Editor’s Note: This article was produced and published by In These Times. It is republished here with permission.
Angelique Estes knew her stay would be rough as soon as she arrived at her new home in Arlington, Texas, in early December 2023.
At 53 years old, Estes had learned to read her environment quickly. She’s lived with cerebral palsy all her life, and her health quickly deteriorated after her husband of nearly 30 years 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—like thousands of Texans in similar circumstances—turned to group homes as a low-cost alternative to the nursing home she couldn’t afford.
By the time she arrived at 1210 Woodbrook Street, a squat, three-bedroom brick house in a quiet suburban neighborhood, she had already cycled through five such boarding homes, none of which had been good. As she took in the tight hallways—so narrow that her ambulance gurney couldn’t fit through—she sensed this time was no better.
“That’s when I started to feel suspicious,” she recalls. But she hadn’t anticipated how much worse it could be.
Estes was taken to a room and placed on a bed. 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 new drug she hadn’t been prescribed—a 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 alone.
“When I realized I wasn’t going to be allowed to leave, I slid onto the floor, thinking they would have to call an ambulance to help me up,” she remembers. “They didn’t.”
Instead, her caregivers pulled her onto a mattress 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—another attempt to compel someone to call an ambulance that could take her away. But nobody called for help.
Finally, five days after she arrived, the message she’d been trying to send to a friend—“I’m being held against my will”—went through. The friend called 911.
As it happened, 1210 Woodbrook Street was already familiar to Arlington law enforcement. Nearly three weeks prior, on Nov. 20, 2023, police officers were dispatched to the house after another resident, an elderly man with significant physical disabilities, had fallen in the backyard. A neighbor found him lying on the ground and called 911.
According to police records, officers interviewed the facility owner, Regla Becquer—who operated five unlicensed, Dallas-area boarding homes for disabled and elderly people, under the name Love and Caring for People LLC—and the fire marshal conducted a house assessment but found no violation.
On Dec. 13, when police officers arrived in response to the call from Estes’ 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, “Yes! Get me out of here!”
Police opened an investigation into the house on Woodbrook Street and Becquer’s 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 resident unable to walk had no access to his wheelchair and had scars “from crawling around,” as Arlington Police Lt. Kimberly Harris later told reporters.
In February 2024, 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’t be the last.
At the time of Becquer’s arrest, Arlington police were investigating 13 cases of residents at Becquer’s homes who had died over the previous year and a half, including at least three instances in which Becquer had taken ownership of her late residents’ property. One of them was 61-year-old Karen Walker, who left Becquer as the sole executor of her estate—including the house on Woodbrook Street—when she died in 2022. Another was 59-year-old Steven Kelly Pankratz, who had moved into one of Becquer’s homes in October 2022 and died there 15 months later.
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’s attorney, Dan Moore—representing him in an unrelated personal injury case—and Moore’s office manager, Janet Jackson, recounted in an interview how Pankratz missed a number of doctor’s appointments while under Becquer’s care and that, when they called to speak with him, Becquer always listened in the background.
“I’d say, ‘Take me off speaker,’ and he would say, ‘I can’t,’ ” Jackson recalled. “She was holding him pretty much hostage.”
At some point after moving into Becquer’s house, Moore says, Pankratz gave Becquer power of attorney, allowing her access to his finances. A 2024 lawsuit filed by Pankratz’s brother alleged that Becquer used Pankratz’s “medical disorientation” to gain access to his savings and credit, buying a car with his money even though Pankratz couldn’t drive. (Pankratz’s brother declined to speak on the record. The lawsuit is still pending.)
On Jan. 12, 2024, Pankratz died. When local emergency services arrived, Pankratz had been deceased for some time. His brother told police that, when they spoke roughly 12 hours before his passing, Pankratz “sounded disoriented and his speech was slurred.” An autopsy later found a mix of psychotropic medications in Pankratz’s system that he’d never been prescribed. The Tarrant County medical examiner ruled his death a homicide, and Becquer was charged with murder. Arlington police said his death was just “the tip of the iceberg.”
