{"id":204,"date":"2026-07-21T16:44:37","date_gmt":"2026-07-21T16:44:37","guid":{"rendered":"https:\/\/summitrelocationtimess.com\/?p=204"},"modified":"2026-07-21T16:44:37","modified_gmt":"2026-07-21T16:44:37","slug":"nowhere-to-go-inside-the-texas-boarding-home-system-where-abuse-neglect-and-exploitation-are-widespread","status":"publish","type":"post","link":"https:\/\/summitrelocationtimess.com\/?p=204","title":{"rendered":"Nowhere to Go: Inside the Texas Boarding Home System Where Abuse, Neglect and Exploitation are Widespread"},"content":{"rendered":"
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Lea este art\u00edculo en espa\u00f1ol. <\/em><\/p>\n<\/div>\n

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This article was produced in partnership with the nonprofit newsroom <\/em>Type Investigations.<\/em><\/p>

Read more The Possibilities of Grief as a Rupture<\/a><\/p>\n<\/div>\n

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Angelique Estes knew her stay would be rough as soon as she arrived at her new home in Arlington, Texas, in early December\u00a02023<\/span>.<\/p>\n

At 53<\/span>\u00a0years old, Estes had learned to read her environment quickly. She\u2019s lived with cerebral palsy all her life, and her health quickly deteriorated after her husband of nearly 30<\/span>\u00a0years died two years prior, leaving her unable to walk. With no family able to care for her and only disability benefits to rely on, Estes\u2009\u2014\u2009like thousands of Texans in similar circumstances\u2009\u2014\u2009turned to group homes as a\u00a0low-cost alternative to the nursing home she couldn\u2019t\u00a0afford.<\/p>\n

By the time she arrived at 1210<\/span> Woodbrook Street, a\u00a0squat, three-bedroom brick house in a\u00a0quiet suburban neighborhood, she had already cycled through five such boarding homes, none of which had been good. As she took in the tight hallways\u2009\u2014\u2009so narrow that her ambulance gurney couldn\u2019t fit through\u2009\u2014\u2009she sensed this time was no\u00a0better.\u00a0<\/p>\n

\u201c<\/span>That\u2019s when I\u00a0started to feel suspicious,\u201d she recalls. But she hadn\u2019t anticipated how much worse it could\u00a0be.\u00a0<\/p>\n<\/div>\n

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Estes was taken to a\u00a0room and placed on a\u00a0bed. Over the following few days, the adult undergarment she needed to wear was rarely changed, and she was only fed instant noodles and mayonnaise sandwiches. She was also given a\u00a0new drug she hadn\u2019t been prescribed\u2009\u2014\u2009a liquid medicine that tasted like mint, which she now believes was used to sedate her. Her roommate, an elderly woman, was too frail to help. With no Wi-Fi or data left on her phone, she felt isolated and\u00a0alone.<\/p>\n

\u201c<\/span>When I\u00a0realized I\u00a0wasn\u2019t going to be allowed to leave, I\u00a0slid onto the floor, thinking they would have to call an ambulance to help me up,\u201d she remembers. \u200b\u201c<\/span>They didn\u2019t.\u201d<\/p>\n<\/div>\n

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Instead, her caregivers pulled her onto a\u00a0mattress on the floor, where she remained for the rest of her time in the home. Trapped and desperate to escape, she eventually tried to cut her wrists\u2009\u2014\u2009another attempt to compel someone to call an ambulance that could take her away. But nobody called for\u00a0help.<\/p>\n

Finally, five days after she arrived, the message she\u2019d been trying to send to a\u00a0friend\u2009\u2014\u2009\u200b\u201c<\/span>I\u2019m being held against my will\u201d\u2009\u2014\u2009went through. The friend called\u00a0911<\/span>.<\/p>\n

As it happened, 1210<\/span> Woodbrook Street was already familiar to Arlington law enforcement. Nearly three weeks prior, on Nov. 20<\/span>, 2023<\/span>, police officers were dispatched to the house after another resident, an elderly man with significant physical disabilities, had fallen in the backyard. A\u00a0neighbor found him lying on the ground and called\u00a0911<\/span>.<\/p>\n

According to police records, officers interviewed the facility owner, Regla Becquer\u2009\u2014\u2009who operated five unlicensed, Dallas-area boarding homes for disabled and elderly people, under the name Love and Caring for People LLC\u2009\u2014\u2009and the fire marshal conducted a\u00a0house assessment but found no\u00a0violation.<\/p>\n

On Dec. 13<\/span>, when police officers arrived in response to the call from Estes\u2019 friend, they found Estes on the mattress on the floor of her room. When first responders asked if she wanted to go to the hospital, Estes yelled, \u200b\u201c<\/span>Yes! Get me out of\u00a0here!\u201d<\/p>\n<\/div>\n

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Angelique Estes cycled through five boarding homes before arriving at 1210 Woodbrook Street in Arlington, Texas, an unlicensed facility where she says she was neglected and held against her will. Photo by Danielle Villasana<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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Police opened an investigation into the house on Woodbrook Street and Becquer\u2019s other properties. Across all five homes, investigators found that residents with significant disabilities had experienced severe neglect: deprived of food, water and medical care; left in soiled adult undergarments that went unchanged for days; isolated from friends and family and prevented from leaving or contacting the outside world. In one case, a\u00a0resident unable to walk had no access to his wheelchair and had scars \u200b\u201c<\/span>from crawling around,\u201d as Arlington Police Lt. Kimberly Harris later told\u00a0reporters.<\/p>\n

In February 2024<\/span>, police arrested Becquer and charged her with abandoning or endangering an individual and creating imminent danger of bodily injury, with regards to the alleged neglect Estes experienced. That charge wouldn\u2019t be the\u00a0last.<\/p>\n

At the time of Becquer\u2019s arrest, Arlington police were investigating 13<\/span> cases of residents at Becquer\u2019s homes who had died over the previous year and a\u00a0half, including at least three instances in which Becquer had taken ownership of her late residents\u2019 property. One of them was 61<\/span>-year-old Karen Walker, who left Becquer as the sole executor of her estate\u2009\u2014\u2009including the house on Woodbrook Street\u2009\u2014\u2009when she died in 2022<\/span>. Another was 59<\/span>-year-old Steven Kelly Pankratz, who had moved into one of Becquer\u2019s homes in October 2022<\/span> and died there 15<\/span> months\u00a0later.<\/p>\n<\/div>\n

