This article examines change in the composition of the Texas nursing home population between 1990 and 2009 in relation to the changing prevalence of diabetes. Data from the federal Minimum Data Set for Texas for 1999 and 2009 were analyzed for change in proportion of age groups by the Two-Sample Proportion Test. Change by gender within age groups while controlling for race/ethnicity was analyzed by the Cochran–Mantel–Haenszel test. The percentage of nursing home residents aged 50 to 64 years increased from 8% in 1999 to 12% in 2009, and the change was statistically significant for each race/ethnic group and both genders. The percentage reporting diabetes increased among all groups with more pronounced change for minorities. These results point to a need for closer examination of the impacts of changing diabetes prevalence on nursing homes.