texas

Texas's term is "Alzheimer's Certification (Certified Alzheimer's Assisted Living Facility)", a separate license or certification. Facilities must give families a written disclosure of their dementia care services.

• A facility must be certified if it advertises care for persons with Alzheimer's disease (26 TAC §553.27(a)).
• The facility must be licensed as a Type B facility (26 TAC §553.27(b)); the certificate is posted, valid for three years and limits the number of residents (§553.27(e)-(g)).
• Manager must be at least 21 and complete 6 hours of continuing education regarding dementia care annually (26 TAC §553.301).
• Staff complete 4 hours of dementia-specific orientation before assuming any job, covering information about Alzheimer's, managing dysfunctional behavior, and identifying and alleviating safety risks (26 TAC §553.303(a)).
• Direct care staff complete 16 hours of on-the-job training within the first 16 hours of employment (26 TAC §553.303(b)).
• Direct care staff complete 12 hours of in-service education regarding Alzheimer's disease annually, including one hour on behavior management, fall prevention or alternatives to restraints (26 TAC §553.303(c)).
• Employ sufficient staff; in large facilities, staff is immediately available when residents are present (26 TAC §553.305).
• A disclosure statement is updated and submitted to HHSC, explained to the resident or family, and a copy provided (26 TAC §553.307(a)-(b)).
• Assessment within 14 days of admission and annually; service plan within 14 days of admission (26 TAC §553.307(c)-(d)).
• Individualized activities program; a facility with 17 or more residents must employ an activity director for 20 hours weekly; structured activities of at least 6 1/2 hours for the week and at least 1 1/2 hours during the weekend (26 TAC §553.309).

• Texas memory care rules

Medicaid Long-Term Care in Texas

Texas's Medicaid program is Texas Medicaid (Medicaid for the Elderly and People with Disabilities). For nursing home Medicaid (2026), the state lists an income limit of $2,982 (individual), special income limit equal to or less than 300% of the SSI federal benefit rate, effective Jan. 1, 2026 and an asset limit of $2,000 (individual); $3,000 (couple), effective Jan. 1, 2026. Residents keep a personal needs allowance of $75 for a nursing facility recipient, effective Jan. 1, 2026.

• STAR+PLUS Home and Community Based Services (HCBS) program: in-home care, assisted living and respite. Serves people who would otherwise require nursing home care. Services include personal assistance services, adult foster care home services, assisted living, emergency response, home delivered meals, nursing services, respite care and minor home modifications.

• Texas Medicaid (Medicaid for the Elderly and People with Disabilities) nursing facility coverage
• Texas Medicaid long-term care limits

Nursing Home Inspections and Complaints in Texas

Texas Health and Human Services Commission (HHSC), Long-term Care Regulation inspects nursing homes in Texas for CMS. To file a complaint, call 800-458-9858 or use the state's complaint page.

• Texas nursing home inspection lookup
• File a nursing home complaint in Texas

Texas Long-Term Care Ombudsman

The State Long-Term Care Ombudsman is a free, confidential advocate for residents of nursing homes and assisted living. Ombudsmen help with complaints, residents' rights and problems with care. Call 800-252-2412.

• Contact the State Long-Term Care Ombudsman

Aging Services and Caregiver Support in Texas

Texas Health and Human Services Commission (HHSC), Aging Services runs Texas's aging services, delivered through local Area Agencies on Aging. Family caregivers can get help through Caregiver support services through Area Agencies on Aging. Adult day services are licensed or certified by Texas Health and Human Services Commission (HHSC), licensed Day Activity and Health Services (DAHS) facilities.

• Texas aging services: Texas Health and Human Services Commission (HHSC), Aging Services
• Area Agencies on Aging in Texas
• Caregiver support in Texas: Caregiver support services through Area Agencies on Aging
• Texas adult day services

Guides for Your Next Step

See how to choose a nursing home, what memory care is, how Medicaid pays for nursing home care and what Medicare covers. For local help, call the Eldercare Locator at 1-800-677-1116.

Frequently Asked Questions