Texas Nursing Home Lawsuits: Deadlines, Caps, and Rulings

Texas nursing home lawsuits generally fall into three buckets: individual claims for abuse, neglect, or wrongful death brought by residents and families; class actions over how the state places and serves residents; and challenges to federal or state regulations that shape the industry. If you are considering a claim against a facility, Texas law gives you two years to file, caps most non-economic damages at $250,000 per defendant, and requires an expert report within 120 days of the defendant’s answer. A separate federal ruling issued in June 2025, Steward v. Young, also found that Texas has been illegally institutionalizing thousands of people with intellectual and developmental disabilities in nursing facilities, and the remedy is still being worked out.

Who Can Sue a Texas Nursing Home

A resident who is injured by abuse or neglect can bring a personal injury claim directly. If the resident has died, Texas wrongful death law lets the children, spouse, and parents file suit. When no family member steps forward, the executor of the estate can bring the claim instead.¹

Recoverable damages include medical expenses, funeral costs, loss of services and support, emotional pain and suffering, and punitive damages when the conduct amounts to gross negligence or abuse.¹

Deadlines and the Expert Report Requirement

The statute of limitations is two years from the date of injury for both personal injury and wrongful death claims against a Texas nursing home. Missing that window generally ends the case before it starts.

Texas also requires plaintiffs in health care liability cases to serve expert reports from qualified professionals within 120 days after the defendant files an answer. The reports must explain the standard of care, how the facility breached it, and how that breach caused the injury. Inadequate reports can result in early dismissal, and the upfront cost of hiring qualified experts is a meaningful barrier for families.²

Damages Caps Under Texas Tort Reform

Texas’s 2003 tort reform law caps non-economic damages, meaning pain and suffering and similar losses, at $250,000 per individual defendant and $250,000 per health care institution. In a case with multiple institutional defendants, the practical maximum is $750,000. Those figures have not been adjusted for inflation since 2003.²

Wrongful death and survival claims are subject to a separate overall damages cap that is adjusted annually and currently exceeds $2.5 million.² Economic damages such as medical bills and funeral costs generally sit outside these caps, which is why the exact mix of losses in a case matters so much to what a family can actually recover.

Suing Over COVID-19 Exposure

Claims tied to COVID-19 face a much steeper standard than ordinary neglect cases. In June 2021, Governor Greg Abbott signed the Pandemic Liability Protection Act (SB 6), which applies retroactively to claims filed on or after March 13, 2020. To win, a plaintiff must prove the facility knowingly failed to comply with government-issued COVID standards and must submit an expert report establishing causation with “reliable scientific evidence.” Without a sufficient expert report within 120 days, courts must dismiss the case and award the defendant its legal costs.³

Before SB 6 took effect, several early Texas cases had already been filed, including one against the West Oaks Nursing and Rehabilitation Center in Austin over the death of a certified nurse aide in April 2020 and one against the Southeast Nursing and Rehabilitation Center in San Antonio over a resident’s death. By late June 2020, Texas health authorities had reported 883 COVID deaths among nursing home residents and 133 in assisted living facilities.⁴

Steward v. Young: The IDD Institutionalization Ruling

On June 17, 2025, U.S. District Judge Orlando L. Garcia of the Western District of Texas issued a 475-page opinion finding that Texas had violated four federal laws by unnecessarily segregating more than 4,000 people with intellectual and developmental disabilities in nursing facilities instead of serving them in the community. The court ruled for the plaintiffs and the U.S. Department of Justice on every claim, citing violations of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, the Nursing Home Reform Act, and the Medicaid Act.⁵⁶

Judge Garcia wrote that the state’s actions caused “irreparable injury” and described the violations as “severe and ongoing.” His opinion documented broken wheelchairs, residents trapped in facilities and unable to visit their families, and families ignored when they advocated for better services. Several named plaintiffs died while waiting for the state to comply.⁷

