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Resident Rights in Texas Facilities

What residents are entitled to, and who enforces it when a community falls short.

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Short answer

Residents of Texas nursing facilities and assisted living communities have enforceable rights covering care quality, dignity, privacy, freedom from restraint, and protection against improper transfer or discharge. The long-term care ombudsman advocates on these rights free of charge, and HHSC enforces them.

Where rights come from

Nursing facility residents are protected by both federal law, through Medicare and Medicaid certification requirements, and Texas state licensing rules. Assisted living residents in Texas are protected by state licensing rules and the terms of their residency agreement — there is no federal assisted living rights framework, which is a meaningful gap.

The rights families most often need to invoke

  • Protection against improper transfer or discharge. A community cannot simply ask a resident to leave. There are notice requirements and appeal rights, and this is the single most common issue ombudsmen handle.
  • Freedom from unnecessary physical or chemical restraint, including medication used to manage behaviour rather than treat a condition.
  • Participation in care planning, including the right of a resident or their representative to be present and to disagree.
  • Access to visitors, and to the ombudsman, at reasonable times.
  • To voice a complaint without retaliation.
If you are being told your parent must leave, call the Capital Area ombudsman at 512-916-6054 before you agree to anything or sign a move-out notice. This is exactly what the office exists for, it is free, and it is independent of HHSC.
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

Does Medicare pay for assisted living in Texas?

No. Medicare does not pay for assisted living room, board, or custodial care anywhere, including Austin. Medicare covers limited skilled nursing facility stays after a qualifying hospital admission, plus home health and hospice. Assisted living in Texas is paid privately, through long-term care insurance, or via Medicaid STAR+PLUS.

Does Texas Medicaid pay for assisted living?

Partially. The STAR+PLUS HCBS waiver covers assisted living care services but explicitly does not cover room and board, which comes from the resident's own income. You must meet nursing facility level of care, income under $2,982 monthly, and assets under $2,000, and usually wait on an interest list.

What's the Medicaid income limit for a nursing home in Texas in 2026?

For a single applicant in 2026, monthly income must be under $2,982 and countable assets under $2,000. Your home and one vehicle are generally exempt. You must also meet Nursing Facility Level of Care. A community spouse may keep a separate resource allowance.

How much money can my spouse keep if I go into a nursing home in Texas?

Texas allows a Community Spouse Resource Allowance so the at-home spouse isn't impoverished, reported at $162,660 for 2026. The applicant spouse is limited to $2,000. Because these figures change annually and the calculation is complex, confirm current amounts with HHSC or a Texas elder law attorney.

How much spending money does a Texas nursing home resident keep?

Texas sets the Personal Needs Allowance at $75 per month, raised from $60 effective January 1, 2024. That's well above the $30 federal minimum. Nearly all remaining income, after Medicare premiums, any spousal allowance, and allowable medical expenses, goes to the facility as applied income.

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