Becquer’s 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, 2026, and there is no plea on record.
As of this November, Arlington police told In These Times and Type Investigations in a statement that they had identified “at least 20 clients who died between September 2022 and February 2024 after staying in one of [Becquer’s] homes.” “To date, Mr. Pankratz’s death is the only client death we have filed charges in connection to,” police said. “The case has been turned over to the Tarrant County District Attorney’s Office.”
By June 2024, the story became national news. But tabloid-esque “true crime” headlines about the “Killer Caretaker” in Texas don’t convey the depth of the horror of the case: Becquer’s homes represent the tragic culmination of a systemic policy failure, wherein Pankratz’s and Estes’ alleged experiences are just two extreme examples of a much larger problem.
The facilities Becquer ran all fall under the rubric of “boarding homes”: a term that in Texas refers to group homes for elderly or disabled people, based in private individuals’ residences, that provide housing, food and varying levels of support, and which frequently operate with little to no oversight.
On their surface, the homes seem like a potentially good solution to complex social problems. As a low-cost, community-based model, boarding homes, which typically cost residents around $1,400 per month—compared with a median cost ranging between $5,475 and $7,087 per month for a nursing home bed—are often the only option for those who can’t afford a private nursing home or don’t 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 million people, including many of Texas’ roughly 2.1 million undocumented immigrants; and two, that the state’s low Medicaid reimbursement rates have contributed to the closure of 84 nursing homes in the past five years and the loss of thousands of long-term care beds.
In this vacuum of care, boarding homes can fill a crucial 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 boarding 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 “unlicensed” homes like Becquer’s is legal in some areas.
The results are grim. Combing through local news coverage, In These Times and Type Investigations found that, between 2020 and 2025, first responders found at least 100 vulnerable people without proper care, including food and medication, in Texas boarding homes. Many had to be hospitalized; some died. In July 2023, a 75-year-old resident of one boarding home near Houston landed in the intensive care unit after one of his caregivers beat him. A few months later, nine people were found injured and malnourished in another Houston-area home.
While the Becquer case recently triggered a handful 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 greater risk of abuse and neglect in states with higher poverty rates, lower levels of Medicaid access and a tendency to embrace deregulation, experts say. Often, that means the South, according to DJ McMaughan, a public health professor at Oklahoma State University who studied Texas’ boarding home system.
But the problem is far from limited to Southern states, McMaughan notes: “Hawaii’s had issues, New York’s had issues, Pennsylvania’s had issues.”
And as the United States faces the largest healthcare cuts in its history—set to strip $500 billion from Medicare and $1 trillion from Medicaid over the next nine years, leaving a projected 16 million people without coverage and possibly closing some 600 nursing homes nationwide—Texas’ boarding home model could represent a painful preview of things to come. Experts anticipate that the cuts will drive more people to boarding homes and other makeshift solutions.
“More people are going to be funneled into the unlicensed [boarding home] and care system,” McMaughan says. “And maybe not even directly, [but] through ending up on the streets or in the hospital and being discharged into an unlicensed boarding home.”
It’s a frightening vision of the future of long-term care in America. Dennis Borel, former executive director of the Coalition of Texans with Disabilities, a local advocacy group, puts it this way: Boarding homes are often “the worst possible place you can live” short of sleeping “under the bridge.”
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 dignified.
In 1999, the Supreme Court’s landmark decision in Olmstead v. L.C.—a case brought by two Georgia women, Lois Curtis and Elaine Wilson, who sought to be transferred out of the psychiatric hospital they lived in—led to a revolution in community-based care. The women’s doctors believed deinstitutionalization would benefit the women, but lack of funding prevented their transition to a community setting. The court found this refusal amounted to segregating Curtis and Wilson from the broader community, constituting unlawful discrimination and a violation of the Americans with Disabilities Act.
