How to Choose a Memory Care Facility in Texas

CareScout's cost survey publishes no statewide median for memory care in Texas, so the state's assisted-living median of $5,666 per month is the closest reference point.1,2 Memory care is built for people with Alzheimer's disease and other dementias, and in Texas, licensed assisted living facilities can offer it.1

If your loved one's dementia has progressed beyond what you can manage at home, this guide will help you understand what memory care looks like, what it costs, what Medicaid covers, and how to find a facility you can trust.

In This Guide

• Key Takeaways
• What Memory Care Is
• Memory Care Costs in Texas
• Does Medicaid Cover Memory Care?
• How to Choose a Facility
• When It's Time for Memory Care
• In-Home Dementia Care Alternatives
• Frequently Asked Questions
• Next Steps

What Memory Care Is (and How It Differs from Assisted Living)

Memory care is long-term care built around people with Alzheimer's disease, other dementias, and cognitive impairments. Assisted living helps with daily tasks; when you compare memory care options, look for the added support a person with dementia needs:

• Secured environments. Locked doors and enclosed outdoor areas guard against wandering. Many people with Alzheimer's disease wander away from home or a caregiver, and wandering can be a serious problem in more advanced dementia.5
• Enough staff, day and night. Ask how many caregivers are on duty per resident on each shift.
• Dementia-trained staff. Caregivers trained in de-escalation, redirection, and communication strategies for cognitive impairment.
• Structured daily routines. A predictable schedule for meals, activities, and rest.
• Planned activities. Programs designed for people with dementia, such as music, art, sensory, and reminiscence activities.
• Medication management. Staff oversight of each resident's medications.

In Texas, assisted living facilities can offer memory care.1 HHSC regulates them under Texas Health and Safety Code Chapter 247 and Texas Administrative Code Title 26, Chapter 553. State law has HHSC set up a separate classification and license for facilities that promote Alzheimer's care, but a facility does not need it to care for or treat residents with Alzheimer's disease or a related disorder. An assisted living facility that advertises memory care must give each resident written notice of whether it holds that classification. HHSC publishes Form 3641, the Alzheimer's Assisted Living Disclosure Statement. A facility that cares for these residents without Alzheimer's certification must still make sure its staff complete competency-based training and annual continuing education on Alzheimer's disease and related disorders, a rule in effect since December 31, 2024.3

Memory Care Costs in Texas

CareScout, a Genworth Financial subsidiary, does not publish a separate statewide memory-care median for Texas in its 2025 Cost of Care Survey. It puts the Texas assisted-living median for a private one-bedroom unit at $5,666 per month ($67,992 per year), below the national median of $6,200 a month, and because Texas assisted living facilities can offer memory care, that is the closest published benchmark.1,2 CareScout collects rates at the metropolitan-area level and notes that actual costs may vary with local market conditions.1

For comparison, here is what the 2025 survey reports for Texas across settings:2

Treat that $5,666 figure as a reference point for pricing a memory care placement, not as a memory care rate, and ask each facility for its actual memory care rate.1

Ask, too, how the rate can change: whether the facility charges a base rate plus add-on fees tied to an assessed level of care, what its full fee schedule is, and how its care level assessment works.

Does Medicaid Cover Memory Care in Texas?

Partially. The STAR+PLUS HCBS program pays for assisted living services, including in an assisted living facility that offers memory care, but the member remains responsible for room and board and, if one applies, a copayment.3,6

What Medicaid Covers

Medicaid pays for the personal care and support services your loved one receives in a licensed assisted living facility contracted with their managed care organization. Nursing, therapy, adaptive aids, medical supplies, and minor home modifications are covered too for members living in a contracted assisted living facility, but as separate STAR+PLUS HCBS services authorized on the individual service plan; they are not part of the assisted living daily rate.6 This can reduce the monthly cost significantly.

The resident pays room and board. You do not have to guess at that amount: under STAR+PLUS HCBS, the room-and-board charge is set at the SSI federal benefit rate minus an $85 personal needs allowance. It is a set rate that changes only when the federal benefit rate changes, generally each January 1, and it cannot be waived, although a facility may choose to accept a member for a lower amount.6 With the 2026 SSI federal benefit rate at $994 a month, that works out to about $909 a month.7 Plan for one more possible charge: a copayment is separate from room and board, not required of SSI recipients but required from members whose financial eligibility was determined under the special institutional criteria.6

What's Required

To qualify for STAR+PLUS HCBS waiver services in memory care:3

• The person must meet Medicaid financial eligibility for the institutional living arrangement, which is the budget Texas applies to HCBS waiver services: in 2026, countable income no more than $2,982/month and countable resources no more than $2,000 for an individual ($5,964 and $3,000 for a couple). Where only one spouse applies, the at-home spouse keeps a protected resource amount equal to the greater of half the couple's combined countable resources or $32,532, capped at $162,660, so a married applicant is not held to the $2,000 figure for the household.7
• They must have a valid medical necessity determination for a Nursing Facility Level of Care (NFLOC)
• The facility must be a licensed assisted living facility contracted with the member's STAR+PLUS managed care organization6

A dementia diagnosis is not the same thing as that determination. The MN/LOC Assessment is reviewed by TMHP clinical staff, who decide whether medical necessity is met.3

The Waitlist Reality

Texas may cap how many people a waiver serves and run an interest list (the state's term for a waitlist) when demand exceeds that capacity. STAR+PLUS HCBS has one, and a person becomes an applicant only when released from it.6 If your loved one needs memory care now, you may need to start with private pay while waiting for a waiver slot. Alternatively, if their needs reach nursing home level, nursing facility care is covered under regular Medicaid rather than a waiver, and the enrollment caps and interest lists apply to the waivers, not to regular Medicaid.8,7

For more on Medicaid coverage options, read our Texas Medicaid programs guide.