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According to those who knew Pankratz, during his time in the home, Becquer systematically isolated him from the people in his life and even from medical care. Pankratz\u2019s attorney, Dan Moore\u2009\u2014\u2009representing him in an unrelated personal injury case\u2009\u2014\u2009and Moore\u2019s office manager, Janet Jackson, recounted in an interview how Pankratz missed a\u00a0number of doctor\u2019s appointments while under Becquer\u2019s care and that, when they called to speak with him, Becquer always listened in the\u00a0background.<\/p>\n

\u201c<\/span>I\u2019d say, \u200b\u2018<\/span>Take me off speaker,\u2019 and he would say, \u200b\u2018<\/span>I can\u2019t,\u2019\u201d Jackson recalled. \u200b\u201c<\/span>She was holding him pretty much\u00a0hostage.\u201d<\/p>\n

At some point after moving into Becquer\u2019s house, Moore says, Pankratz gave Becquer power of attorney, allowing her access to his finances. A\u00a02024<\/span> lawsuit filed by Pankratz\u2019s brother alleged that Becquer used Pankratz\u2019s \u200b\u201c<\/span>medical disorientation\u201d to gain access to his savings and credit, buying a\u00a0car with his money even though Pankratz couldn\u2019t drive. (Pankratz\u2019s brother declined to speak on the record. The lawsuit is still\u00a0pending.)<\/p>\n

On Jan. 12<\/span>, 2024<\/span>, Pankratz died. When local emergency services arrived, Pankratz had been deceased for some time. His brother told police that, when they spoke roughly 12<\/span>\u00a0hours before his passing, Pankratz \u200b\u201c<\/span>sounded disoriented and his speech was slurred.\u201d An autopsy later found a\u00a0mix of psychotropic medications in Pankratz\u2019s system that he\u2019d never been prescribed. The Tarrant County medical examiner ruled his death a\u00a0homicide, and Becquer was charged with murder. Arlington police said his death was just \u200b\u201c<\/span>the tip of the iceberg.\u201d<\/p>\n<\/div>\n

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Left: The boarding home at 1210 Woodbrook Street, Arlington, Texas, where Angelique Estes says she was held against her will. Right: The boarding home at 7411 Lake Whitney Drive, Arlington, where Steven \u201cKelly\u201d Pankratz died on Jan. 12, 2024. Both homes were owned and operated by Regla Becquer, who faces multiple criminal charges, including murder. PHOTOS BY DANIELLE VILLASANA<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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Becquer\u2019s lawyer declined to comment as both criminal cases are still pending. Becquer, who is currently in pretrial detention, did not respond to mailed questions about the criminal cases or the civil lawsuit (in which Becquer appears to be representing herself). The trial date for both criminal charges has been set for April 1<\/span>, 2026<\/span>, and there is no plea on\u00a0record.<\/p>\n

As of this November, Arlington police told In These Times<\/em> and Type Investigations <\/em>in a\u00a0statement that they had identified \u200b\u201c<\/span>at least 20<\/span> clients who died between September 2022<\/span> and February 2024<\/span> after staying in one of [Becquer\u2019s] homes.\u201d \u200b\u201c<\/span>To date, Mr. Pankratz\u2019s death is the only client death we have filed charges in connection to,\u201d police said. \u200b\u201c<\/span>The case has been turned over to the Tarrant County District Attorney\u2019s\u00a0Office.\u201d<\/p>\n

By June 2024<\/span>, the story became national news. But tabloid-esque \u200b\u201c<\/span>true crime\u201d headlines about the \u200b\u201c<\/span>Killer Caretaker\u201d in Texas don\u2019t convey the depth of the horror of the case: Becquer\u2019s homes represent the tragic culmination of a\u00a0systemic policy failure, wherein Pankratz\u2019s and Estes\u2019 alleged experiences are just two extreme examples of a\u00a0much larger\u00a0problem.<\/p>\n

The facilities Becquer ran all fall under the rubric of \u200b\u201c<\/span>boarding homes\u201d: a\u00a0term that in Texas refers to group homes for elderly or disabled people, based in private individuals\u2019 residences, that provide housing, food and varying levels of support, and which frequently operate with little to no\u00a0oversight.<\/p>\n

On their surface, the homes seem like a\u00a0potentially good solution to complex social problems. As a\u00a0low-cost, community-based model, boarding homes, which typically cost residents around $1<\/span>,400<\/span> per month\u2009\u2014\u2009compared with a\u00a0median cost ranging between $5<\/span>,475<\/span> and $7<\/span>,087<\/span> per month for a\u00a0nursing home bed\u2009\u2014\u2009are often the only option for those who can\u2019t afford a\u00a0private nursing home or don\u2019t qualify for Medicare or Medicaid. In Texas, the problem is compounded by two factors: one, that the state has the highest percentage of uninsured residents in the country, totaling about 5<\/span>\u00a0million people, including many of Texas\u2019 roughly 2<\/span>.1<\/span> million undocumented immigrants; and two, that the state\u2019s low Medicaid reimbursement rates have contributed to the closure of 84<\/span> nursing homes in the past five years and the loss of thousands of long-term care\u00a0beds.<\/p>\n<\/div>\n

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In this vacuum of care, boarding homes can fill a\u00a0crucial gap. But experts say patchwork regulations and lack of oversight also make residents susceptible to isolation, neglect, abuse and financial exploitation. No medical training is required to open a\u00a0boarding home, even though residents often have extensive medical needs. Since not all local governments in Texas require boarding homes to apply for permits and licenses, running \u200b\u201c<\/span>unlicensed\u201d homes like Becquer\u2019s is legal in some\u00a0areas.<\/p>\n

The results are grim. Combing through local news coverage, In These Times <\/em>and Type Investigations<\/em> found that, between 2020<\/span> and 2025<\/span>, first responders found at least 100<\/span> vulnerable people without proper care, including food and medication, in Texas boarding homes. Many had to be hospitalized; some died. In July 2023<\/span>, a\u00a075<\/span>-year-old resident of one boarding home near Houston landed in the intensive care unit after one of his caregivers beat him. A\u00a0few months later, nine people were found injured and malnourished in another Houston-area\u00a0home.<\/p>\n

While the Becquer case recently triggered a\u00a0handful of policy reforms aimed at providing greater oversight of boarding homes, experts say they still fall far short of truly addressing the issue. Such facilities exist under different designations across the country, with a\u00a0greater risk of abuse and neglect in states with higher poverty rates, lower levels of Medicaid access and a\u00a0tendency to embrace deregulation, experts say. Often, that means the South, according to DJ McMaughan, a\u00a0public health professor at Oklahoma State University who studied Texas\u2019 boarding home\u00a0system.<\/p>\n<\/div>\n