The decision was hailed as a major victory for disability rights as well as a deinstitutionalization movement that, fueled by continuous reports of isolation and abuse in large institutions, had been advocating for decades to reintegrate people with mental illnesses and developmental disabilities into community settings. In its aftermath, dozens of institutions were closed across the nation. But no cohesive plan was made to ensure alternative forms of care were adequate and safe.
The United States lacks comprehensive federal regulations for residential care facilities, which are governed at the state level—or, 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 “boarding home” is a “personal care home” in Pennsylvania, and a “board and care home” in California, for example.)
“Nobody wants to live in a nursing home, that’s just the bottom line,” McMaughan says. “But, unfortunately, in the U.S., as we move people into the community, we don’t have a good support system in the community for people who need a higher level of care.”
The ways long-term care is paid for in the United States have also contributed to the rise of boarding homes. Since Medicare generally does not cover long-term care, many Americans who end up in nursing homes are forced to spend down their life savings on care fees before they qualify for Medicaid to take over the payments.
Texas’ refusal to expand Medicaid under the Affordable Care Act has also translated into some of the country’s harshest requirements for accessing Medicaid—restricting elderly and disabled applicants’ total assets to $2,000, further shrinking residents’ chances of accessing affordable long-term care.
And while some nursing homes operate “Medicaid wings,” with fewer amenities and staff and cheaper food, Medicaid reimbursements often still fall short of covering the true costs of housing, food and care for each resident. In Texas, this has resulted in the loss of more than 3,200 Medicaid beds in the past five years.
As nursing homes continue to close, boarding homes seem like a natural answer. Harris County, which encompasses the Houston area, has more than 300 registered homes, potentially representing thousands of beds. But as more low-income Texans are pushed toward boarding homes, they encounter a system with almost no guardrails.
Unlike nursing homes and assisted-living facilities, Texas boarding homes aren’t required to obtain state licensure. And while some cities and counties, like Harris, require boarding homes to apply for local permits—a distinct, and far less onerous process than the state licensing nursing homes undergo—others do not. In 2009, Texas passed a law creating model standards for boarding homes, but the adoption of those standards is voluntary for local governments. As a result, there are starkly inconsistent legal regimes for boarding homes across Texas.
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—where Becquer ran three of her homes—opted not to implement any regulations until this year.
The patchwork approach provides an easy loophole for boarding home owners seeking to avoid oversight. “People that were operating unscrupulous boarding homes” in communities that had adopted stricter regulations, says Borel, “simply moved outside the city limits to an unregulated environment.”
Then there’s 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 “light housework, meal preparation, transportation, grocery shopping, money management, laundry services or assistance with self-administration of medication.” They are forbidden from providing “personal care services,” which include helping residents eat, get dressed, get in and out of bed, administer medications or bathe, among other personal needs.
The idea, according to Borel, was to make opening a boarding 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 behalf.
Some boarding homes do operate within the limits of the law. Rebecca Walker, who has managed two Houston-area boarding homes for more than 10 years, was among the first to obtain a license when Harris County implemented its new regulations in 2022. Walker inherited the facilities from her mother, who opened her first community-care home in the late 1980s, after Walker’s brother was diagnosed with a severe mental health condition, in order to build a space in the community where people with similar conditions could live.
Walker’s facilities cater specifically to people with mental health issues and intellectual disabilities, and before accepting new residents, she always runs an evaluation. A key requirement is the local regulation that residents don’t require 24-hour care and are able to walk, so that they can evacuate the premises in the event of an emergency.
Other boarding homes, however, advertise themselves as providing a much broader range of services; some even pose as registered assisted living facilities, which both provide more extensive services to residents and require state licenses and registration.
This basic disconnect—between what boarding homes can legally provide and what many of their residents require—should preclude a boarding home’s ability 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 cases.
