Texas Memory Care (Residential Alzheimer’s Care): Laws, Costs & Financial Help

Legal Definition of Memory Care in Texas

In Texas, an assisted living facility (ALF) is defined as an establishment that provides food, shelter, medication administration and personal care services to four or more persons who are unrelated to the proprietor. ALFs are either Type A or Type B in Texas, and any ALF that advertises, markets or otherwise promotes itself as providing specialized care for residents with Alzheimer’s disease or other dementias must have a Type B license from the Texas Health and Human Services Commission (HHSC), which oversees all ALFs in Texas. The HHSC also classifies ALFs as being either small (4-16 residents) or large (17 or more residents).

• Residents in a Type A ALF must be mentally and physically capable of evacuating the facility unassisted in case of emergency, must be able to follow emergency instructions and must not require routine supervision during sleeping hours.
• Residents in a Type B ALF do not have to meet any of the above requirements. They must not be confined to their bed, although they can require assistance getting in and out of bed.

Type B ALFs must be certified to provide care residents with Alzheimer’s disease and other dementia. The staff receive specialized training that covers dementia symptoms, stages of Alzheimer’s, behavioral interventions and communicating with residents with dementia, and they must complete 12 hours of in-service education regarding Alzheimer’s disease on an annual basis.

Assisted Living Laws & Regulations

Admissions Requirements & Process

To be admitted to an assisted living facility (ALF) in Texas, applicants must be at least 55 years old and have a medical need for living in an ALF. If they have medical needs that can not be met by the ALF, they will not be admitted.

Residents will undergo a comprehensive assessment within 14 days of admission. There is no state-mandated form for the process, but the assessment must include an evaluation of the resident’s behavioral symptoms, psychosocial issues and Activities of Daily Living Patterns.

ALFs in Texas must provide residents with a “disclosure statement” when they move in to the facility. This documents details what services and care supports are offered, potential fees, resident rights and all of the facility’s policies, including those regarding eviction/discharge. It is unlikely a residence will provide their disclosure statement on their website. However, by law, the residence must provide this documentation to residents upon admission.

Facility/Residence Requirements

In Texas, dementia-certified Type B facilities must be designed for patients’ safety and well-being. This can include special locks to prevent wandering, a secure outdoor area so residents can spend time in the open air, bright lighting and paint colors and an easy-to-navigate facility layout. Additionally, there are limits to the number of residents allowed per room, although residents in memory care facilities typically have single units or just one roommate.

Staff & Training Requirements

All employees in ALFs in Texas must:

• Be at least 18 years old
• A high school graduate
• Complete 4 hours of orientation on any topic before assuming job responsibilities

Attendants in ALFs in Texas must complete 16 hours of on-the-job supervision in their first 16 hours of employment after orientation.

Direct care staff must complete six hours of in-service education annually, and two hours of the training must be competency-based.

Any staff working with residents with Alzheimer’s disease or related dementias in Type B ALF must undergo the dementia-specific training mentioned above, which covers dementia symptoms, stages of Alzheimer’s, behavioral interventions and communicating with residents with dementia.

There isn’t a specified staff-to-resident ratio in Texas. Assisted living facilities, including memory care homes, must have enough employees to meet the residents’ needs. With memory care, the overnight staff must be awake at all times, regardless of the size of the residence. For large Alzheimer-certified facilities or units, there must be two night-shift employees on duty.

Evictions

There are no state regulations in Texas that guide the process of evicting a resident from an ALF. Residences will have their own procedures for handling evictions, discharges, and transfers. Generally, a person cannot remain in a residence where their personal and medical needs cannot be met.

It’s important to know the policy on evicting, discharging, or transferring residents before moving in. It is most likely included in the “disclosure statement” ALFs are required to provide residents when they move in to the facility. If not, be sure to get it in writing to have clarity and avoid an unfair eviction.For tips on evictions, including what to do if you receive an eviction notice, click here.

Reporting Complaints and Concerns

If you have concerns or complaints about a memory care community or a resident’s treatment, you can contact Texas’s long term care ombudsman office. This is a governmental entity that protects the elderly living in long-term care communities and ensures that the communities are complying with their move-in contract. They also help to resolve problems, investigate injustices, and act as oversight to different state and federal programs that have to do with the health and welfare of elderly residents in long-term care facilities.

Texas Memory Care / Residential Alzheimer’s Care Costs

There can be significant differences in the cost of ALFs depending on what part of Texas you are in. The table below lists the median monthly cost of Type A ALFs and Type B ALFs (which provide care for people with dementia) in different regions of the state as of 2025. The table also includes the statewide median as well as the median for non-metropolitan areas. Individuals who are in the early to mid stages of dementia may be best suited for assisted living facilities, which are less expensive than memory care, while those with more severe symptoms or who are in the late stages of dementia will likely need memory care.