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But the problem is far from limited to Southern states, McMaughan notes: \u200b\u201c<\/span>Hawaii\u2019s had issues, New York\u2019s had issues, Pennsylvania\u2019s had\u00a0issues.\u201d<\/p>\n

And as the United States faces the largest healthcare cuts in its history\u2009\u2014\u2009set to strip $500<\/span> billion from Medicare and $1<\/span> trillion from Medicaid over the next nine years, leaving a\u00a0projected 16<\/span> million people without coverage and possibly closing some 600<\/span> nursing homes nationwide\u2009\u2014\u2009Texas\u2019 boarding home model could represent a\u00a0painful preview of things to come. Experts anticipate that the cuts will drive more people to boarding homes and other makeshift\u00a0solutions.<\/p>\n

\u201c<\/span>More people are going to be funneled into the unlicensed [boarding home] and care system,\u201d McMaughan says. \u200b\u201c<\/span>And maybe not even directly, [but] through ending up on the streets or in the hospital and being discharged into an unlicensed boarding\u00a0home.\u201d<\/p>\n

It\u2019s a\u00a0frightening vision of the future of long-term care in America. Dennis Borel, former executive director of the Coalition of Texans with Disabilities, a\u00a0local advocacy group, puts it this way: Boarding homes are often \u200b\u201c<\/span>the worst possible place you can live\u201d short of sleeping \u200b\u201c<\/span>under the\u00a0bridge.\u201d<\/p>\n<\/div>\n

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A Hidden Population<\/div>\n<\/div>\n
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The boarding home model was born from good intentions: to free people living with disabilities from restrictive institutions, restore them to their communities and make long-term care more humane and\u00a0dignified.<\/p>\n

In 1999<\/span>, the Supreme Court\u2019s landmark decision in Olmstead v. L.C.<\/em>\u2014a\n case brought by two Georgia women, Lois Curtis and Elaine Wilson, who \nsought to be transferred out of the psychiatric hospital they lived \nin\u2009\u2014\u2009led to a\u00a0revolution in community-based care. The women\u2019s doctors \nbelieved deinstitutionalization would benefit the women, but lack of \nfunding prevented their transition to a\u00a0community setting. The court \nfound this refusal amounted to segregating Curtis and Wilson from the \nbroader community, constituting unlawful discrimination and a\u00a0violation \nof the Americans with Disabilities\u00a0Act.<\/p>\n

The decision was hailed as a\u00a0major victory for disability rights as \nwell as a\u00a0deinstitutionalization movement that, fueled by continuous \nreports of isolation and abuse in large institutions, had been \nadvocating\n for decades to reintegrate people with mental illnesses and \ndevelopmental disabilities into community settings. In its aftermath, \ndozens of institutions were closed across the nation. But no cohesive \nplan was made to ensure alternative forms of care were adequate and\u00a0safe.<\/p>\n

The United States lacks comprehensive federal regulations for residential care facilities, which are governed at the state level\u2009\u2014\u2009or, in some states, including Texas, at the county or municipal level. This lack has resulted in inconsistent policies and regulations across the country, compounded by the fact that different states use different names to describe community-based care facilities and different legal definitions of the services they can provide. (What Texas calls a \u200b\u201c<\/span>boarding home\u201d is a \u200b\u201c<\/span>personal care home\u201d in Pennsylvania, and a \u200b\u201c<\/span>board and care home\u201d in California, for\u00a0example.)<\/p>\n<\/div>\n

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\u201c<\/span>Nobody wants to live in a\u00a0nursing home, that\u2019s just the bottom line,\u201d McMaughan says. \u200b\u201c<\/span>But, unfortunately,\n in the U.S., as we move people into the community, we don\u2019t have a\u00a0good\n support system in the community for people who need a\u00a0higher level of\u00a0care.\u201d<\/p>\n

The ways long-term care is paid for in the United States \nhave also contributed to the rise of boarding homes. Since Medicare \ngenerally does not cover long-term care, many Americans who end up in \nnursing homes are forced to spend down their life savings on care fees \nbefore they qualify for Medicaid to take over the\u00a0payments.<\/p>\n

Texas\u2019\n refusal to expand Medicaid under the Affordable Care Act has also \ntranslated into some of the country\u2019s harshest requirements for \naccessing Medicaid\u2009\u2014\u2009restricting elderly and disabled applicants\u2019 total \nassets to $2<\/span>,000<\/span>, further shrinking residents\u2019 chances of accessing \naffordable long-term\u00a0care.<\/p>\n

And while some nursing homes operate \n\u200b\u201c<\/span>Medicaid wings,\u201d with fewer amenities and staff and cheaper food, \nMedicaid reimbursements often still fall short of covering the true \ncosts of housing, food and care for each resident. In Texas, this has resulted in the loss of more than 3<\/span>,200<\/span> Medicaid beds in the past five\u00a0years.<\/p>\n

As nursing homes continue to close, boarding homes seem like a\u00a0natural answer. Harris County, which encompasses the Houston area, has more than 300<\/span> registered homes, potentially representing thousands of beds. But as more low-income Texans are pushed toward boarding homes, they encounter a\u00a0system with almost no\u00a0guardrails.<\/p>\n<\/div>\n

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As nursing homes continue to close, more low-income Texans are pushed toward boarding homes, where they encounter a system with almost no guardrails. \n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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Unlike nursing homes and assisted-living facilities, Texas boarding homes aren\u2019t required to obtain state licensure. And while some cities and counties, like Harris, require boarding homes to apply for local permits\u2009\u2014\u2009a distinct, and far less onerous process than the state licensing nursing homes undergo\u2009\u2014\u2009others do not. In 2009<\/span>, Texas passed a\u00a0law creating model standards for boarding homes, but the adoption of those standards is voluntary for local governments. As a\u00a0result, there are starkly inconsistent legal regimes for boarding homes across\u00a0Texas.<\/p>\n

Some cities, like Dallas, El Paso and San Antonio, adopted the standards; others, like Houston and Austin, created their own regulations; and still others, like Arlington\u2009\u2014\u2009where Becquer ran three of her homes\u2009\u2014\u2009opted not to implement any regulations until this year.<\/p>\n

The patchwork approach provides an easy loophole for boarding home owners seeking to avoid oversight. \u200b\u201c<\/span>People that were operating unscrupulous boarding homes\u201d in communities that had adopted stricter regulations, says Borel, \u200b\u201c<\/span>simply moved outside the city limits to an unregulated\u00a0environment.\u201d<\/p>\n