In an extensive review of court cases and through interviews with roughly 30 current and former boarding home residents, family members, lawyers and advocates, In These Times and Type Investigations found that hospital and rehab facility patients in need of 24-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 Commission.
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’ care. Nevertheless, patients were still referred to these facilities.
While some public authorities have raised concerns that hospital discharge managers are incentivized to send patients to boarding homes—in 2021, during a Texas legislative hearing, an official from the Harris County District Attorney’s Office said that hospitals sometimes receive a referral fee—the motivation may be far more mundane:
There is nowhere else for people to go. 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 roof over their head.
“Generally, people are just happy that the unhoused, people with mental health issues, people with addiction, older adults who don’t have any family—they don’t have to worry about them, because they’re in the home,” McMaughan says. “It’s basically any hidden population that nobody really cares about. People who don’t have advocates. Out of sight, out of mind.”
In mid-July 2012, Manuel lay alone in a dark, narrow bedroom in a suburb of Houston, pondering his options.
He had been transferred to the boarding home three days earlier. The EMTs took him from an ambulance to a room 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 answered.
The house had electricity, but nobody would turn the light on for him, leaving him in the dark. The man working as the home’s caregiver showed up just twice in three days to bring him food and water, before disappearing again.
As the hours ticked by, Manuel felt a growing sense of panic: “I need to get out of here,” he thought to himself, “even if I have to crawl.”
It was easier said than done. Years earlier, in 1993, when Manuel was 19, 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 job at a dollar store in Houston. (Manuel is a pseudonym. We are not publishing his real name to protect his identity, given his immigration status.)
Two years later, a driver ran a red 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 wheelchair with limited mobility from the neck down.
The accident plunged Manuel into the murky depths of America’s healthcare system, in which rising costs and lack of adequate oversight can leave patients—particularly undocumented immigrants without health insurance—with few options for care, and vulnerable to exploitation and abuse.
In the initial aftermath of the accident, Manuel spent nearly a year between Houston’s Ben Taub Hospital and Quentin Mease Health Center, undergoing treatment for his injuries. Federal law requires hospitals to provide emergency care regardless of a patient’s immigration status and health insurance. Eventually, though, the hospitaldetermined that Manuel was stable enough to be discharged, and a sympathetic social worker, who also used a wheelchair, found him a bed in an area nursing home.
In his early twenties, Manuel was far younger than the home’s other residents, but he was grateful to have a place to stay. He knew his family in Mexico couldn’t afford to care for him.
But after living in the nursing home for four years, Manuel was suddenly moved to another facility—then another, and another. The transfers were sudden. He was unsure why they happened and wasn’t told where he would be taken next.
Manuel’s 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, the year after Manuel’s accident, Congress passed the Welfare Reform Act that introduced strict work requirements and did away with the so-called PRUCOL doctrine—Permanent Residence Under Color of Law—which 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 entirely.
In 2001, 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, Houston’s Harris County Hospital District stopped providing essential medical supplies—including wheelchairs and catheters—to patients ineligible for Medicaid, including undocumented people like Manuel.
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-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 neglect.
By the time Manuel was transferred in July 2012, he had lived in eight different facilities—seven nursing homes and one boarding home. But the boarding home he arrived at in 2012 represented a new level of neglect.
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 serious risk to his health: Going days without being cleaned could aggravate his bedsores. Dehydration could lead to a severe urinary tract infection.
Much as Angelique Estes would do 11 years later, Manuel decided drastic action was necessary. He called 911 and told the operator he was having a heart attack, then convinced the paramedics who showed up to take him to the emergency room, where he told a social worker about the neglect he’d experienced. He was moved to a new home.
Manuel’s case is not an anomaly. Another undocumented boarding home resident, Miguel (a pseudonym to protect his safety), described living for months in a home where the bathroom wasn’t fully accessible, and the only way he could shower was to take public transportation to a community center 30 minutes away.
