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Nursing homes in Texas

Texas has 1,177 Medicare- or Medicaid-certified nursing homes in 217 counties, with 133,493 certified beds in total. The state average CMS overall rating is 2.7 of 5 against a national average of 3.0, and homes report 3.39 nurse staffing hours per resident per day against 3.86 nationally.

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Texas against the national average

MeasureTexasUnited States
Overall rating (1 to 5)2.73.0
Health inspection rating2.82.8
Staffing rating1.92.9
Nurse staffing hours per resident per day3.393.86
Registered nurse hours per resident per day0.430.69
Nursing staff turnover55.3%45.8%
Health deficiencies in the latest inspection9.49.2
Fines per home, past three years1.50.9

Averages are published by CMS. Health inspection ratings are set within each state, so compare them across states with care.

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Cities with at least 3 homes, by the city in each home's CMS address. Every home is also listed by county below.

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Nursing home rules and contacts in Texas

Federal rules on residents' rights, discharge notices and Medicare coverage are the same in every state. These are the offices to call in Texas, and the rules the state sets for itself.

Personal needs allowance (Medicaid)
A Medicaid resident keeps $75 a month for personal expenses ($150 for a couple). The amount rose from $60 ($120 for a couple) on January 1, 2024. State law sets it at not less than $75 a month. Source: Tex. Hum. Res. Code § 32.024(w); Texas Medicaid State Plan Amendment TX 23-0027
Holding a bed during a hospital stay or leave
Texas Medicaid pays to hold a bed only during a therapeutic home visit of up to 3 days, if a physician authorized such visits in the plan of care and the home documents the visit; a visit longer than 3 days is treated as a discharge from the first day. The state plan does not pay to hold a bed during a hospital stay. Before a hospital transfer or therapeutic leave, the home must give written information about its bed-hold policy, and it may charge to hold a bed only under a written agreement, no more than the daily Medicaid rate, and not for days the state is paying. A resident whose absence lasts longer than the bed-hold period returns to their previous room if available, or to the first available bed in a semi-private room, if they still need the home's services and are eligible for Medicaid or Medicare nursing home coverage. Source: 26 Tex. Admin. Code §§ 554.503 and 554.2603; Texas Medicaid State Plan, Attachment 4.19-C
Visiting
A resident, or the resident's guardian or legally authorized representative, may name an essential caregiver, whom the home may not bar from in-person visits. State rules require the home to allow the essential caregiver to visit for at least 2 hours a day, with physical contact if the resident chooses. The home may revoke the designation if the caregiver breaks its safety protocols; the resident may then name someone else, and the revocation can be appealed to the state. The home may suspend these visits only with state approval when in-person visits pose a serious community health risk, for up to 7 days at a time, and never for more than 14 days in a row or 45 days in a calendar year. Source: Tex. Health & Safety Code ch. 260B; 26 Tex. Admin. Code § 570.514
Discharge notice
In a Medicaid-certified home, a resident has 90 days to appeal a discharge through a state fair hearing. If the appeal is filed before the discharge date, the resident may stay until the hearing officer decides, except in nonpayment cases and the situations the rule lists for short-notice discharge (danger to the health or safety of others, urgent medical needs, improved health, or a stay of less than 30 days). If the discharge is found inappropriate, the home must readmit the resident immediately or to the next available bed. Before an immediate discharge for health or safety reasons, other than to a hospital, the home must call the State Long-Term Care Ombudsman office. Source: 26 Tex. Admin. Code § 554.502
Cameras in rooms
A resident may place a video camera or audio recorder in their own room after asking the home on a state form; a guardian or legal representative asks for a resident who lacks capacity. Every roommate must consent and may set limits. The home must allow it, provide a reasonably secure place to mount it and power, and may not refuse admission or remove a resident because of the request. The resident pays all costs except electricity, and a notice is posted at the room entrance. Source: Tex. Health & Safety Code §§ 242.841–242.852

Checked against Texas state sources on Oct 9, 2026. Rules and phone numbers change, so confirm with the office listed. For the rules that apply in every state, see residents' rights, how to file a complaint and how Medicaid pays for a nursing home.

Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026.