Then there\u2019s the fundamental mismatch between what boarding homes are legally allowed to do and what many claim to offer. Under Texas law, boarding homes may only offer limited services: providing \u200b\u201c<\/span>light housework, meal preparation, transportation, grocery shopping, money management, laundry services or assistance with self-administration of medication.\u201d They are forbidden from providing \u200b\u201c<\/span>personal care services,\u201d which include helping residents eat, get dressed, get in and out of bed, administer medications or bathe, among other personal\u00a0needs.<\/p>\n<\/div>\n

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Illustration by Jasjyot Singh Hans<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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The idea, according to Borel, was to make opening a\u00a0boarding home relatively easy, to increase the number of low-cost housing options for people with disabilities. But with little public scrutiny or attention from policymakers, some unlicensed boarding homes have been free to operate without pushback, exploiting and endangering vulnerable residents who often have no one to speak on their\u00a0behalf.<\/p>\n

Some boarding homes do operate within the limits of the law. Rebecca \nWalker, who has managed two Houston-area boarding homes for more than 10<\/span>\n years, was among the first to obtain a\u00a0license when Harris County \nimplemented its new regulations in 2022<\/span>. Walker inherited the facilities\n from her mother, who opened her first community-care home in the late \n1980<\/span>s, after Walker\u2019s brother was diagnosed with a\u00a0severe mental health \ncondition, in order to build a\u00a0space in the community where people with \nsimilar conditions could\u00a0live.<\/p>\n

Walker\u2019s facilities cater \nspecifically to people with mental health issues and intellectual \ndisabilities, and before accepting new residents, she always runs an \nevaluation. A\u00a0key requirement is the local regulation that residents \ndon\u2019t require 24<\/span>-hour care and are able to walk, so that they can \nevacuate the premises in the event of an\u00a0emergency.<\/p>\n

Other boarding\n homes, however, advertise themselves as providing a\u00a0much broader range \nof services; some even pose as registered assisted living facilities, \nwhich both provide more extensive services to residents and require state licenses and\u00a0registration.<\/p>\n

This\n basic disconnect\u2009\u2014\u2009between what boarding homes can legally provide and \nwhat many of their residents require\u2009\u2014\u2009should preclude a\u00a0boarding home\u2019s \nability to take in residents with significant medical and personal care needs. But in practice, it does not, and the discrepancy is often at the heart of neglect and abuse\u00a0cases.<\/p>\n<\/div>\n

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In an extensive review of court cases and through interviews with roughly 30<\/span> current and former boarding home residents, family members, lawyers and advocates, In These Times<\/em> and Type Investigations<\/em> found that hospital and rehab facility patients in need of 24<\/span>-hour care have been discharged to boarding homes. In some cases, that has included homes that had been under investigation for years by the Texas Health and Human Services\u00a0Commission.<\/p>\n

In at least two cases, patients were discharged to boarding homes that faced allegations of serious medical neglect from families whose loved ones died while in the homes\u2019 care. Nevertheless, patients were still referred to these\u00a0facilities.<\/p>\n

While some public authorities have raised concerns that hospital discharge managers are incentivized to send patients to boarding homes\u2009\u2014\u2009in 2021<\/span>, during a\u00a0Texas legislative hearing, an official from the Harris County District Attorney\u2019s Office said that hospitals sometimes receive a\u00a0referral fee\u2009\u2014\u2009the motivation may be far more mundane: There is nowhere else for people to\u00a0go.<\/p>\n

The same structural lack of oversight that could expose boarding home residents to inadequate care, neglect and even violence also allows them to have a\u00a0roof over their\u00a0head.<\/p>\n

\u201c<\/span>Generally, people are just happy that the unhoused, people with mental health issues, people with addiction, older adults who don\u2019t have any family\u2009\u2014\u2009they don\u2019t have to worry about them, because they\u2019re in the home,\u201d McMaughan says. \u200b\u201c<\/span>It\u2019s basically any hidden population that nobody really cares about. People who don\u2019t have\u00a0advocates.\u00a0<\/p>\n

\u201c<\/span>Out of sight, out of\u00a0mind.\u201d<\/p>\n<\/div>\n

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Dangerous Conditions, Limited Options<\/div>\n<\/div>\n
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In mid-July 2012<\/span>, Manuel lay alone in a\u00a0dark, narrow bedroom in a\u00a0suburb of Houston, pondering his\u00a0options.\u00a0<\/p>\n

He had been transferred to the boarding home three days earlier. The EMTs took him from an ambulance to a\u00a0room in the back of the house and left him there. No one was around to help him settle in, and when Manuel called out, nobody\u00a0answered.\u00a0<\/p>\n

The house had electricity, but nobody would turn the light on for him, leaving him in the dark. The man working as the home\u2019s caregiver showed up just twice in three days to bring him food and water, before disappearing\u00a0again.<\/p>\n

As the hours ticked by, Manuel felt a\u00a0growing sense of panic: \u200b\u201c<\/span>I need to get out of here,\u201d he thought to himself, \u200b\u201c<\/span>even if I\u00a0have to\u00a0crawl.\u201d<\/p>\n

It was easier said than done. Years earlier, in 1993<\/span>, when Manuel was 19<\/span>, life had seemed full of possibilities. He had traveled to the United States as an undocumented immigrant, hoping to find work and send money home to his parents in Mexico. Soon after arriving, he found a\u00a0job at a\u00a0dollar store in Houston. (Manuel is a\u00a0pseudonym. We are not publishing his real name to protect his identity, given his immigration\u00a0status.)<\/p>\n<\/div>\n

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Two years later, a\u00a0driver ran a\u00a0red light and crashed into the minivan that Manuel was riding in. The impact threw Manuel from the vehicle, and he landed face down on the asphalt, injuring his spinal cord and leaving him with quadriplegia, bound to a\u00a0wheelchair with limited mobility from the neck\u00a0down.<\/p>\n

The accident plunged Manuel into the murky depths of America\u2019s healthcare system, in which rising costs and lack of adequate oversight can leave patients\u2009\u2014\u2009particularly undocumented immigrants without health insurance\u2009\u2014\u2009with few options for care, and vulnerable to exploitation and\u00a0abuse.<\/p>\n

In the initial aftermath of the accident, Manuel spent nearly a\u00a0year between Houston\u2019s Ben Taub Hospital and Quentin Mease Health Center, undergoing treatment for his injuries. Federal law requires hospitals to provide emergency care regardless of a\u00a0patient\u2019s immigration status and health insurance. Eventually, though, the hospital determined that Manuel was stable enough to be discharged, and a\u00a0sympathetic social worker, who also used a\u00a0wheelchair, found him a\u00a0bed in an area nursing\u00a0home.<\/p>\n