The case, filed in December 2010, was brought by the Center for Public Representation, Disability Rights Texas, and Sidley Austin, with the DOJ intervening in 2011 and formally joining as plaintiff-intervenor in 2012.⁸ Judge Garcia found that Texas failed to conduct the preadmission screenings required by the 1987 Nursing Home Reform Act, which are meant to identify whether people with IDD could be served in community programs rather than nursing homes, and that residents’ health deteriorated faster in facilities than it would have in community settings.⁹

The ruling itself did not order specific changes. Judge Garcia directed both sides to submit remedial proposals by August 1, 2025. The plaintiffs and DOJ asked for an overhaul of the screening and evaluation program, specialized services for all IDD residents, informed consent before nursing home placements, and a major expansion of community-based residential alternatives under ongoing court supervision.¹⁰ Texas filed more than 100 objections along with a motion for reconsideration, and as of early 2026 the remedial order had not been finalized.⁵

If you have a family member with an intellectual or developmental disability currently living in a Texas nursing facility, Steward is a class action, so any court-ordered remedy would apply to the class rather than requiring individual suits. It does not, however, resolve claims for personal injury, abuse, or neglect, which still have to be brought separately under the rules described above.

Federal Staffing Rules No Longer Apply

A federal minimum-staffing rule that plaintiffs might once have cited as a benchmark is no longer in force. CMS finalized a rule in April 2024 requiring at least 3.48 hours of nursing care per resident per day and a registered nurse on site around the clock.¹¹ Attorney General Ken Paxton sued in August 2024, and on April 7, 2025, Judge Matthew Kacsmaryk vacated the requirements, finding CMS had exceeded its statutory authority.¹² CMS officially repealed the standards on December 2, 2025, returning to the prior rule requiring an RN on duty for at least eight consecutive hours daily.¹³

How to Report Abuse or Neglect to the State

Before or alongside a lawsuit, you can bring problems to the Texas Health and Human Services Commission. HHSC oversees nursing home regulation, running on-site inspections that examine clinical records, staff qualifications, resident rights, fire safety, and sanitation. Facilities that fall short face administrative penalties, license suspension or revocation, and, for the most serious violations, referral to the Attorney General’s office for civil penalties or injunctive relief.¹⁴

Facilities themselves must report allegations of abuse or serious injury to the state within two hours, and other allegations within 24 hours. A May 2025 report from the state’s Office of Inspector General on one facility found that 9 of 49 incidents were not reported within the required timeframe, 27 of 49 missed the five-day follow-up deadline, more than half of employee registry checks were performed after hiring rather than before, and 18 of 61 employee records lacked documentation of mandatory abuse and neglect training.¹⁵ Those reporting failures matter in litigation too, because they often surface in the records a plaintiff’s expert reviews when building a case.

1
Terry Bryant Accident & Injury Law. Sue Nursing Home Wrongful Death
2
Painter Law Firm. Medical Malpractice Caps
3
Littler Mendelson. Texas Enacts New COVID-19 Liability Protection Law
4
Herrman & Herrman. File a COVID-19 Wrongful Death Lawsuit Against a Nursing Home
5
Center for Public Representation. Steward v. Young
6
Center for Public Representation. Court Issues Landmark Disability Decision for People With Intellectual and Developmental Disabilities in Texas Nursing Facilities
7
Houston Public Media. Judge Rules Texas Has Been Illegally Placing People With Severe Disabilities in Nursing Homes for Decades
8
Civil Rights Litigation Clearinghouse. Steward v. Young
9
Texas Tribune. Texas Nursing Home Disabilities Intellectual Developmental Lawsuit IDD
10
Center for Public Representation. CPR Submits Proposed Remedial Order in Texas Nursing Facility Case
11
Centers for Medicare & Medicaid Services. Minimum Staffing Standards for Long-Term Care Facilities
12
American Hospital Association. District Court Strikes Down CMS Minimum Nurse Staffing Rule
13
American Hospital Association. CMS Repeals Minimum Staffing Requirements Skilled Nursing Long-Term Care Facilities
14
Texas Health and Human Services Commission. 26 Tex. Admin. Code § 553.353
15
Texas Health and Human Services OIG. Nursing Facility Inspection Finds Issues