To choose an assisted living facility in Texas, do three things before you sign. Confirm the facility is licensed, find out what its state inspections have turned up, and match it to your loved one's real care needs. Start with the Texas Health and Human Services Commission (HHSC), which licenses and inspects every assisted living facility in the state and lets you find and compare licensed facilities online. The most recent CareScout Cost of Care Survey, fielded in 2025 and published in March 2026, puts the Texas median for assisted living at about $5,666 per month. If your loved one is on Medicaid, the STAR+PLUS Home and Community Based Services (HCBS) program can cover the care services in assisted living, but not room and board.

This guide walks you through what you'll pay, what Medicaid covers (and doesn't), how to check a facility's official track record, and what to ask before you sign.

In This Guide

How Assisted Living Is Licensed in Texas

There is no federal license for assisted living. Every state built its own rules, so the same kind of care is named and regulated differently from one state to the next. In Texas, the Texas Health and Human Services Commission (HHSC) licenses and regulates assisted living facilities under Texas Health and Safety Code Chapter 247 and 26 Texas Administrative Code (TAC) Chapter 553. A facility must hold a current HHSC license to legally provide assisted living in Texas. After its initial licensing inspection, state law requires HHSC to inspect each facility at least every two years and lets it inspect at other reasonable times to assure compliance. HHSC's own consumer guidance says it inspects licensed assisted living facilities once a year and also looks into complaints about them.

The practical takeaway: before you tour, confirm the facility is HHSC-licensed and ask what its recent inspections found. A clean license and a clear inspection record are the floor, not a bonus. If a facility advertises or markets memory care, Texas law requires it to tell each resident in writing whether or not it holds HHSC's Alzheimer's license classification. HHSC's form for that notice is Form 3641, the Alzheimer's Assisted Living Disclosure Statement.

What Assisted Living Costs in Texas

The most current statewide figures come from the CareScout (formerly Genworth) 2025 Cost of Care Survey, fielded July through November 2025 and published in March 2026. In Texas, the median cost of assisted living is about $67,992 per year, or roughly $5,666 per month, below the national median of $74,400 per year ($6,200 per month). Here is how assisted living compares with the other main care options in Texas.

Care type Median monthly cost Median annual cost
Assisted living about $5,666 about $67,992
Non-medical caregiver (home care, 44 hours a week) about $5,720 about $68,640
Nursing home, semi-private room about $5,627 about $67,525
Nursing home, private room about $7,604 about $91,250

CareScout prices assisted living as a private one-bedroom unit and collects rates by metro area, so one statewide median hides real differences between Texas cities. These are provider-reported survey medians, not a quote for your loved one. If your loved one needs memory care, medication management, or help with several activities of daily living, ask each facility how it prices that extra care and get its level-of-care fee schedule in writing. Always ask for a detailed, written breakdown of what's included and what costs extra. For a fuller comparison across every care setting, see our guide to the cost of senior care in Texas.

How to Pay for Assisted Living

  • Private pay: savings, retirement accounts, Social Security, and pension income.
  • Long-term care insurance may cover some or all of the cost, depending on the policy.
  • VA Aid and Attendance pension has a maximum annual rate of $34,488 for a veteran with one dependent, for December 1, 2025 through November 30, 2026. That's a ceiling, not a payment: VA pays the difference between it and the household's countable income, in monthly payments, and non-reimbursable medical expenses above a set threshold can lower countable income.
  • Medicaid HCBS covers care services only (see below).
  • Bridge loans and life insurance conversions are options some families use for short-term funding.

For a full walkthrough of every funding path, see our guide to how to pay for assisted living in Texas.

Not sure how to pay for assisted living? Chat with Brevy's care navigator about funding options for your family's situation.

What Services Are Included

Texas assisted living facilities provide individualized health and personal care assistance in a homelike setting, with an emphasis on personal dignity, autonomy, independence, and privacy. The services include:

  • Meals
  • Personal care: bathing, dressing, and toileting
  • Medication: administering or supervising medication

Beyond that core, what a facility offers varies, so ask each one what its base rate covers: housekeeping, laundry, activities, overnight staffing, and how much nursing is available on site versus brought in from outside. If your loved one needs ongoing skilled nursing, therapy, or intensive medical care, a nursing facility, or home health combined with assisted living, may be a better fit. See our comparison of home care versus home health in Texas if you're weighing in-home options.

Does Medicaid Pay for Assisted Living in Texas?

