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What Happens When the Money Runs Out

Spend-down, Medicaid transitions, and why you should ask a community about this before you move in.

HomeCosts & PayingWhat Happens When the Money Runs Out
Short answer

If private funds run out, the options are the Medicaid STAR+PLUS waiver for assisted living care services, Medicaid nursing facility coverage, or moving to a community that accepts Medicaid. Many Austin-area assisted living communities do not contract with Medicaid managed care at all.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not contract with Medicaid managed care will ask your parent to leave when private funds are exhausted — often with thirty days' notice, at the point when moving is hardest.

Ask directly: do you accept STAR+PLUS, and how many current residents are on it? The second half of that question matters. A community can technically hold a contract and still have no Medicaid beds available.

The waiting problem

STAR+PLUS assisted living services are interest-list driven. Getting on the list takes a phone call; getting through it can take considerably longer. Families who wait until funds are nearly gone discover the timeline does not bend for them. If Medicaid is a realistic eventual path, join the interest list early, even while paying privately.

How Austin families pay for care. Medicare does not cover assisted living. Texas has no broad state assisted living benefit. The main routes are private funds, Medicaid STAR+PLUS, and VA Aid and Attendance. Read the full explanation →
The Austin-area long-term care ombudsman. Free, confidential and independent of Texas HHS. Capital Area covers Travis, Williamson and Hays at 512-916-6054. Read the full explanation →

Questions Austin families ask

Where can I see nursing home inspection results in Texas?

Two places. Texas HHSC publishes survey results with cited and corrected deficiency dates at apps.hhs.texas.gov/ltcsearch. Medicare's Care Compare adds one-to-five star ratings covering health inspections, staffing, and quality measures. HHSC surveys most nursing facilities about once a year on health and life safety code compliance.

Who do I call to report a problem at an Austin nursing home?

Call Texas HHSC Complaint and Incident Intake at 1-800-458-9858, weekdays 7 a.m. to 7 p.m. That line covers nursing homes, assisted living, home health, and hospice. You can also contact the Capital Area ombudsman at 512-916-6054 for free, confidential advocacy.

How do I report suspected elder abuse in Texas?

Call the Texas Abuse Hotline at 1-800-252-5400, available 24 hours a day, if action is needed within 24 hours. Non-urgent reports can be filed at txabusehotline.org. If someone faces immediate risk of death or serious harm, call 911. Reports are confidential and may be anonymous.

Should I call APS or HHSC about a problem at my mom's facility?

It depends where it happened. Adult Protective Services, 1-800-252-5400, handles abuse or neglect of adults living in the community. Abuse or neglect inside a licensed facility goes to HHSC Complaint and Incident Intake at 1-800-458-9858. Families frequently call the wrong number and lose time.

What is a long-term care ombudsman and is it free in Austin?

Yes, completely free and confidential. Ombudsmen advocate for nursing home and assisted living residents on rights, care quality, improper discharge, and restraint use. The office is independent of Texas HHS. Austin's regional office is Capital Area, reachable at 512-916-6054 or 888-622-9111, option three.

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