Licensing and startup
How to start a home care agency in Texas.
There is no national licence and no universal process. In Texas, home care runs through Health and Human Services under one framework, and the differences that matter come from which services you intend to deliver.
First, work out which provider type you are
Home care
Services in a client private residence. Texas licenses these as Home and Community Support Services Agencies. Most non-medical private-pay agencies fall under the Personal Assistance Services category.
Assisted living
Residential facilities providing housing, meals, and personal care. Licensed and surveyed separately, with Type A and Type B classifications driven by resident mobility and care needs.
Group homes
Requirements vary sharply by the population served. Some operate under HCSSA licensure, others under separate residential or waiver frameworks. Read this first.
The order of operations
The most expensive mistake is doing these out of sequence, because several steps depend on decisions made earlier. Confirm each requirement with HHSC as you go.
- Decide your service mix. This determines your licence category, and your category determines everything downstream, including which policies you need.
- Form the business entity and get the registrations that the application will ask you to evidence.
- Identify your administrator and confirm they meet the qualification requirements for your category. This is a common stumbling block.
- Build your policies and procedures covering the services you listed, and only those services. Policies that do not match the application invite questions.
- Prepare your forms and record systems before you have staff or clients, so files are complete from the first day rather than reconstructed later.
- Complete the HHSC Presurvey Training. The administrator and alternate must finish it before the application is submitted.
- Submit a complete application with fees, and expect requests for additional information.
- Prepare for the initial survey. Your documentation is what gets examined, so a mock audit before the survey is time well spent.
What to have written before you apply
- Policies and procedures matching your service categories, dated and version-controlled
- Personnel file structure with a checklist that enforces sequence
- Client admission packet including service agreement and client rights
- Service plan template and a documented review interval
- Incident log, complaint log, and corrective action register
- Emergency preparedness plan
- A twelve-month calendar for reviews, training, and internal audits
Verify everything. Requirements change and this page is a starting map, not an authority. Confirm current rules, fees, forms, and training requirements directly with Texas Health and Human Services before you rely on any of it.
Where to start
If you have not applied yet, the $147 bundle is the right entry point. If you want every document customized to your agency for you, that is the $1,497 package.
Texas Licensing Starter Bundle
- Texas rule crosswalk and readiness workbook, citing 26 TAC Chapter 558 line by line
- 15 model policies Texas requires, including registry checks and abuse reporting
- Personnel file and client file checklists built from the rules
- HHSC application guide and initial survey prep guide
Complete Texas Home Care System
- 17 standard operating procedures, from intake to emergencies
- 14 printable forms, including incident, complaint and service agreement
- 9 tracking logs for incidents, complaints, training and more
- The Texas Licensing Starter Bundle, with 15 Texas model policies, included
- Editable Microsoft Word files plus PDF copies
- 14-day deployment guide and dashboard
- No renewal fee to keep using what you bought
Done-With-You Setup
- Everything in the $497 system
- A short intake form instead of calls
- Every document customized to your agency within 5 business days
- Written review of your HHSC application file before you submit
- Email support for 30 days
Licensing questions
Do I need a licence to run a non-medical home care agency in Texas?
Generally yes. Personal assistance services delivered in a client home fall under HCSSA licensure through Texas Health and Human Services, regardless of whether clients pay privately. Confirm your specific service mix with HHSC before operating.
How much does a Texas home care licence cost?
The HHSC fee for an initial three-year licence is $2,625. Most new agencies budget $5,000 to $15,000 in total once insurance, setup and early operations are included. Verify current fees directly with HHSC.
How long does it take?
HHSC rules allow up to 45 days to confirm an application is complete, then up to 45 more days to issue the license. An incomplete application restarts part of that clock, so documentation readiness is the part you control. (26 TAC §558.31)
What is pre-survey training?
The administrator and alternate administrator must complete the HHSC Presurvey Training before the license application is submitted. (26 TAC §558.13) It does not count toward the 24 hours of administrator training a first-time administrator needs. (§558.259)
What causes most application delays?
Incomplete or inconsistent documentation. Policies that do not match the services listed on the application, missing administrator qualification evidence, and gaps in required forms are routine causes of requests for more information.
Free Texas survey-prep checklist
One printable page covering the records to check before an HHSC survey.
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ApexCare Governance™ provides operational documentation and educational guidance. It is not a law firm and not a licensed regulatory consultant. It does not provide legal advice, interpret regulations, certify compliance, or guarantee any licensing or inspection outcome. Verify all current requirements directly with Texas Health and Human Services.