Your parent can't live alone anymore. The hospital says choose a facility by Friday.
The ER discharge planner just handed you a printout with three assisted living communities. You have 48 hours to decide — and you don't know whether your parent needs home care, assisted living, or a nursing home. You don't know what Texas Medicaid covers, how the STAR+PLUS waiver works, or whether the family home is at risk from estate recovery. Your siblings are calling with opinions. You don't have power of attorney. And the one "free" referral service you called is already pushing a facility that charges $7,000 a month.
Meanwhile, an elder law attorney in Texas charges $250 to $500 per hour. A private geriatric care manager bills $150 to $350 per hour. And the free placement services — A Place for Mom, Caring.com — are paid commissions by the facilities they recommend, sometimes 50% to 100% of the first month's rent. Their recommendations follow the commission, not your parent's clinical needs.
You don't need a referral service picking facilities for you. You need to know how to assess your parent's actual care level, compare every option available in Texas, navigate the financial rules, and protect your family's assets — before you sign anything.
The Texas Care Transition Navigator
This is a 10-chapter guide built specifically for the Texas elder care system — where Medicaid works differently from nearly every other state. It does not place your parent in a facility or provide legal representation. It is the decision framework, financial analysis, and facility vetting system that the hospital discharge planner, the free referral service, and the state website all leave out.
At its core is the Texas Care Transition Navigator — a structured method that walks you from "I think my parent needs help but I don't know what kind" through to a fully vetted care arrangement with the legal authority, financial protections, and facility due diligence completed in the right order. It handles the part everyone gets wrong: understanding that Texas is an income-cap state with no spend-down option, that the STAR+PLUS HCBS waiver has a 6-to-18-month interest list, that a Miller Trust is required if your parent earns even one dollar over the $2,982 monthly limit, and that the state will pursue estate recovery against the family home after age 55.
What's inside — the 10-chapter guide, 9 standalone worksheets, and the complete Texas care system
- ADL and IADL Assessment Framework — the same functional criteria Texas uses to determine care levels, adapted into a plain-language worksheet so you can accurately assess whether your parent needs companionship, personal care, or skilled nursing before any facility tour or Medicaid application.
- Every Texas Care Model Compared Side by Side — home care, adult day care, Type A assisted living, Type B assisted living, memory care, and nursing homes. Real 2026 costs: $5,720/month median for home care, $5,666 for assisted living, $5,627 for a semi-private nursing home room, and $7,837 for private. What each setting can legally provide and where each one falls short.
- The STAR+PLUS and Medicaid Eligibility Roadmap — how the income cap works, the $2,982 monthly threshold, the $2,000 asset limit, spousal protections (CSRA up to $162,660, MMNA up to $4,066.50), and the Miller Trust setup process. Plus realistic HCBS waiver wait times by Texas metro — 6 to 12 months in Houston, 8 to 16 months in Austin — so you know when to file.
- Facility Vetting System — how to read HHSC inspection reports, how to tell the difference between Type A and Type B assisted living licenses, the questions to ask on every tour, and how to use the state's Long-Term Care Provider Search to check violation history. Because the facility brochure never mentions the citation from last quarter.
- MERP Protection and Lady Bird Deed Strategy — how Medicaid Estate Recovery works in Texas, which exceptions apply (surviving spouse, disabled child, hardship waiver), and how Lady Bird Deeds and Transfer on Death Deeds bypass probate to keep the family home out of MERP's reach. Organized as a preparation checklist for your attorney meeting, so you walk in with the deed information ready instead of paying $400 an hour for information gathering.
- Legal Authority Checklist — Statutory Durable Power of Attorney for finances, Medical Power of Attorney for healthcare, when a "springing" POA requires written physician certification, and the guardianship threshold. Because without these documents, you cannot sign an admission contract, access medical records under HIPAA, or manage a bank account — no matter how much caregiving work you're doing.
- Crisis Timeline and Transition Planner — what to do when you have 48 hours after a hospital discharge versus 6 months of gradual decline. How to coordinate across siblings, when to involve the Long-Term Care Ombudsman, and how to avoid locking your family into a bad long-term arrangement under crisis pressure.
- Complete Payment Source Analysis — private pay, long-term care insurance, VA Aid & Attendance, STAR+PLUS, Community Attendant Services (CAS), and Nursing Home Medicaid. What each source covers, who qualifies, and how to combine them to bridge the gap between what your parent can afford and what care actually costs.
Who this is for
The adult child in Texas who just realized their parent can't live alone safely anymore — and is drowning in conflicting information from hospital social workers, facility sales teams, free referral services, and siblings. The family comparing home care agencies against assisted living communities without any framework for deciding. The spouse trying to figure out whether Medicaid will cover the $5,700-per-month bill — and learning that Texas has an income cap that blocks most applicants unless they establish a Miller Trust. And the caregiver doing all the coordination work without power of attorney, one medical emergency away from a guardianship court proceeding.
Why not use the free resources?
Because the free resources are designed for different purposes — and none of them does what this guide does.
The Texas Health and Human Services website (hhs.texas.gov) has the policy manuals and program forms. They're written for regulators and case managers, not for a family member sitting in a hospital waiting room trying to make a decision before discharge. The STAR+PLUS handbook alone is hundreds of pages of administrative procedure.
Texas Law Help (texaslawhelp.org) provides excellent self-help forms for powers of attorney and MERP overviews. It does not cover facility selection, care-level assessment, cost comparison, or financial planning.
A Place for Mom and Caring.com provide free facility matching — funded by commissions from the facilities they recommend. Facilities that accept Medicaid generally do not pay referral commissions, so the platform's recommendations systematically exclude the most affordable options. A Washington Post investigation found these services frequently direct families to facilities with documented licensing violations.
This guide has no facility affiliations, no placement commissions, and no referral agreements. It helps you evaluate any facility in Texas — including those that accept Medicaid — using the state's own inspection data.
An honest guarantee
Work through the Texas Care Transition Navigator. If the guide does not make the Texas elder care system clearer and more navigable than any combination of free websites, referral services, or initial professional consultations — email us within 30 days for a full refund. The risk of trying it is a fraction of one elder law attorney billable hour. The risk of choosing the wrong care level, missing the STAR+PLUS filing window, or losing the family home to MERP is measured in tens of thousands of dollars and years of regret.
For — less than fifteen minutes of attorney time — you get the 10-chapter guide, 9 standalone printable worksheets (ADL assessment, care setting comparison, facility tour scorecard, financial snapshot, MERP protection checklist, and more), and the asset protection strategies that the free resources leave out.
Stop guessing which care option fits. Get the guide, follow the system, and make this decision with the full picture — not a hospital discharge printout.