In his early twenties, Manuel was far younger than the home\u2019s other residents, but he was grateful to have a\u00a0place to stay. He knew his family in Mexico couldn\u2019t afford to care for\u00a0him.<\/p>\n

But after living in the nursing home for four years, Manuel was suddenly moved to another facility\u2009\u2014\u2009then another, and another. The transfers were sudden. He was unsure why they happened and wasn\u2019t told where he would be taken\u00a0next.<\/p>\n

Manuel\u2019s experience highlights the increasing challenges that undocumented patients face when seeking long-term care, particularly in states like Texas, which have systematically eliminated medical support for undocumented migrants. In 1996<\/span>, the year after Manuel\u2019s accident, Congress passed the Welfare Reform Act that introduced strict work requirements and did away with the so-called PRUCOL doctrine\u2009\u2014\u2009Permanent Residence Under Color of Law\u2009\u2014\u2009which allowed undocumented immigrants to access most federal assistance programs. In the wake of the changes, some states, such as New York and Massachusetts, kept PRUCOL in place. Others, including Texas, abandoned it\u00a0entirely.<\/p>\n<\/div>\n

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Illustration by Jasjyot Singh Hans<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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In 2001<\/span>, the Texas attorney general issued an opinion arguing that public clinics and hospitals could only spend public funds on undocumented immigrants for specific services, such as emergency care, immunizations and the treatment of communicable diseases. Some municipal entities restricted access even further; in 2005<\/span>, Houston\u2019s Harris County Hospital District stopped providing essential medical supplies\u2009\u2014\u2009including wheelchairs and catheters\u2009\u2014\u2009to patients ineligible for Medicaid, including undocumented people like\u00a0Manuel.<\/p>\n

These changes have made access to nursing homes, assisted-living facilities and other forms of long-term care incredibly difficult for undocumented individuals. Consequently, even when undocumented people require 24<\/span>-hour care, boarding homes are often the only facilities that will accept them. Experts say that people like Manuel, who are in the country alone or whose family members cannot advocate for them for fear of retaliation, are often the most vulnerable to abuse and\u00a0neglect.<\/p>\n

By the time Manuel was transferred in July 2012<\/span>, he had lived in eight different facilities\u2009\u2014\u2009seven nursing homes and one boarding home. But the boarding home he arrived at in 2012<\/span> represented a\u00a0new level of\u00a0neglect.<\/p>

Read more The People Fighting Back: Inside Maine\u2019s Immigrant Defense Movement<\/a><\/p>\n

Lying in the bedroom at the back of the home, Manuel was hungry, thirsty and his adult undergarment needed to be changed. All of this posed a\u00a0serious risk to his health: Going days without being cleaned could aggravate his bedsores. Dehydration could lead to a\u00a0severe urinary tract\u00a0infection.<\/p>\n

Much as Angelique Estes would do 11<\/span>\u00a0years later, Manuel decided drastic action was necessary. He called 911<\/span> and told the operator he was having a\u00a0heart attack, then convinced the paramedics who showed up to take him to the emergency room, where he told a\u00a0social worker about the neglect he\u2019d experienced. He was moved to a\u00a0new home.<\/p>\n

Manuel\u2019s case is not an anomaly. Another undocumented boarding home resident, Miguel (a pseudonym to protect his safety), described living for months in a\u00a0home where the bathroom wasn\u2019t fully accessible, and the only way he could shower was to take public transportation to a\u00a0community center 30<\/span>\u00a0minutes\u00a0away.<\/p>\n

For many boarding home residents, neglect isn\u2019t the only hardship they face. In 2024<\/span>, I\u00a0visited Nando (not his real name), an undocumented immigrant from Central America, at another East Texas boarding home, where he had been living for more than a\u00a0year.<\/p>\n<\/div>\n

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Another undocumented resident, Miguel (a pseudonym to protect his safety), lived for months in a boarding home without an accessible bathroom. To bathe, he would take a 30-minute bus ride to the closest community center. Photo by Danielle Villasana<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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From the outside, the single-story bungalow, with its freshly cut lawn, appeared tranquil and inviting, like something out of a\u00a0sitcom. Inside, however, the blinds were drawn and residents were left unsupervised and often unattended. Nando led me to the disheveled backyard, where holes and cracks in the ground made it unsafe for him to navigate his wheelchair. On the way, we passed Nando\u2019s bedroom, where his elderly roommate was sleeping. A\u00a0bench blocked the door, making the entrance impassable. At least six people with various mental and physical disabilities were living in the house. The lone caregiver was nowhere to be seen, and Nando frequently had to wait for hours to be transferred from his wheelchair to his\u00a0bed.<\/p>\n

Still, Nando told me that this was the best boarding home he\u2019d ever lived in. Since 2019<\/span>, he\u2019d cycled through a\u00a0series of facilities, where he said he\u2019d sometimes been humiliated and beaten up. A\u00a0photo from one of his previous homes features his bed: a\u00a0bare plastic pad on top of a\u00a0filthy mattress. Nando had many of his belongings stolen, including his wheelchair, at different homes over the years. In another case, he said, the house manager would leave elderly residents lying on the floor if they fell, and once even threw a\u00a0bag of urine at Nando\u2019s face, injuring his\u00a0eye.<\/p>\n

\u201c<\/span>I just wanted to die because I\u00a0thought, \u200b\u2018<\/span>What\u2019s the use of living a\u00a0life like this, where you\u2019re being mistreated?\u2019\u201d he told\u00a0me.<\/p>\n<\/div>\n

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Abuse can be common in boarding homes, McMaughan says. Sometimes the violence is perpetrated by other residents, including younger residents with intellectual disabilities or violent tendencies, who are put in charge of older adults in the home, McMaughan\u00a0adds.<\/p>\n

Boarding home residents can also be susceptible to financial fraud, according to experts. Diana Aycox, a\u00a0petite woman in her seventies, had grown up in Fort Worth and was well known in her community. She babysat for her neighbors, was active in her local church and had good friends who took an interest in her when she developed\u00a0dementia.<\/p>\n

As Aycox\u2019s illness progressed, however, her friends didn\u2019t know how best to care for her, and she didn\u2019t have any immediate family who could help. So, around early 2021<\/span>, she entered a\u00a0boarding home outside Arlington run by Ireka Hamilton, who also managed several other homes in the area, all unlicensed. (At the time, Arlington did not require boarding homes to be\u00a0licensed.)<\/p>\n

As often happens with residents who have no other family members, Hamilton, in her capacity as boarding home operator, was appointed to manage Aycox\u2019s Social Security benefits. Soon after, Hamilton applied to become Aycox\u2019s legal guardian, claiming Aycox was\u00a0incapacitated.<\/p>\n