Partly. Through the STAR+PLUS HCBS program, Texas Medicaid covers the care services in a licensed assisted living facility contracted with the member's managed care organization, starting with personal care assistance. Nursing, therapy, adaptive aids, medical supplies, and minor home modifications are covered too, but as separate STAR+PLUS HCBS services authorized on the member's individual service plan; they are not included in the assisted living daily rate.

What Medicaid does not cover: Room and board. That charge is the member's responsibility, and Texas sets it at the Supplemental Security Income (SSI) federal benefit rate minus an $85 personal needs allowance. It is a set rate that changes only when the federal benefit rate changes, which generally happens each January 1, and it cannot be waived, although a facility may choose to accept a member for a lower amount. The 2026 SSI federal benefit rate, the maximum monthly federal SSI payment, is $994 for an individual, so room and board works out to about $909 per month.

One more charge to plan for: a copayment is separate from room and board. It is not required of SSI recipients, but it is required from members whose financial eligibility was determined under the special institutional criteria, so some residents owe it on top of the room-and-board charge.

There's a waitlist. The STAR+PLUS HCBS program has an interest list (waitlist). Someone on it becomes an applicant only after being released from the list, confirming interest, and submitting Form H1200, so access is not immediate for everyone who qualifies. See our guide to Texas Medicaid HCBS waivers for how the interest list works and how to apply.

While your loved one waits, ask about Community First Choice (CFC). It's a Medicaid State Plan benefit, not a waiver, that pays for personal assistance services in a community-based setting for Medicaid members who qualify for an institutional level of care and need help with daily activities, and HHSC does not list it among the Texas programs with interest lists. Community Attendant Services (CAS) is another Texas Medicaid long-term services program that offers personal assistance services.

How to Check a Facility's License and Inspections

This is the step that turns a brochure into real due diligence. Before you tour, confirm the facility is licensed and find out what its state inspections have found.

1
Step 1

HHSC Long-Term Care Provider Search

Use HHSC's Long-Term Care Provider Search to find and compare licensed assisted living facilities in your area.

2
Step 2

Ask the facility directly

Ask what HHSC found at its recent inspections and what the facility changed in response. A well-run facility should be able to walk you through them.

3
Step 3

Report a problem

Call HHSC Complaint and Incident Intake toll-free at 800-458-9858 to report a complaint about a resident's care or treatment, including abuse, neglect, or exploitation. Agents answer Monday through Friday, 7 a.m. to 7 p.m.; leave a message after hours and you'll get a call back by the next workday. You can also file a complaint online or by email.

State law requires HHSC to inspect each facility at least every two years, and HHSC says it inspects them once a year. Ask about more than the latest visit. A facility with no recent problems is a good sign, but look for patterns over time, not a single incident.

How to Choose an Assisted Living Facility in Texas

Match the Facility to the Need

The single most useful move is to match the facility to your loved one's actual care needs, today and as they change. Ask what happens when needs increase: can the same facility legally provide more care, or will your parent have to move? A facility licensed and staffed for higher-acuity or dementia care can keep a resident who would otherwise have to relocate. Confirm the answer in writing before you commit.

Questions to Ask During a Tour

Tour at least three facilities. Visit at different times of day, including a mealtime. Ask:

  • What's included in the base monthly rate, and what costs extra?
  • What happens when my parent's care needs increase? Is a higher level of care available here?
  • What's the staff-to-resident ratio during the day? At night?
  • How do you handle medication management?
  • Can residents keep their own doctors?
  • What's the discharge policy if my parent needs more care than you can provide?
  • Do you accept Medicaid (STAR+PLUS HCBS) for the care services portion?

Understanding the Contract

Before signing, request the Assisted Living Disclosure Statement (HHSC Form 3647). Texas requires every facility to give each prospective resident, or their representative, this consumer disclosure statement on HHSC's standard form. Read it alongside the contract, and make sure you understand in writing what the base rate covers, what costs extra, how much notice you'll get before a rate increase, and the discharge and refund terms. Ask about anything vague, and have a family member or elder law attorney review it if the contract is complex.

