Senior care in Converse, Live Oak, and Selma in northeast San Antonio, Texas: licensing, costs, Medicaid, veterans benefits, and who to call first.
By San Antonio Senior Advisor Care Team · October 06, 2026
Families searching for senior care in Converse, Live Oak, and Selma, Texas are looking at the northeast edge of Bexar County, a corridor that runs along Interstate 35 and Loop 1604 and sits close to JBSA-Randolph. This part of the San Antonio area grew quickly through the 1990s and 2000s as military families, civilian base employees, and retirees settled in neighborhoods like Converse's Dover and Miller's Point areas, Live Oak's established subdivisions, and Selma's retail-heavy corridor near the Guadalupe and Comal county line. Many of the people who bought homes there decades ago are now in their seventies and eighties, and their adult children are starting to ask the same question: should Mom or Dad stay home with help, or is it time for assisted living or memory care?
The northeast side has a different feel from Stone Oak or Alamo Heights. Housing is more mixed, many families are multigenerational, and a large share of residents are bilingual, with Spanish spoken at home and at church. That matters when you tour a community. Ask whether care staff speak Spanish during the overnight shift and not only at the front desk, because a resident with dementia often reverts to a first language. Whatever you choose, every assisted living facility in Texas is licensed by the Texas Health and Human Services Commission (HHSC) under Chapter 247 of the Texas Administrative Code, and you can look up any facility's license and inspection history at apps.hhs.texas.gov/HSPubDisclosure before you ever schedule a tour.
Texas licenses assisted living facilities as Type A or Type B. A Type A facility is designed for residents who can walk and evacuate on their own with minimal help. A Type B facility can serve residents who need help to evacuate, which is why most memory care and higher-acuity communities hold a Type B license. If your parent has dementia, wanders, or uses a wheelchair or walker, confirm the license type in writing before you pay a deposit. A pleasant tour does not tell you what the HHSC license allows the building to do.
When you evaluate a community in Converse, Live Oak, or Selma, pull the inspection record. Look for citations tied to medication administration, staffing at night, resident rights, and emergency evacuation, and read how quickly the facility corrected each one. A single minor citation is normal; a pattern of repeat citations is a reason to keep looking. If something goes wrong after move-in, the HHSC complaint line is 1-800-458-9858, and families can also reach the Long-Term Care Ombudsman through the Alamo Area Council of Governments (AACOG) at 210-362-5200 or aacog.com, which advocates for residents at no cost.
Cost is usually the deciding factor, and northeast Bexar County is often somewhat more affordable than the Medical Center and far north corridors, though prices vary widely by acuity and by what is included. Ask every community for a written fee schedule that separates the base rent from care-level charges, medication management, incontinence care, and the community fee. Memory care generally costs more than standard assisted living because of higher staffing, so compare equivalent care levels rather than headline monthly rates. Ask what triggers a price increase and how much notice you get.
For families who cannot pay privately, Texas Medicaid's STAR+PLUS Home and Community-Based Services (HCBS) waiver can help pay for care in a participating assisted living facility, though not every community accepts it and the state's interest list can mean a long wait. Managed care organizations serving the San Antonio area include Molina Healthcare, Superior HealthPlan (Centene), UnitedHealthcare Community Plan, and Amerigroup. Veterans, a large share of the northeast side population because of JBSA-Randolph and nearby Fort Sam Houston, may qualify for VA Aid and Attendance through the Audie L. Murphy Memorial VA Hospital, and the Texas Veterans Commission (tvc.texas.gov) offers free help with claims. Surviving spouses may qualify as well, so ask before assuming you are ineligible.
Many northeast side families first meet the senior care system in a hospital room. Northeast Methodist Hospital in Live Oak and the Baptist and Methodist hospitals along the I-35 and Loop 410 corridors, as well as Brooke Army Medical Center (BAMC) for eligible military beneficiaries, all have discharge planners or case managers. When a parent is admitted, ask for the case manager on day one rather than the day of discharge. Federal rules require hospitals to give patients a list of post-acute providers and to respect patient choice, so you are not obligated to accept the first facility suggested.
Short-term rehabilitation in a skilled nursing facility is a different benefit from assisted living. Medicare Part A may cover a limited skilled nursing stay after a qualifying inpatient hospital stay of at least three days, but it does not pay for long-term assisted living. Families commonly confuse the two and are surprised by the bill. Ask the case manager to explain which services Medicare covers, what will be private pay, and whether a trial stay or respite stay at an assisted living community is an option while you finish the decision.
Not every family needs a move right away. Adult day programs, in-home personal assistance, home-delivered meals, and respite care can extend the time a parent safely lives in Converse or Live Oak. AACOG, the Area Agency on Aging for the 13-county Alamo region, can screen families for services, caregiver support, and benefits counseling through its Aging and Disability Resource Center line at 210-362-5200. Texas also offers programs through HHSC that may help with in-home attendant care for Medicaid-eligible adults.
Caregiver burnout is the quiet risk in all of this. Adult children on the northeast side often commute to jobs downtown or at the base while managing a parent's medications and appointments. Build a backup plan before a crisis: identify two or three licensed communities, know which accept short respite stays, and keep power of attorney and medical directive documents current. If a parent has memory loss, schedule a visit to a Type B community now, while pressure is low, so you can compare it calmly against staying home.
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