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What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

HomeCosts & PayingWhat Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity available.

How families pay for care. STAR+PLUS HCBS pays for care services inside a participating facility, not room and board. VA Aid and Attendance adds up to $2,874/month for a veteran with a dependent. Read the full explanation →
The local long-term care ombudsman. Tarrant County: Area Agency on Aging of Tarrant County Ombudsman Program, 817-258-8000. Outside Tarrant County: statewide line 800-252-2412. Read the full explanation →

Questions families ask

How do I report suspected abuse or neglect in a Fort Worth-area facility?

Call the Texas Abuse Hotline at 1-800-252-5400, available 24 hours a day statewide, to report suspected abuse, neglect or exploitation of an older adult. If someone is in immediate danger, call 911 first.

What's the difference between reporting to APS and reporting to HHSC in Texas?

Adult Protective Services (1-800-252-5400) investigates concerns about a specific person's safety, including self-neglect. HHSC's Complaint and Incident Intake line (1-800-458-9858) investigates a licensed facility's regulatory compliance -- staffing, physical conditions, and whether the facility followed required procedures.

Is Texas Adult Protective Services a single statewide hotline or run by county?

Texas APS runs one statewide 24-hour hotline (1-800-252-5400) rather than separate county offices with separate numbers. This is the same number whether you're calling from Fort Worth, Arlington, Burleson, or anywhere else in Tarrant, Parker, Johnson, Denton or Wise County.

Can I report a concern anonymously in Texas?

Yes. Texas Adult Protective Services accepts anonymous reports through the statewide hotline at 1-800-252-5400 or online at the Texas Department of Family and Protective Services' reporting portal.

What happens after I report suspected abuse to APS?

An APS caseworker reviews the report and, for situations that meet the threshold for investigation, typically responds within a set timeframe based on the severity described, ranging from immediate response for emergencies to several days for lower-risk reports.

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