For many boarding home residents, neglect isn’t the only hardship they face. In 2024, I visited 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 year.
From the outside, the single-story bungalow, with its freshly cut lawn, appeared tranquil and inviting, like something out of a sitcom. 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’s bedroom, where his elderly roommate was sleeping. A bench 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 bed.
Still, Nando told me that this was the best boarding home he’d ever lived in. Since 2019, he’d cycled through a series of facilities, where he said he’d sometimes been humiliated and beaten up. A photo from one of his previous homes features his bed: a bare plastic pad on top of a filthy 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 bag of urine at Nando’s face, injuring his eye.
“I just wanted to die because I thought, ‘What’s the use of living a life like this, where you’re being mistreated?’ ” he told me.
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 adds.
Boarding home residents can also be susceptible to financial fraud, according to experts. Diana Aycox, a petite 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 dementia.
As Aycox’s illness progressed, however, her friends didn’t know how best to care for her, and she didn’t have any immediate family who could help. So, around early 2021, she entered a boarding 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 licensed.)
As often happens with residents who have no other family members, Hamilton, in her capacity as boarding home operator, was appointed to manage Aycox’s Social Security benefits. Soon after, Hamilton applied to become Aycox’s legal guardian, claiming Aycox was incapacitated.
In early 2022, a Tarrant County probate court appointed an investigator to assess Hamilton’s application. During the investigation, Aycox remained in Hamilton’s care. Then, in August 2023, property records show that Hamilton bought Aycox’s home. Andrea Casanova, an elder law attorney whom a judge appointed as Aycox’s legal guardian two months later, says Aycox didn’t receive any money from the sale.
“Diana was supposed to receive the proceeds,” says Casanova. “She never got those.”
Casanova also says that, at the time, Aycox was in no state to make decisions over her estate.
“We have all the medical evidence to show she couldn’t have understood what she was doing,” Casanova continues. “So that’s just an instantaneous exploitation scenario.” Soon after becoming her guardian, Casanova removed Aycox from the boarding home and blocked Hamilton from accessing Aycox’s Social Security account.
It wasn’t the first time Hamilton had come under scrutiny. In 2013, the Texas Department of Aging and Disability Services (DADS)—which was absorbed by the Texas Health and Human Services Commission in 2017—opened an investigation into several boarding homes operated by Hamilton and a business partner. When the DADS surveyors visited one facility in Grand Prairie, in July 2013, 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 bathing.
More inspections followed. By the end of October 2013, surveyors had visited Hamilton’s boarding homes six times. Each time, DADS found the facilities were offering personal care services that they were not allowed to provide. In 2014, in response to the DADS findings, a civil court ordered Hamilton and her partner to cease operations and pay $25,000 in attorney’s fees and penalties. But they continued operating.
Then, in 2020, a woman named Ella Sanders died of sepsis caused by a urinary tract infection while in Hamilton’s care. Sanders’ children filed a lawsuit, claiming her death was the result of gross neglect. In the suit, Sanders’ daughter, Cara Jefferson, claimed she removed her mother from Hamilton’s boarding home after finding her “lying on her back in urine and feces because her adult diaper was not changed.” 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 2024.
In These Times and Type Investigations sent detailed questions to Hamilton’s latest known address and reached out via phone and social media, but did not receive a response.
Tanya Winn knew nothing about these allegations when Oasis Senior Advisors, a private company that helps families locate senior care facilities, recommended Hamilton’s homes in October 2021, presenting them as a “senior living community.”
To Winn, it seemed like the perfect setup for her mother, Ellen Johnston, who had late-stage Parkinson’s and didn’t want to live in a large nursing home, as well as for her father, who had recently been diagnosed with dementia. Nobody told Winn that Hamilton’s boarding homes were not subject to the same licensing and regulatory requirements as the nursing homes operating in the state.