In early 2022<\/span>, a\u00a0Tarrant County probate court appointed an investigator to assess Hamilton\u2019s application. During the investigation, Aycox remained in Hamilton\u2019s care. Then, in August 2023<\/span>, property records show that Hamilton bought Aycox\u2019s home. Andrea Casanova, an elder law attorney whom a\u00a0judge appointed as Aycox\u2019s legal guardian two months later, says Aycox didn\u2019t receive any money from the\u00a0sale.<\/p>\n

\u201c<\/span>Diana was supposed to receive the proceeds,\u201d says Casanova. \u200b\u201c<\/span>She never got\u00a0those.\u201d<\/p>\n

Casanova also says that, at the time, Aycox was in no state to make decisions over her\u00a0estate.<\/p>\n

\u201c<\/span>We have all the medical evidence to show she couldn\u2019t have understood what she was doing,\u201d Casanova continues. \u200b\u201c<\/span>So that\u2019s just an instantaneous exploitation scenario.\u201d Soon after becoming her guardian, Casanova removed Aycox from the boarding home and blocked Hamilton from accessing Aycox\u2019s Social Security\u00a0account.<\/p>\n<\/div>\n

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It wasn\u2019t the first time Hamilton had come under scrutiny. In 2013<\/span>, the Texas Department of Aging and Disability Services (DADS)\u2009\u2014\u2009which was absorbed by the Texas Health and Human Services Commission in 2017<\/span>\u2009\u2014\u2009opened an investigation into several boarding homes operated by Hamilton and a\u00a0business partner. When the DADS surveyors visited one facility in Grand Prairie, in July 2013<\/span>, they concluded that Hamilton and her partner were providing services beyond what boarding homes are legally permitted to offer, including administering medication and assisting residents with eating, moving and\u00a0bathing.<\/p>\n

More inspections followed. By the end of October 2013<\/span>, surveyors had visited Hamilton\u2019s boarding homes six times. Each time, DADS found the facilities were offering personal care services that they were not allowed to provide. In 2014<\/span>, in response to the DADS findings, a\u00a0civil court ordered Hamilton and her partner to cease operations and pay $25<\/span>,000<\/span>\u00a0in attorney\u2019s fees and penalties. But they continued\u00a0operating.<\/p>\n<\/div>\n

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Then, in 2020<\/span>, a\u00a0woman named Ella Sanders died of sepsis caused by a\u00a0urinary tract infection while in Hamilton\u2019s care. Sanders\u2019 children filed a\u00a0lawsuit, claiming her death was the result of gross neglect. In the suit, Sanders\u2019 daughter, Cara Jefferson, claimed she removed her mother from Hamilton\u2019s boarding home after finding her \u200b\u201c<\/span>lying on her back in urine and feces because her adult diaper was not changed.\u201d Sanders had developed bedsores from not being moved, and she also had bruises on her arms and legs, according to the lawsuit, which was settled in\u00a02024<\/span>.<\/p>\n

In These Times<\/em> and Type Investigations<\/em> sent detailed questions to Hamilton\u2019s latest known address and reached out via phone and social media, but did not receive a\u00a0response.<\/p>\n

Tanya Winn knew nothing about these allegations when Oasis Senior Advisors, a\u00a0private company that helps families locate senior care facilities, recommended Hamilton\u2019s homes in October 2021<\/span>, presenting them as a \u200b\u201c<\/span>senior living\u00a0community.\u201d<\/p>\n

To Winn, it seemed like the perfect setup for her mother, Ellen Johnston, who had late-stage Parkinson\u2019s and didn\u2019t want to live in a\u00a0large nursing home, as well as for her father, who had recently been diagnosed with dementia. Nobody told Winn that Hamilton\u2019s boarding homes were not subject to the same licensing and regulatory requirements as the nursing homes operating in the\u00a0state.<\/p>\n

Touring the facilities also didn\u2019t set off any immediate red flags. Johnston would be sharing a\u00a0bedroom with another resident, but it was a\u00a0large, clean space with a\u00a0private bathroom. At $1<\/span>,500<\/span> a\u00a0month, it seemed like a\u00a0good deal\u2009\u2014\u2009so much so that Winn also moved her father into another house Hamilton\u00a0ran.<\/p>\n

\u201c<\/span>They showed us this closet where they kept everybody\u2019s medications, they showed us a\u00a0menu,\u201d Winn says. \u200b\u201c<\/span>All of that was\u00a0bullshit.\u201d<\/p>\n

Winn says the alarm bells started going off about 10<\/span>\u00a0days later, when her mother began sending her incoherent, cryptic text messages. Johnston said she had been joking. Today, Winn wonders whether her mother had been given an incorrect dose of medication or had been\u00a0drugged.<\/p>\n<\/div>\n

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Miguel’s bedroom dresser in his current home. PHOTO BY DANIELLE VILLASANA<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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On Thanksgiving, while an employee was helping Johnston\u2019s roommate prepare for a\u00a0family visit, Winn noticed the woman\u2019s hair hadn\u2019t been washed or combed in weeks. \u200b\u201c<\/span>You could see mats on the back of her head,\u201d Winn\u00a0says.<\/p>\n

She relocated her mother to the same house where her father was living, but the problems continued. Her mother began texting her, saying she was hungry. \u200b\u201c<\/span>Are they not feeding you?\u201d Winn would ask. \u200b\u201c<\/span>Yes, but it\u2019s just not enough,\u201d her mother replied. Johnston also developed a\u00a0bedsore, which became a\u00a0crater in her lower back. In late January 2022<\/span>, Johnston called Winn in agony, telling her, \u200b\u201c<\/span>I can\u2019t take it\u00a0anymore.\u201d\u00a0<\/p>\n

Johnston called 911<\/span> and was immediately hospitalized. Soon after, Winn also removed her father from Hamilton\u2019s boarding home. Then, she started digging, and learned about the long list of allegations against Hamilton stretching back more than a\u00a0decade.<\/p>\n

No one at Oasis Senior Advisors had alerted Winn to these allegations when recommending Hamilton\u2019s boarding homes. Oasis Senior Advisors did not respond to requests for comment.\u200b\u201c<\/span>Things could have gone much worse,\u201d Winn says. Her mother and father are both now stable, but nearly four years later, Johnston\u2019s bedsore is still healing, her skin so thin that it opens easily, and Winn is still grappling with the neglect her mother\u00a0experienced.<\/p>\n<\/div>\n

