Statute of Limitations
Texas's personal injury SOL is 2 years (Tex. Civ. Prac. & Rem. Code § 16.003). The Texas Medical Liability Act (TMLA, Tex. Civ. Prac. & Rem. Code § 74.001) applies to healthcare claims and requires an expert report within 120 days of filing. TMLA noneconomic damages cap of $250,000 per healthcare provider (with a $750,000 aggregate in multi-defendant cases) applies to nursing home negligence claims. Notice of claim 45 days before suit is required.
2 years from date of injury (expert report required within 120 days of filing; 45-day notice required)
Where to File in Texas
Texas provides enhanced remedies for nursing home abuse through the Texas Human Resources Code § 102 (Nursing Home Residents' Bill of Rights) and the Texas Health & Safety Code Chapter 242. Critically, Chapter 74 of the Texas Civil Practice & Remedies Code governs healthcare liability claims and imposes a 180-day notice-of-claim requirement before suit can be filed, along with a mandatory expert report from a qualified healthcare professional within 120 days of filing. Failure to timely serve the expert report results in dismissal with prejudice and fee-shifting — one of the most punishing procedural traps in elder abuse litigation.
The statute of limitations for nursing home negligence and elder abuse in Texas is two years from the date the cause of action accrues (CPRC § 74.251). Wrongful death claims must be filed within two years of death (CPRC § 16.003). The discovery rule applies when the injury was inherently undiscoverable. Texas imposes a healthcare liability cap of $250,000 in non-economic damages against a single healthcare provider and $500,000 total per occurrence — a significant constraint that can affect settlement leverage in cases involving severe but non-fatal injuries. Damages in wrongful death cases for a deceased elder may be further limited by reduced life-expectancy evidence.
The Texas Health and Human Services Commission (HHSC) regulates nursing facilities and investigates complaints through its Long-Term Care Regulatory (LTCR) division. The Texas Long-Term Care Ombudsman Program operates under HHSC and provides complaint and advocacy records. The Texas Attorney General's Medicaid Fraud Control Unit (MFCU) investigates criminal abuse in Medicaid-certified facilities. Surveyors must complete annual inspections and respond to complaint investigations; all LTCR enforcement orders, penalty assessments, and corrective action plans are public record under TPIA and are essential litigation exhibits.
Texas has approximately 1,200 nursing facilities. The state does not impose a minimum staffing ratio by statute (unlike California), relying instead on federal OBRA standards. CMS Payroll-Based Journal data consistently shows Texas facilities staffing below national medians on RN hours per resident day. Large chains with significant Texas presence include Fundamental Long Term Care, Ensign Group, and SavaSeniorCare. Arbitration clauses are common in Texas admission agreements; however, post-Kindred Nursing Centers v. Clark (2017), mandatory pre-dispute arbitration agreements are enforceable only if voluntarily executed by an authorized representative — not a condition of admission for Medicaid residents.
Exposure in Texas
Source: Texas Health and Human Services Commission, 2025
Source: Texas Health Care Association, 2024
Source: Tex. Civ. Prac. & Rem. Code § 74.301
Clinics & Specialists in Texas
Memorial Hermann — Texas Medical Center, Level I Trauma
Your Legal Team
Denise Okafor
Partner, Elder Abuse Litigation Group
Austin, TX
Denise Okafor has spent 14 years fighting for nursing home residents and their families across Texas, where a large and growing elderly population creates significant demand for quality elder abuse litigation. Her public health background informs her systemic approach to nursing home cases — she investigates not just individual failures but facility-wide patterns of understaffing, inadequate training, and corporate cost-cutting that create conditions for resident harm. Denise is particularly adept at using CMS payroll-based journal staffing data, survey deficiency reports, and corporate financial records to demonstrate that understaffing was a deliberate business decision rather than an isolated oversight — a framework that supports punitive damage claims. She has obtained verdicts and settlements totaling over $60 million for Texas nursing home residents and their families, including multiple seven-figure wrongful death recoveries.
Education
- J.D., University of Texas School of Law (2012)
- B.S., Public Health, Texas A&M University (2009)