How to Choose a Memory Care Facility in Texas

Check the License and Inspections

A Texas assisted living facility that offers memory care is licensed by HHSC under 26 TAC Chapter 553, and one that advertises memory care must disclose in writing whether it holds HHSC's Alzheimer's classification.3,1 Find and compare licensed facilities in the HHSC Long-Term Care Provider Search. HHSC must inspect each assisted living facility at least every two years, and to report a problem with care, call HHSC Complaint and Incident Intake at 800-458-9858.1 Ask each facility about its recent inspections, and look for patterns: a single minor violation is different from repeated problems.

Visit at Different Times

Tour during a structured activity so you can see how staff interact with residents. Then visit unannounced on an evening or weekend. The quality of care often differs between planned tours and normal operations.

Questions to Ask

• What's your staff-to-resident ratio? (During the day and at night. Night shifts matter.)
• What dementia-specific training do caregivers receive? (Look for Alzheimer's Association or similar certified training programs.)
• How do you handle wandering and elopement? (Ask about specific safety features, not just "we have secured doors.")
• What happens when my loved one's needs increase? (Ask whether residents can stay through end of life, or must move once they reach a certain care level.)
• What's included in the base rate, and what costs extra? (Ask specifically about medication management, incontinence supplies, and laundry.)
• Can I see a sample daily schedule?
• How do you communicate with families about changes in condition?

Red Flags

• Staff can't answer specific questions about their dementia care approach
• The facility smells like urine or cleaning chemicals covering urine
• Residents are parked in front of a TV with no engagement
• High staff turnover (ask directly: "How long has your longest-serving caregiver been here?")
• Pressure to sign a contract during your first visit

When It's Time for Memory Care

This is one of the hardest calls a family makes. There's no single threshold, but these signs suggest it may be time:

• Safety issues at home. Leaving the stove on, wandering outside, falls becoming frequent.
• Caregiver burnout. You're exhausted, your own health is suffering, or you're unable to leave them alone.
• Increased aggression or agitation. Behavioral changes that make home care unsafe for the caregiver or the person with dementia.
• Nighttime restlessness. Sundowning (increased confusion in the evening) that disrupts the entire household.
• Care needs exceeding what home care provides. When 24-hour supervision is needed and home care hours aren't enough.

Many families feel guilty about this decision. That guilt is understandable, and it doesn't mean you're giving up on them: a good memory care facility exists to provide the secured setting, routine, and trained staff that are hard to sustain at home.

In-Home Dementia Care Alternatives

If your loved one is in the earlier stages of dementia, in-home care may be a good fit. Non-medical in-home care in Texas runs a median of about $30 per hour.2 At the survey's standard 44 hours per week, that works out to roughly $5,720 per month, close to the $5,666 assisted-living median that is the closest reference point for memory care.2,1

Options for in-home dementia care:

• Private-pay home care agencies that specialize in or train for dementia care
• Medicaid personal attendant services, through STAR+PLUS or through Community Attendant Services (CAS), which is a separate program9
• Consumer Directed Services (CDS), an option in STAR+PLUS and other Texas Medicaid programs that lets you hire and manage your own attendants, who can include family members (separate rules limit which relatives can be paid)9
• Adult day care for structured daytime programs with caregiver respite

The Alzheimer's Association's Texas chapters, including the six confirmed on its own site (Houston and Southeast Texas, Dallas and Northeast Texas, North Central Texas, San Antonio and South Texas, Capital of Texas in Austin, and West Texas, which covers Amarillo, El Paso, Lubbock, the Permian Basin, and San Angelo) offer caregiver support groups, education programs, and local resources, and the Association says its support groups and education programs are free.4 The Association's national 24/7 Helpline, 1-800-272-3900, is one line for the whole country rather than a chapter number, staffed around the clock by someone who can register you for those free programs or set up a free care consultation with a master's-level dementia expert.4

Next Steps

If you're considering memory care for someone you love, start by visiting two or three facilities in your area. Nothing replaces seeing a place in person, talking to staff, and observing how residents are treated.

Here's where to go from here:

• Find licensed facilities: Search the HHSC Long-Term Care Provider Search1
• Learn about paying for care: Our how to pay for senior care guide covers every funding option
• Explore Medicaid coverage: Read our Texas Medicaid programs guide to understand what's covered
• Consider assisted living: If memory care isn't needed yet, our assisted living guide may be more relevant
• Get caregiver support: The Alzheimer's Association 24/7 Helpline (1-800-272-3900), your local Area Agency on Aging (1-800-252-9240, whose services include information and referral, benefits counseling, care coordination, and caregiver support), and our respite care guide can help12

Learn More

Find personalized help finding Texas memory care 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.