Texas offers one of the largest and most diverse selections of nursing homes in the United States, reflecting the size and regional variety of the state itself. From the major metros of Dallas–Fort Worth, Houston, San Antonio, and Austin to mid-sized cities and rural communities, families can find skilled nursing facilities that range from smaller, neighborhood settings to large campuses with extensive clinical resources. This breadth is helpful, but it also makes the decision process more complex. The overview below explains how care works in Texas, what to look for in a facility, how payment typically functions, and practical steps to start your search.
Levels of care and what they mean
Texas nursing homes focus on 24/7 medical oversight and assistance with activities of daily living. Facilities often coordinate rehabilitative services (physical, occupational, and speech therapy), wound management, medication administration, and care planning with physicians and nurse practitioners. If your loved one needs long-term custodial support plus frequent clinical monitoring, a nursing home can be the right fit; if needs are lighter, consider assisted living or memory care communities in the same city as alternatives with different staffing models and social environments.
How to compare facilities in Texas
- Staffing and outcomes: Review nurse coverage, therapy availability, and recent quality measures. Ask about care plans, fall prevention, and infection-control practices.
- Location: Proximity to family and major hospitals (e.g., in Dallas, Houston Medical Center, San Antonio’s medical district, or Austin) simplifies logistics and specialist visits.
- Specialized programs: Some facilities emphasize post-acute rehab, cardiac recovery, respiratory support, or memory-support units; match these to your needs.
- Environment and activities: Daily life matters. Visit common areas, dining rooms, and outdoor spaces; ask about activities, religious services, and transportation.
Paying for care
Families commonly combine private funds with Medicare (for short-term skilled rehab following a qualifying hospital stay) and, when eligible, Texas Medicaid for long-term care. Medicare does not cover ongoing custodial stays; it is time-limited and condition-based. Long-term care insurance, veterans’ programs, and managed-care plans may contribute depending on the policy. Always verify benefits, coverage periods, and network status directly with the facility and insurer.
Practical next steps
- Shortlist 3–5 facilities in your target city (e.g., Dallas, Houston, San Antonio, Austin).
- Schedule in-person tours and ask for a sample care plan and current staffing ratios.
- Confirm hospital affiliations, transportation arrangements, and emergency procedures.
- Review the admission agreement, bed-hold policy, and processes for care conferences.
Below you’ll find Texas cities with available facilities. Start with your preferred metro for easier family involvement, then compare at least two options side-by-side. A thoughtful, stepwise approach will help you balance clinical fit, location, and budget.