With its mild winters and hot summers, it's easy to see why Texas attracts so many retirees; In fact, Texas is the #6th most popular retirement living destination. If you are considering an assisted-living facility in the Lone Star State, read on to learn more about the types of assisted living care available, services provided, state safety regulation, average assisted living costs, and ways to pay for care.
Long-term care options in Texas
Texas offers a range of experiences, from the hot, humid summers of Houston and Dallas to the dry desert climate of Western Texas. There are big cities and small rural communities. One thing all of Texas has in common, however, is the desire to help the elderly live as independently as possible. Placing a loved one in a senior living community can be sobering, but it doesn’t have to be: In the Lone Star State, chances are great that your relative will find the place that is perfect for them to live out their golden years.
Types of care
In Texas, there are many different types of senior housing, ranging from independent living communities to skilled nursing facilities. The options are vast; there are over 300 assisted living facilities alone, and that doesn’t count over 500 independent living communities or a large number of nursing homes. Here are some of the senior living options that might be right for your loved one.
Independent living community: An independent living community is perfect for seniors who are ready to downsize and say goodbye to the stresses of home maintenance but who are also still quite independent. These senior living developments are comprised of individual units that provide privacy and independence. There are generally a lot of social activities available and, depending on the community, meals served in a common area. There might be grocery stores, restaurants, banks, beauty salons, and other businesses on the property or within close proximity.
Assisted living community: An assisted living community is for senior citizens who need some help with the activities of daily living. There are two main types of assisted living facilities in Texas. Type A facilities are for those who don’t need supervision while sleeping and who can follow directions and evacuate themselves in case of an emergency. Type B facilities are for those who might need some supervision and assistance at night and who might need help getting out in case of an emergency. There are also facilities for people who need no assistance other than medication management, but they are not a traditional type of assisted living community because they don’t offer other personal care services.
Nursing home: For a senior citizen who requires 24-hour nursing services, a nursing home might be the best option. These provide a range of personal care and medical services for people whose needs are too great for an assisted living facility.
Continuing retirement community: A continuing retirement living care community caters to a range of needs. Typically, a senior citizen who is ready to downsize moves into an independent living community on the property. As his or her needs increase, they can move into assisted living, then, if needed, a nursing home. Because it’s all on the same property, there is a continuum of senior care and a familiarity that can help assisted living residents to avoid some of the anxiety that accompanies moving.
Adult day care: If your loved one lives with you (or another relative) and you need respite either occasionally or on a regular basis while you go to work, an adult day care center might be the right option. There are three types in Texas, depending on the individual’s needs. A social day care is geared toward recreational, social activities with meals provided and only some health-related services available. A medical or health day care provides more health-related services for people with greater needs. Finally, a specialized
In-home care: Your loved one might prefer to stay at home (his or her own or that of a relative). If he or she has needs that family cannot meet, such as needing assistance with personal care or medical needs, in-home care is an option. This means that a personal care assistant or a nurse would come to the house to provide the services that are needed. In some cases, the caregiver would stay the whole time the person was alone, and in other cases, they would come at set times of the day.
The largest providers in Texas
In the United States, there are several providers of assisted living that have facilities in some or most states. The national provider with the most facilities in Texas is Brookdale, with 73 assisted living communities. Atria Senior Living has 15, Sunrise Senior Living has five, Holiday Retirement has two, and Blue Harbor has one in the Lone Star State.
Quality and safety
The quality and safety of assisted living facilities in Texas have been going up in recent years. Improvements have been made where needed, and now Texas has one of the most transparent access to pertinent data in the United States. All assisted living facilities require state licensing. By using the Long-term Care Provider Search, you can find out which facilities are up-to-date on their inspections, certifications, and licenses. You can also learn about any violations. If they accept Medicaid, then they must also be licensed by the federal government.
Texas assisted living costs
The median monthly cost for assisted living care in the United States is $3,750. In Texas, you’ll pay a bit less on average; the median cost there is $3,500. The price will vary not only by the facility but also by the city. For example, in Texarkana, the median monthly cost is $2,600. In the Midland/Odessa area, as well as in Dallas and Amarillo, expect to pay between $3,600 and $3,800. If you were to place your relative in an assisted-living facility in Victoria, however, you’d likely pay closer to $5,025. Outside of the metro areas, the median cost is a little over $3,000.