If these prices are too high, there are more affordable memory care options in bordering states like Arkansas and Oklahoma.

Financial and Care Assistance for Memory Care in Texas

There are several sources of financial and care assistance for qualified Texas seniors with Alzheimer’s disease and other dementias who reside in assisted living facilities or specialty care assisted living facilities. They include Medicaid Home and Community Based Services (HCBS) Waivers, the Program of All-Inclusive Care for the Elderly (PACE), Veterans Affairs (VA) pensions and Supplemental Security Income (SSI), as well as elder loans, tax credits and reverse mortgages.

Medicaid Long-Term Care

Texas Medicaid will not cover the cost of assisted living facilities or specialty care assisted living facilities. However, Texas Medicaid will cover long-term care services and supports for seniors in assisted living or memory care through the following programs:

STAR+PLUS
Texas’ STAR+PLUS Waiver covers long-term care services and supports for qualified Texas seniors who require a Nursing Facility Level of Care (NFLOC) but live in the community instead, including assisted living residences. A diagnosis of dementia does not guarantee a NFLOC designation, but many seniors with dementia will meet the requirements for a NFLOC. STAR+PLUS Waiver applicants also have to meet an asset limit, which is $2,000 for individuals in 2026, and an income limit, which is $2,982/month for an individual in 2026. These limits can change depending on the applicant’s marital status and whether or not their spouse is also applying for Medicaid.

STAR+PLUS Waiver benefits include nursing services, adult day care, meal delivery, Personal Emergency Response Services (PERS) and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting). These benefits will be available depending on the needs and circumstances of each individual, including which services are available at the assisted living residence. Medicaid will not duplicate long-term care benefits, but it might add to them. For example, if the assisted living residence provides 15/hours week of personal care assistance, a STAR+PLUS Waiver beneficiary might receive 20/hours week.

STAR+PLUS Waiver benefits are delivered via a managed care organization with a network of healthcare providers. STAR+PLUS Waiver beneficiaries also have the option to self-direct some of their care, which means they can choose caregivers outside of the network, including family members, but not spouses. The STAR+PLUS Waiver has a limited number of enrollment spots (about 24,000 as of 2025) and once those spots are full additional applicants will be placed on a waitlist.

Day Activity and Health Services
Texas seniors who have Medicaid for the Elderly and People with Disabilities (MEPD) and have a chronic medical condition can receive daytime supervision and health services through the Day Activity and Health Services (DAHS) program. The chronic medical condition can be Alzheimer’s disease or other dementias, and program participants can live in a small (4-16 residents) Type A assisted living facility (as well as their own home). There are DAHS care facilities throughout the state that will provide supervision, nursing services, therapies, meals and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting).

To qualify for MEPD, individuals need to meet an asset limit, which is $2,000 in 2026, and an income limit, which is $994/month in 2026. These limits can change depending on the applicant’s marital status and whether or not their spouse is applying for Medicaid.

Program of All-Inclusive Care for the Elderly
Texas residents age 55 and over who require a NFLOC can have all of their healthcare coverage, including Medicaid and Medicare, streamlined into one plan with the Program of All-Inclusive Care for the Elderly (PACE). PACE also offers vision, dental and hearing care, and PACE day centers provide day-time supervision, meals, social activities and regular health checkups for program participants. Being enrolled in Medicaid and/or Medicare is not a requirement for PACE, but it is free for Texas Medicaid for the Elderly and People with Disabilities (MEPD) beneficiaries. Texas’ PACE programs are located in El Paso (Bienvivir Senior Health Services), Lubbock (Silver Star PACE) and Amarillo (The Basics at Jan Werner).

Nursing Home Medicaid and Money Follow the Person
Texas’s Nursing Home Medicaid will cover all nursing home expenses, including room and board, for all eligible applicants. To qualify, applicants must require a NFLOC, and they must meet an asset limit ($2,000 for individuals in 2026) and an income limit ($2,982/month for individuals in 2026).

Texas Nursing Home Medicaid beneficiaries who want to leave the nursing home and return to a small group home with no more than four unrelated residents (or their own home or the home of a relative) can receive assistance with the transition through the Money Follows the Person program. The assistance can include paying for moving expenses, utility set-up fees, essential furniture and appliances, as well as long-term care coverage in the new residence.