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\u201c<\/span>How did I\u00a0see signs but miss so much?\u201d she\u00a0asks.<\/p>\n

A similar question has haunted Manuel. Initially, after he staged his own rescue via the faked heart attack, Manuel was transferred to a\u00a0better boarding home. But within months, he was moved again, to yet another neglectful home. Food was again scarce, the caretakers again absent and another resident began physically abusing him. He and other residents called the police multiple\u00a0times.<\/p>\n

Thinking back to those days, Manuel wonders why the officers didn\u2019t\u00a0intervene.<\/p>\n

\u201c<\/span>How can the police not see?\u201d he says in Spanish. \u200b\u201c<\/span>I\u2019m telling you, they\u2019re beating up my housemates, we\u2019re alone, we\u2019re bedridden, there\u2019s nobody to take care of us. You don\u2019t know what\u2019s going\u00a0on?\u201d<\/p>\n<\/div>\n

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Patchwork Regulations and Lack of Oversight<\/div>\n<\/div>\n
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Behind this lack of oversight, experts say, is a\u00a0governing system and policy framework that make it almost impossible to crack down on bad actors. No single state agency is responsible for making sure abuses like these don\u2019t happen, and Adult Protective Services, the agency often designated to investigate such abuses, is understaffed and underfunded. Some municipalities, like Dallas and Houston, have established boarding home task forces, but experts say their effectiveness has been\u00a0limited.<\/p>\n

Texas state Sen. Borris Miles saw firsthand how the lack of oversight can lead to neglect and\u00a0abuse.<\/p>\n

One night in September 2020<\/span>, amid a\u00a0torrential downpour, Miles\u2019 phone rang at around 2<\/span>\u00a0a.m. The caller was a\u00a0police constable working in Miles\u2019 district in Harris County, who had been trying to perform a\u00a0wellness check on the residents of a\u00a0house in south Houston, after a\u00a0request by a\u00a0family member of one resident. But nobody was letting him\u00a0in.<\/p>\n<\/div>\n

\n
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In September 2020, Texas state Sen. Borris Miles saw firsthand how the lack of boarding home oversight can lead to neglect and abuse. Illustration by Jasjyot Singh Hans<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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After the call, Miles and his wife got into their truck. The rain was so heavy that some streets were flooded, but when they finally made it to the house, Miles was able to talk to some neighbors, who shared that they thought the house was a\u00a0boarding home.<\/p>\n

Miles started banging on the door. He could hear people inside, but they told him they couldn\u2019t let him\u00a0in.<\/p>\n

\u201c<\/span>They had no access to the locks,\u201d Miles\u00a0says.\u00a0<\/p>\n

Emergency responders broke down the front door and found 37<\/span> people living in a\u00a0three-bedroom house with one functional\u00a0bathroom.<\/p>\n

\u201c<\/span>People were being abused,\u201d Miles says. \u200b\u201c<\/span>Their medical prescriptions were being taken and sold off to other\u00a0individuals.\u201d<\/p>\n<\/div>\n

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Since that night, Miles has become one of the few vocal representatives working to reform boarding home policies in Texas. In 2021<\/span>, at Miles\u2019 urging, the state legislature passed a\u00a0law increasing the penalty for operating an unlicensed boarding home where licensure is required to a\u00a0Class B\u00a0misdemeanor, punishable by up to 180<\/span>\u00a0days in jail and a $2<\/span>,000<\/span>\u00a0fine.<\/p>\n

Advocates say that increasing penalties for boarding home operators is a\u00a0welcome development, but it fails to tackle a\u00a0larger structural issue: the lack of comprehensive state\u00a0regulations.<\/p>\n

Even Miles\u2019 hard-won sanctions are only applicable to those counties and municipalities that require licensure. And stiffer penalties ultimately mean nothing if the agencies responsible for oversight and enforcement don\u2019t have the time or resources to investigate reports of\u00a0abuse.<\/p>\n

\u201c<\/span>The enforcement piece wasn\u2019t there,\u201d says Dennis Borel, former director of the Coalition of Texans with\u00a0Disabilities.\u00a0<\/p>\n

Some believe that reform can come only from public investment in these facilities and regulation encouraging transparency and higher standards. \u200b\u201c<\/span>In order to regulate them to a\u00a0quality level of human habitation, there would have to be state funding,\u201d Borel says. \u200b\u201c<\/span>And they would have to submit to regular inspections and file\u00a0reports.\u201d<\/p>\n

Borel, who worked on Texas\u2019 boarding home legislation more than a\u00a0decade ago during his time with the coalition, says the goal at the time was to develop rules \u200b\u201c<\/span>with a\u00a0light touch.\u201d The reasoning was that, while stricter regulations may increase accountability, they can also drive up costs, making boarding homes inaccessible to a\u00a0large part of the\u00a0population.<\/p>\n<\/div>\n

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Angelique Estes shares an AI image she created. Photo by Danielle Villasana<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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A \n found that, in the absence of safer alternatives, \u200b\u201c<\/span>if local regulators \nrevoke a\u00a0permit for a\u00a0boarding home, it could result in those residents \nexperiencing homelessness and impacting other entities such as state \nhospitals, shelters, and the criminal justice\u00a0system.\u201d<\/p>\n

But \naffordability was not the only reason to keep the boarding home \nregulation minimal. This decision was also aimed at protecting \nresidents\u2019 right to choose where they live\u2009\u2014\u2009a right that many people with disabilities have to fight\u00a0for.<\/p>\n

\u201c<\/span>There\u2019s\n a\u00a0certain paternalistic approach in that as well, where we\u2019re saying, \n\u200b\u2018<\/span>Hey, we\u2019re going to choose for you what your living environment looks \nlike,\u2019\u201d McMaughan says. \u200b\u201c<\/span>Sometimes in an effort to protect groups of \npeople who are perceived to be vulnerable or are vulnerable, we remove that ability to assess and take on\u00a0risks.\u201d<\/p>\n

Today, Borel believes stricter regulations are necessary, even if it limits the options available. \u200b\u201c<\/span>I\u2019m thinking, \u200b\u2018<\/span>No more light touch,\u2019\u201d he\u00a0says.<\/p>\n<\/div>\n

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A Growing Landscape of Unsafe Homes<\/div>\n<\/div>\n
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After being rescued from Becquer\u2019s facility, Angelique Estes was briefly transferred to another boarding home and then, ultimately, discharged to a\u00a0nursing home. Here, Estes says she\u2019s enjoying the benefits of quality\u00a0care.<\/p>\n

