Texas care costs by metro
Approximate 2024 medians for major Texas markets (Genworth Cost of Care 2024):1
- Houston-The Woodlands: nursing home (semi- private) ~$6,200/month; assisted living ~$4,250/month
- Dallas-Fort Worth-Arlington: nursing home ~$6,400/month; assisted living ~$4,500/month
- San Antonio: nursing home ~$5,800/month; assisted living ~$3,900/month
- Austin-Round Rock: nursing home ~$7,100/month; assisted living ~$4,800/month
- El Paso / Rural West TX: nursing home ~$5,200/month; assisted living ~$3,400/month
For context, the national median private nursing-home room is ~$10,025/month; California Bay Area runs $17,200/month. Even Austin (Texas’s most expensive metro) is materially below US-coastal pricing.
Texas ALF licensure — Type A vs Type B
Texas Health and Human Services Commission (HHSC) regulates assisted living under 26 Tex. Admin. Code Ch. 553. Two license types matter:2
- Type A. Residents who can evacuate the facility unassisted in an emergency. Most independent residents who need help with ADLs but are mobile and cognitively oriented qualify for Type A.
- Type B. Residents who cannot evacuate unassisted. Includes residents with significant mobility impairments, dementia in advanced stages, or other conditions affecting self-rescue capability.
Implications:
- A Type A facility legally cannot retain a resident whose condition deteriorates to non-Type-A status. That resident must move — either to a Type B facility or to skilled nursing.
- Type B facilities can provide more intensive care but generally cost more.
- Many Texas families select Type A based on present need, then face a forced move 1–3 years later as their parent’s needs progress.
Memory care in Texas
Texas does not separately license “memory care” as a distinct facility type. Memory care services are delivered either within a Type B ALF that has the capability, or within a nursing home’s specialized dementia unit.
Texas memory care typically adds $1,200–$2,000/month over the same property’s standard assisted living rate.
Nursing-home quality in Texas
Texas nursing facilities are regulated by HHSC and inspected by both HHSC and CMS. Three quality signals:
- CMS Care Compare (medicare.gov/care-compare) for federal Five-Star ratings
- HHSC Long Term Care Search for Texas- specific inspection data
- Payroll-based staffing data— Texas has fewer state-level staffing requirements than CA or NY, so compare facility-reported staffing carefully
For how to evaluate a facility in practice (visit twice, read recent inspection reports, ask about license tier, verify staffing), the same approach as in our FL Care Settings guide applies. Texas-specific tooling lives at hhs.texas.gov.