Veteran’s Affairs (VA)

Qualified Texas veterans (or their surviving spouses) can also receive financial assistance through a Veterans Affairs (VA) Pension that they could use to pat for assisted living or memory care. There are three levels of VA Pensions – Basic, Aid & Attendance (A&A) and Housebound. To qualify for any of them, veterans or their surviving spouses need to meet a net worth limit of $163,699 (effective Dec. 2025 – Nov. 2026), which is calculated by adding the total of their assets to their annual income. Some assets are exempt, like a primary home, primary vehicle and household furniture and appliances. VA Pension applicants also have to meet an income limit to be eligible – their income must be less than the VA Pension they are applying for in order for them to qualify. And veterans must meet a military service requirement, which includes not having received a dishonorable discharge.

To qualify for A&A, veterans or their surviving spouses must also meet a medical requirement, which is one of the following must be true:

• They need help to perform the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) OR,
• They have to stay in bed for at least a large portion of the day due to illness OR,
• They are in a nursing home due to loss of mental or physical abilities OR,
• Their eyesight is extremely limited (5/200 or less in both eyes even with glasses or contacts; or concentric contraction of the visual field to 5 degrees or fewer).

To qualify for Housebound, veterans must spend most of their time in their home due to a permanent disability.

There is no medical requirement for VA Basic Pensions.

Qualified veterans or their surviving spouses are entitled to their Maximum Annual Pension Rate (MAPR) minus their annual income. The following MAPRs are effective from Dec. 1, 2024, to Nov. 30, 2025.

VA Basic Pension MAPRs

• Veterans without spouses or children: $17,441
• Veterans with dependent spouses or children: $22,839
• Surviving spouses without dependent children: $11,699
• Surviving spouses with dependent children: $15,311
• Two veterans married to each other: $22,839

VA Aid & Attendance MAPRs

• Veterans without spouses or children: $29,093
• Veterans with dependent spouses or children: $34,448
• Surviving spouses without dependent children a maximum of $18,697
• Surviving spouses with dependent children: $22,304
• Two veterans married to each other and one qualifies for A&A: $34,448
• Two veterans married to each other and one qualifies for A&A and the other for Housebound: $38,350
• Two veterans married to each other and both qualify for A&A: $46,143

VA Housebound

• Veterans without spouses or children: $21,313
• Veterans with dependent spouses or children: $26,710
• Surviving spouses without dependent children: $14,298
• Surviving spouses with dependent children: $17,902
• Two veterans married to each other and one qualifies for Housebound: $26,710
• Two veterans married to each other and both qualify for Housebound: $30,580
• Two veterans married to each other and one qualifies for Housebound and the other for A&A: $38,350

Veterans’ Homes
The Veterans Land Board (VLB), which is part of the Texas General Land Office (GLO), operates Veterans Homes in Texas, and the homes are regulated by the Texas health and Human Services Commission and the U.S. Department of Veterans Affairs. To live in a Texas Veterans Home, applicants must have resided in the state for only one day and they must have a physician’s note stating their need for skilled nursing care. Also, they must have served for at least 90 days, have a DD214, and have been honorably discharged.

There are 10 Veterans Homes in Texas. They are located in Amarillo, Big Spring, Bonham, El Paso, Floresville, Fort Worth, Houston, McAllen, Temple and Tyler.

Supplemental Security Income

Dementia patients age 65 and over with limited income and assets may qualify for Supplemental Security Income (SSI). These funds can be used to pay for the cost of assisted living or memory care. As of 2026, the maximum SSI benefit for an individual is $994/month and for a married couple it’s $1,491/month.

To qualify for SSI, applicants must be age 65 and over or have a significant disability, and they must meet an income limit and an asset limit. As of 2026, individuals may meet the SSI income limit if they earn less than $2,073/month OR they get less than $1,014/month from non-work sources, like Social Security benefits or pension payments. They may meet the SSI asset limit if they have $2,000 or less in countable assets. For couples, the income limit is $3,067/month in work income or $1,511/month in non-work income, and the asset limit is $3,000.

Other Options

1) Eldercare loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a Medicaid approval or waiting to sell a home. More on bridge loans for memory care.

2) Some tax credits and deductions can provide financial relief for seniors with dementia and their families. Seniors with limited financial resources can claim the Credit for the Elderly and/or the Disabled, as long as no one can claim them as a dependent. If someone (like an adult child) can claim the senior as a dependent, they can utilize the Child and Dependent Care Credit, and they can deduct any medical or dental expenses they paid for the senior.

3) A reverse mortgage loan can be a viable option for some senior homeowners who are in need of extra income to help pay dementia care. However, reverse mortgages are not recommended for every senior homeowner who needs extra income, so it’s important to consult with a professional before taking out one of these loans.