\u201c<\/span>We do meditation, exercise, improv, trivia, family feud, things like that,\u201d she tells me. \u200b\u201c<\/span>I\u2019ve got physical therapy.\u201d Her health has improved enough that she\u2019s begun using AI programs to create pictures portraying her and her late husband, which she shares with friends on\u00a0Facebook.<\/p>\n

Looking back, Estes is proud of the role she played in getting Becquer arrested and bringing accountability to one corner of the boarding home industry. \u200b\u201c<\/span>I\u2019m the one that actually put her in jail,\u201d she\u00a0says.<\/p>\n

Becquer\u2019s arrest also triggered a\u00a0number of new policies. Following a\u00a02024<\/span> investigative series by journalist Tanya Eiserer at local Dallas news outlet WFAA, in April, the city of Arlington created new regulations for boarding homes, requiring permits, routine inspections and criminal background checks for operators and staff, similar to those adopted by Houston and Harris\u00a0County.<\/p>\n<\/div>\n

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Angelique Estes shares a wedding photo at her Dallas nursing home. After her husband of nearly 30 years died in 2021, Estes’ health rapidly deteriorated, leaving her unable to walk. Photo by Danielle Villasana<\/span>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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In June, Texas passed two new state-level laws. The first upgraded the charge for providing personal care services without being licensed as an assisted living facility from a\u00a0Class B\u00a0misdemeanor to a\u00a0Class A\u00a0misdemeanor, a\u00a0more serious criminal offense. The second prohibits placement agencies from referring clients to unlicensed boarding homes\u2009\u2014\u2009in counties that require licensure or permits\u2009\u2014\u2009unless no other option is available, and it requires that agencies disclose any previous complaints about the boarding homes to potential\u00a0clients.<\/p>\n

While experts believe these laws are encouraging, they still fail to address the systemic nature of the issue: the lack of comprehensive state regulations for boarding homes and the absence of safer long-term care alternatives for lower-income\u00a0individuals.<\/p>\n

Experts point out that more extensive reforms are needed, particularly as they expect a\u00a0surge in the number of uninsured people across the country following the recent cuts to Medicaid\u2009\u2014\u2009the largest provider of long-term care services in the\u00a0country.<\/p>\n

\u201c<\/span>These are the largest cuts to Medicaid in history,\u201d McMaughan says. \u200b\u201c<\/span>People who are accessing home- and community-based care, or maybe they were at a\u00a0waiver program\u2009\u2014\u2009they\u2019re gonna lose that funding and they\u2019re more likely to be in a\u00a0situation where an unlicensed boarding care home is the best\u00a0option.\u201d<\/p>\n

A new survey conducted by the American Health Care Association and the National Center for Assisted Living found that 55<\/span>% of nursing home providers will have to reduce their Medicaid beds in response to funding\u00a0cuts.<\/p>\n

Michael Lepore, associate dean of the College of Nursing at the University of Massachusetts Amherst, says states could also decrease the Medicaid rates that go to nursing homes, leading to more nursing home closures. \u200b\u201c<\/span>That again could lead to an increase of unlicensed care homes,\u201d says\u00a0Lepore.<\/p>\n

Others agree. \u200b\u201c<\/span>There is no doubt in my mind that we are increasing the market for [boarding] homes,\u201d Borel\u00a0says.<\/p>\n<\/div>\n

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Truly tackling the issue of unsafe boarding homes, McMaughan argues, would require a \u200b\u201c<\/span>complete overhaul of the system,\u201d creating more accessible and safe long-term care services, with more stringent regulations. \u200b\u201c<\/span>That\u2019s a\u00a0huge issue with long-term support and services\u2009\u2014\u2009that many of the regulations simply don\u2019t have teeth.\u201d McMaughan adds that cracking down on unsafe boarding homes would require more funding to Adult Protective\u00a0Services.<\/p>\n

\u201c<\/span>If we valued older adults, disabled folks or adults in need of supportive services, then we would fund Adult Protective Services as well,\u201d McMaughan says. The lack of funding is an \u200b\u201c<\/span>indictment of the values of our\u00a0governance.\u201d<\/p>\n

Borel agrees: \u200b\u201c<\/span>There is no interest in safeguarding this population by those in control. If there were, they would do it. [Texas is] not a\u00a0poor state. This is not a\u00a0poor country. If there were a\u00a0true interest in supporting the full range of our citizenry, they would do\u00a0it.\u201d<\/p>\n

The task shouldn\u2019t be impossible. Much of what constitutes safe and dignified care is relatively\u00a0basic.<\/p>\n

In 2019<\/span>, after years of bouncing between boarding homes and hospitals, Manuel was transferred to a\u00a0nursing home in west Houston. When he arrived, the staff fed him and gave him a\u00a0shower\u2009\u2014\u2009something he had not been able to do for more than 10<\/span>\u00a0years, since most of the bathrooms of the boarding homes he lived in were not wheelchair accessible. To Manuel, feeling the water running down his body was like a\u00a0rebirth. He was later transferred to yet another nursing home, on the outskirts of the city. The facility is far from luxurious, but to Manuel, it\u2019s the best place he\u2019s ever\u00a0lived.<\/p>\n

\u201c<\/span>They give you three meals, they give you enough water and they turn you over,\u201d he says. \u200b\u201c<\/span>And when I\u00a0call for them, they\u00a0come.\u201d<\/p>\n

After his long journey through the Texas boarding home system, Manuel is afraid that his current good fortune won\u2019t last and that he\u2019ll eventually be moved again. For now, he says, he\u2019s taking it day by\u00a0day.<\/p>\n

\u201c<\/span>I pray to be here for a\u00a0long time.\u201d<\/p>\n<\/div>\n

\n

This article was produced in partnership with the nonprofit newsroom <\/em>Type Investigations, with support from the Puffin Foundation and the Fund for Investigative Journalism. <\/em>Fact-checking by Arman Deendar and Thomas\u00a0Birmingham.<\/em><\/p>

Read more Don\u2019t Look Away from Cuba<\/a><\/p>\n<\/div>\n<\/div>\n<\/article>\n<\/div>","protected":false},"excerpt":{"rendered":"

As the United States faces the largest healthcare cuts in its history, Texas presents a frightening vision of the future of long-term care.<\/p>\n","protected":false},"author":1,"featured_media":193,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,4],"tags":[],"class_list":["post-204","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-feature","category-investigation"],"yoast_head":"\nNowhere to Go: Inside the Texas Boarding Home System Where Abuse, Neglect and Exploitation are Widespread - Summit Relocation Timess<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/summitrelocationtimess.com\/?p=204\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nowhere to Go: Inside the Texas Boarding Home System Where Abuse, Neglect and Exploitation are Widespread - 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