Touring the facilities also didn’t set off any immediate red flags. Johnston would be sharing a bedroom with another resident, but it was a large, clean space with a private bathroom. At $1,500 a month, it seemed like a good deal—so much so that Winn also moved her father into another house Hamilton ran.
“They showed us this closet where they kept everybody’s medications, they showed us a menu,” Winn says. “All of that was bullshit.”
Winn says the alarm bells started going off about 10 days 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 drugged.
On Thanksgiving, while an employee was helping Johnston’s roommate prepare for a family visit, Winn noticed the woman’s hair hadn’t been washed or combed in weeks. “You could see mats on the back of her head,” Winn says.
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. “Are they not feeding you?” Winn would ask. “Yes, but it’s just not enough,” her mother replied. Johnston also developed a bedsore, which became a crater in her lower back.
In late January 2022, Johnston called Winn in agony, telling her, “I can’t take it anymore.” Johnston called 911 and was immediately hospitalized. Soon after, Winn also removed her father from Hamilton’s boarding home. Then, she started digging, and learned about the long list of allegations against Hamilton stretching back more than a decade.
No one at Oasis Senior Advisors had alerted Winn to these allegations when recommending Hamilton’s boarding homes. Oasis Senior Advisors did not respond to requests for comment.
“Things could have gone much worse,” Winn says. Her mother and father are both now stable, but nearly four years later, Johnston’s bedsore is still healing, her skin so thin that it opens easily, and Winn is still grappling with the neglect her mother experienced.
“How did I see signs but miss so much?” she asks.
A similar question has haunted Manuel. Initially, after he staged his own rescue via the faked heart attack, Manuel was transferred to a better 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 times.
Thinking back to those days, Manuel wonders why the officers didn’t intervene.
“How can the police not see?” he says in Spanish. “I’m telling you, they’re beating up my housemates, we’re alone, we’re bedridden, there’s nobody to take care of us. You don’t know what’s going on?”
Behind this lack of oversight, experts say, is a governing 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’t 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 limited.
Texas state Sen. Borris Miles saw firsthand how the lack of oversight can lead to neglect and abuse.
One night in September 2020, amid a torrential downpour, Miles’ phone rang at around 2 a.m. The caller was a police constable working in Miles’ district in Harris County, who had been trying to perform a wellness check on the residents of a house in south Houston, after a request by a family member of one resident. But nobody was letting him in.
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 boarding home.
Miles started banging on the door. He could hear people inside, but they told him they couldn’t let him in.
“They had no access to the locks,” Miles says.
Emergency responders broke down the front door and found 37 people living in a three-bedroom house with one functional bathroom.
“People were being abused,” Miles says. “Their medical prescriptions were being taken and sold off to other individuals.”
Since that night, Miles has become one of the few vocal representatives working to reform boarding home policies in Texas. In 2021, at Miles’ urging, the state legislature passed a law increasing the penalty for operating an unlicensed boarding home where licensure is required to a Class B misdemeanor, punishable by up to 180 days in jail and a $2,000 fine.
Advocates say that increasing penalties for boarding home operators is a welcome development, but it fails to tackle a larger structural issue: the lack of comprehensive state regulations.
Even Miles’ 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’t have the time or resources to investigate reports of abuse.
“The enforcement piece wasn’t there,” says Dennis Borel, former director of the Coalition of Texans with Disabilities.
Some believe that reform can come only from public investment in these facilities and regulation encouraging transparency and higher standards. “In order to regulate them to a quality level of human habitation, there would have to be state funding,” Borel says. “And they would have to submit to regular inspections and file reports.”
Borel, who worked on Texas’ boarding home legislation more than a decade ago during his time with the coalition, says the goal at the time was to develop rules “with a light touch.” The reasoning was that, while stricter regulations may increase accountability, they can also drive up costs, making boarding homes inaccessible to a large part of the population.
A 2022 report by the Texas Health and Human Services Commission found that, in the absence of safer alternatives, “if local regulators revoke a permit for a boarding home, it could result in those residents experiencing homelessness and impacting other entities such as state hospitals, shelters, and the criminal justice system.”