Your Rights as a Resident

Texas law gives assisted living residents a bill of rights, and every facility must post it in a prominent place. Texas Health and Safety Code Sec. 247.064 lists 14 rights, including the right to:

  • Manage their own financial affairs
  • Privacy
  • Present grievances to the facility or to state agencies without threat of reprisal
  • A safe and decent living environment, with considerate and respectful care that recognizes their dignity and individuality
  • Keep every constitutional, civil, and legal right, none of which a resident loses just by living in an assisted living facility

The posted bill of rights must be written in the resident's primary language and must carry the state's toll-free number for reporting abuse or neglect. A facility also may not retaliate against anyone for filing a complaint, presenting a grievance, or providing information in good faith.

If you believe a resident's rights are being violated, there are two routes. To file a formal complaint about a resident's care or treatment, call HHSC Complaint and Incident Intake at 800-458-9858. To get help resolving a problem, call the Texas Long-Term Care Ombudsman program at 800-252-2412. Its ombudsmen advocate for assisted living residents for free and act only with the consent of the resident or their representative.

Frequently Asked Questions

How much does assisted living cost in Texas?

The statewide median is about $5,666 per month ($67,992 per year) in the CareScout 2025 Cost of Care Survey, published in March 2026, below the national median of $6,200 per month. CareScout collects rates by metro area and prices a private one-bedroom unit, so your local cost can differ, and the median isn't a quote for any one resident. Ask each facility how it prices extra care as needs grow.

Does Texas Medicaid cover assisted living?

Partly. The STAR+PLUS HCBS program covers personal care in a contracted facility, and nursing and therapy can be authorized separately on the service plan, but it does not cover room and board. The resident pays room and board, set at the SSI federal benefit rate ($994 a month for an individual in 2026) minus an $85 personal needs allowance, which is about $909 per month. That charge cannot be waived, though a facility may choose to accept a member for a lower amount, and it holds steady until the federal benefit rate changes, generally each January 1. A copayment is a separate charge, owed by members whose financial eligibility was determined under the special institutional criteria but not by SSI recipients. The program has an interest list (waitlist), so access isn't immediate for everyone.

How do I check an assisted living facility's license and inspections in Texas?

Find and compare licensed facilities in the HHSC Long-Term Care Provider Search, then ask each facility what its recent HHSC inspections found. State law requires HHSC to inspect each facility at least every two years, and HHSC says it inspects them once a year. To report concerns, call HHSC Complaint and Incident Intake at 800-458-9858.

What's the difference between assisted living and a nursing home?

Assisted living provides personal care (meals, bathing, dressing, medication) in a homelike setting for people who need some daily help. Nursing homes (skilled nursing facilities) serve people with more complex medical needs. On cost, Texas is unusual: a semi-private nursing home room has the lowest median in the country, about $5,627 a month, roughly the same as the $5,666 assisted living median, while a private room runs about $7,604 a month. See our guide to Texas nursing homes for more.

Next Steps to Choose Assisted Living in Texas

Learn More

These related Texas guides go deeper on cost, coverage, and care types, including how the STAR+PLUS HCBS program covers care services but not room and board.

Care TypesAssisted Living by State: Costs, Rules and Medicaid CoverageWhat assisted living costs, how licensing and Medicaid coverage differ from state to state, plus a guide to all 50 states so you can jump straight to yours. Care TypesHow to Choose a Memory Care Facility in TexasCareScout has no Texas memory care median; its $5,666/month assisted-living median is the closest reference. What STAR+PLUS covers and how to choose a facility. Care TypesHow to Choose a Nursing Home in TexasNursing homes in Texas in 2026: a semi-private room runs about $67,525/year, well below the national median. What it costs, how Medicaid pays, how to choose. Care TypesHome Care vs Home Health in TexasHome care vs home health in Texas: what each covers, what home care costs, when Medicare and Medicaid pay, and how to find a licensed provider near you. MedicaidTexas Medicaid HCBS Coverage for Assisted LivingTexas HCBS waiver programs help seniors stay home instead of a nursing facility. Learn how STAR+PLUS HCBS, CLASS, HCS, interest lists, and applying work. VA BenefitsVA Aid and Attendance in TexasLearn about VA Aid and Attendance in Texas for 2026: eligibility, the $34,488 yearly ceiling for a veteran with a spouse, how to apply, and free help. FinancialHow to Pay for Senior Care in TexasA plain-English guide to paying for senior care in Texas: Medicaid, Medicare, VA benefits, insurance, and private pay options. Costs and eligibility for 2026. Care TypesAssisted Living vs. Memory Care in TexasAssisted living vs. memory care in Texas: about $5,666/month for daily-living help vs. somewhat more for secured, dementia-trained care. How to decide.

Find personalized help choosing senior care options at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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