Comparing nearby states
Depending on which part of Texas you or your loved one lives in, a facility in a nearby state might also be an option. Remember that cost should not be the only criteria you use when deciding where your relative will live. In New Mexico, the median monthly cost is $4,000; in Oklahoma and Arkansas, it’s just over $3,000; and in Louisiana, expect to pay approximately $3,300 per month.
Paying for care
Assisted living care is expensive, so it’s reasonable that you might be concerned about how you or your loved one will pay for it. The good news is that there are several options to consider when deciding how to pay for assisted living in the Lone Star State.
Private funds (retirement account, proceeds from a house sale, etc.): If your loved one is going to sell
Medicaid waivers: Usually, Medicaid will pay for nursing home care. Sometimes, however, a waiver called STAR+PLUS will allow for assisted living care to be covered. There are income requirements and also medical requirements; the assisted living residents must need nursing care or 24-hour supervision to qualify. The Area Agency on Aging is where you would go to find out more about how to apply and qualify for this waiver.
Reverse mortgages: A reverse mortgage is a loan taken out by an older adult whose home is paid off (or nearly so). Repayment of the loan takes place after the home is sold or after the death of the owner. Texas has one of the largest markets for reverse mortgages; this is partially due to the high number of retirees in the state. To qualify for a reverse mortgage, your relative will need to have financial counseling. Also, if they are receiving state benefits, they need to look into how that extra income each month might affect the benefits.
Long-term care insurance: Long-term care insurance is a type of insurance that your relative might have purchased earlier in life to pay for assisted living services or nursing home care. Texas participates in a program that allows those with long-term care insurance to count the benefits paid by the insurance company against assets that would normally be counted by Medicaid. This means that if your relative uses their insurance to pay for some of their care, Medicaid will disregard an equal number of dollars in assets (up to a maximum based on age) when determining eligibility. The Texas Department of Insurance has published a shopper’s guide to long-term care insurance that can explain the program.
Programs for veterans: There are state veterans’ homes in the Lone Star State that can make senior living more affordable for veterans. In addition, Veterans’ Aid and Attendance is a program that might pay for some of the costs of long-term care. You can contact your local Veterans Service Office to find out more about the programs available.
Elderlife Financial can help you understand how to pay for assisted living.
Types of assisted living in Texas
Texas breaks assisted living down into several types. The two most common are Type A and Type B. Type A provides fewer services and is designed for people who can follow directions, sleep without supervision, and care for their own personal hygiene needs. Type B is for those who cannot do those activities. At any assisted living care community, there is assistance available for the activities of daily living (bathing, toileting, grooming, etc.) and medication management.
Other services include meals and social activities. Some include transportation and various types of therapies and amenities. The specifics will depend on the facility, so if you are considering different facilities, be sure to find out what is included with each.
There are some regulations that specify how much space each resident must be allotted based on the type of facility. Rooms might be single, double, or quadruple. The maximum allows is four residents per room, but only half of the rooms in any facility can house more than two residents. Some facilities will offer a private bathroom, while others will offer at least one bathroom for every six residents.
Only Type B facilities offer services for residents with Alzheimer's disease or dementia. The memory care staff needs to be properly trained to provide Alzheimer's care. If it’s a concern for your loved one, be sure to ask whether there is adequate staffing to handle your relative’s needs.
Resources in Texas
There are 630 hospitals in Texas, so it’s very likely that any assisted living community that you are considering will be within a short distance from one of them. There are highly renowned cancer centers in Texas, as well as medical practices that cater to geriatric patients.
The Texas law includes a section on special rights for the elderly. These include rights pertaining to communication, safety, financial issues, medical issues, and more. You can review them at the Texas Attorney General’s website.
Making the transition to assisted living
If your loved one lives in Texas, they will be required to be assessed by the facility that they would like to live in. It’s important for both the facility and your loved one to know that their needs can be met in their chosen community. It’s possible that they might not meet the requirements; for example, if it is a Type A facility and your relative needs help to get out of bed, they might instead be referred to a Type B facility.
If your loved one needs 24-hour nursing care, they might be referred to a nursing home rather than accepted into the assisted living facility. Don’t get discouraged if this happens; the most important thing is for your relative to be in the housing type that can best meet their needs and keep them safe and as independent as they can be.
State oversight of long-term care
Assisted living facilities in Texas are overseen by Texas Health and Human Services. In addition, the Long-Term Care Ombudsman is an advocate for those living in assisted living facilities and nursing homes in the Lone Star State.