But affordability was not the only reason to keep the boarding home regulation minimal. This decision was also aimed at protecting residents’ right to choose where they live—a right that many people with disabilities have to fight for.
“There’s a certain paternalistic approach in that as well, where we’re saying, ‘Hey, we’re going to choose for you what your living environment looks like,’ ” McMaughan says. “Sometimes in an effort to protect groups of people who are perceived to be vulnerable or are vulnerable, we remove that ability to assess and take on risks.”
Today, Borel believes stricter regulations are necessary, even if it limits the options available.
“I’m thinking, ‘No more light touch,’ ” he says.
After being rescued from Becquer’s facility, Angelique Estes was briefly transferred to another boarding home and then, ultimately, discharged to a nursing home. Here, Estes says she’s enjoying the benefits of quality care.
“We do meditation, exercise, improv, trivia, family feud, things like that,” she tells me. “I’ve got physical therapy.” Her health has improved enough that she’s begun using AI programs to create pictures portraying her and her late husband, which she shares with friends on Facebook.
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. “I’m the one that actually put her in jail,” she says.
Becquer’s arrest also triggered a number of new policies. Following a 2024 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 County.
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 Class B misdemeanor to a Class A misdemeanor, a more serious criminal offense. The second prohibits placement agencies from referring clients to unlicensed boarding homes—in counties that require licensure or permits—unless no other option is available, and it requires that agencies disclose any previous complaints about the boarding homes to potential clients.
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 individuals.
Experts point out that more extensive reforms are needed, particularly as they expect a surge in the number of uninsured people across the country following the recent cuts to Medicaid—the largest provider of long-term care services in the country.
“These are the largest cuts to Medicaid in history,” McMaughan says. “People who are accessing home- and community-based care, or maybe they were at a waiver program—they’re gonna lose that funding and they’re more likely to be in a situation where an unlicensed boarding care home is the best option.”
A new survey conducted by the American Health Care Association and the National Center for Assisted Living found that 55% of nursing home providers will have to reduce their Medicaid beds in response to funding cuts.
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. “That again could lead to an increase of unlicensed care homes,” says Lepore.
Others agree. “There is no doubt in my mind that we are increasing the market for [boarding] homes,” Borel says.
Truly tackling the issue of unsafe boarding homes, McMaughan argues, would require a “complete overhaul of the system,” creating more accessible and safe long-term care services, with more stringent regulations. “That’s a huge issue with long-term support and services—that many of the regulations simply don’t have teeth.” McMaughan adds that cracking down on unsafe boarding homes would require more funding to Adult Protective Services.
“If we valued older adults, disabled folks or adults in need of supportive services, then we would fund Adult Protective Services as well,” McMaughan says. The lack of funding is an “indictment of the values of our governance.”
Borel agrees: “There is no interest in safeguarding this population by those in control. If there were, they would do it. [Texas is] not a poor state. This is not a poor country. If there were a true interest in supporting the full range of our citizenry, they would do it.”
The task shouldn’t be impossible. Much of what constitutes safe and dignified care is relatively basic.
In 2019, after years of bouncing between boarding homes and hospitals, Manuel was transferred to a nursing home in west Houston. When he arrived, the staff fed him and gave him a shower—something he had not been able to do for more than 10 years, 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 rebirth. 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’s the best place he’s ever lived.
“They give you three meals, they give you enough water and they turn you over,” he says. “And when I call for them, they come.”
After his long journey through the Texas boarding home system, Manuel is afraid that his current good fortune won’t last and that he’ll eventually be moved again. For now, he says, he’s taking it day by day.
“I pray to be here for a long time.”
This article was produced in partnership with the nonprofit newsroom Type Investigations, with support from the Puffin Foundation and the Fund for Investigative Journalism. Fact-checking by Arman Deendar and Thomas Birmingham.
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