For families
I don't know where to start: the first three calls to make when a parent needs more care
. By Erika Crossley, AI Perfect Fit Senior Living Placement, Houston.
Make three calls, in this order. First, the doctor or the hospital discharge planner, to learn what level of help your parent needs and whether they can get out of a building on their own in an emergency. Second, the money: Medicare will not pay for assisted living, so find out about savings, long-term care insurance, Texas Medicaid STAR+PLUS and VA benefits. Third, a placement advisor who will put the Chapter 121 disclosure in writing, or Erika directly. Do not tour anything until the first two calls are done.
Step by step
Call 1: the doctor or the discharge planner, and ask two questions
What does my parent need help with every day (bathing, dressing, moving, medications, meals, supervision)? And could my parent get out of a building without help and follow directions in an emergency? In Texas those two answers decide the license type. Under 26 TAC 553.5 a Type A home may only keep someone who can evacuate without help, follow emergency directions and does not need attendance at night; anyone else needs a Type B home; and nobody who is permanently bedfast belongs in either. Write the answers down; every home will ask.
Call 2: the money, before any tour
Medicare.gov says Medicare doesn't pay for long-term care, and assisted living is long-term care. So the call is to whoever knows your parent's finances: monthly income, savings, any long-term care insurance policy, whether your parent is a wartime veteran or surviving spouse (VA Aid and Attendance adds a monthly payment to a VA pension), and whether Medicaid is realistic (Texas STAR+PLUS lists assisted living among its waiver services). Land on one monthly number you can carry for three years.
Call 3: a placement advisor who puts it in writing, or Erika
Texas Business and Commerce Code Chapter 121 requires any placement advisor to give you a written disclosure at the time of referral: what they do, who pays them, that you can stop at any time without penalty, and that their list may not include every home that fits. Ask for it on the first call. Ask too for the license number of every home on the list; the advisor is required to audit licenses and may not knowingly send you to an unlicensed home. If you call Erika instead, you get the same disclosure first and a shortlist checked against the state's file.
Then, and only then, tour
Take the two answers from call 1 and the number from call 2 to every tour. Ask the home: what is your license type and number, what is the monthly rate and what raises it, who is awake at night, and what happens when Mom needs more help than today. Confirm the license on HHSC's directory the same day; a home that is not on it may not call itself assisted living under Health and Safety Code 247.021.
If the discharge is tomorrow
Make calls 1 and 2 in the same afternoon from the hospital room; the discharge planner can give you the care answers in minutes. Then call an advisor or Erika with the care level, the budget, the area and the discharge date, and ask for licensed homes with an open bed today. A short respite stay in a licensed home is a legitimate way to buy two weeks to choose well.
Sourced facts
Every law, fee and coverage statement above rests on one of these government pages, read on October 7, 2026. Anything marked ESTIMATE on this page is not from a government source and is labeled where it appears.
- Type A and Type B defined by evacuation capability, night attendance and the ability to follow emergency directions; no permanently bedfast residents. Source: Texas Secretary of State, Texas Register (26 TAC §553.5, in-force text), 26 TAC §553.5 Types of Assisted Living Facilities: Type A and Type B.
- Medicare doesn't pay for long-term care, including care in an assisted living facility. Source: Medicare.gov (Centers for Medicare and Medicaid Services), Long-term care coverage.
- Texas STAR+PLUS HCBS waiver services include assisted living. Source: Texas Health and Human Services Commission, STAR+PLUS (Texas Medicaid managed care for adults with disabilities or age 65 and older).
- VA Aid and Attendance adds a monthly payment to a VA pension for qualifying veterans and survivors. Source: U.S. Department of Veterans Affairs, VA Aid and Attendance benefits and Housebound allowance.
- A placement advisor must give a written disclosure at the time of referral, audit licenses, and may not knowingly refer to an unlicensed community. Source: Texas Legislature, 89th Regular Session, enrolled bill text, Senate Bill 1383 (2025), adding Business and Commerce Code Chapter 121, Referral Agencies for Senior Living Communities.
- A home without a license may not use the term assisted living. Source: Texas Legislature, Health and Safety Code, Health and Safety Code §247.021 License Required.
- HHSC's licensed directory, with license number and expiration date for every home. Source: Texas Health and Human Services Commission, Licensed Assisted Living Facility Directory (spreadsheet).
7 government sources cited on this page.
Questions people ask next
What is the difference between assisted living and a nursing home?
In Texas an assisted living home provides food, shelter and personal care services such as help with bathing, dressing, moving and medications, under Health and Safety Code Chapter 247. A nursing home provides skilled nursing care under a different chapter. If the doctor says your parent needs daily skilled nursing, that is a nursing home conversation; most parents who need help with daily tasks and supervision fit assisted living.
Should I call the big community down the street or a small home?
Both are licensed the same way. Small homes (16 or fewer residents) tend to have one caregiver for a handful of residents and a home-cooked kitchen; large communities have more activities and more staff on site. The license type and the monthly number matter more than the size, so make calls 1 and 2 first.
Who pays the placement advisor?
Usually the home or community your parent moves into, under a contract. Chapter 121 requires the advisor to tell you in writing who pays. Erika is paid one month's rent by the home only after a confirmed move-in; the family pays nothing.
How fast can this go?
With the care level, the budget and the area in hand, a shortlist of licensed homes with open beds can come back the same day. Touring and deciding usually takes a few days. If the hospital says tomorrow, say so on the first call.
From Erika
If you are standing in a hospital hallway reading this on your phone, call me at 346-546-5654 or start the conversation online. You will get my written disclosure first, then a shortlist of licensed homes that fit what your parent needs and what you can pay. I am not a lawyer and I do not run a home, so none of this is legal advice; it is what the state's own pages say, linked so you can read them yourself.