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Nursing Home vs. Assisted Living

Texas licenses these under separate rule chapters -- Chapter 242 for nursing homes, Chapter 247 for assisted living -- for meaningfully different levels of medical care.

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Short answer

Texas licenses nursing homes under Health and Safety Code Chapter 242 and assisted living under Chapter 247 -- two different regulatory frameworks for two different populations. Nursing homes provide 24-hour licensed nursing for higher medical acuity; assisted living helps with daily activities but not ongoing skilled nursing.

Nursing homes carry federal CMS star ratings through Medicare's Care Compare tool. Assisted living facilities do not -- there is no equivalent star system for that category anywhere in the country. A resident whose medical needs exceed a Type B assisted living license will need to transition to a nursing home; ask any assisted living community what that transition process typically looks like.

Questions families ask

What is Medicaid Estate Recovery, and does it affect a Fort Worth family's home?

Texas's Medicaid Estate Recovery Program (MERP) can seek reimbursement from a deceased Medicaid recipient's probate estate for long-term-care costs paid by the state, including nursing facility care and some STAR+PLUS HCBS services -- but only after death, and with protections for a surviving spouse or dependent children.

What does assisted living cost in the Fort Worth area?

The 2024 CareScout Cost of Care Survey puts Texas's statewide median assisted living cost at $5,250 a month. No primary source publishes a Fort Worth- or Tarrant County-specific figure separate from that state median, so local pricing likely runs close to or somewhat above it given the metro's growth.

What does memory care cost in Fort Worth?

There is no published memory-care median anywhere in the country -- CareScout does not survey memory care as its own category, in Texas or any other state. Any specific memory-care dollar figure you see online is an estimate or an extrapolation, not a sourced statistic.

How much does in-home care cost in Tarrant County?

The 2024 CareScout survey puts Texas's home health aide median at roughly $28/hour, which works out to about $4,850 a month at 40 hours a week. Non-medical home care (companionship, help with daily tasks) and skilled home health are priced and covered differently, so confirm which you're actually being quoted.

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