ApexCare Governance

Home · Texas

Texas Health and Human Services Commission (HHSC)

Texas HCSSA licensing and the documentation HHSC checks.

Texas licenses home care under one framework regardless of who pays. Here is what applies, what a survey looks at, and where agencies most often get cited.

Licence and authority

Home and Community Support Services Agency (HCSSA)

26 Texas Administrative Code, Chapter 558. More than 6,000 licensed agencies statewide as of 2019.

Survey cadence

An initial survey after you request it, the next within 18 months, then at least every 36 months, plus complaint investigations (§558.501)

Fees and timeline

$2,625 for an initial three-year licence

Up to 45 days to confirm the application is complete, then up to 45 days to issue the license (§558.31). Verify current fees directly with HHSC.

Licence categories

  • Personal Assistance Services (PAS), the category most non-medical private-pay agencies fall under
  • Licensed Home Health Services
  • Licensed and Certified Home Health Services
  • Hospice

Worth knowing before you apply

  • The administrator and alternate must complete the HHSC Presurvey Training before the application is submitted (§558.13).
  • After licensing, you must serve at least one client and request your initial survey within 6 months (§558.521).
  • Assisted living facilities are licensed separately, with Type A and Type B classifications.
  • Payment source does not exempt you. Private-pay agencies are licensed and surveyed the same as others.

Where Texas agencies get cited

  • Incomplete personnel files, particularly checks and training dated after the first shift
  • Incident documentation kept informally rather than in a consistent reviewable log
  • Policies that are out of date or describe services the agency does not deliver
  • No evidence of supervisory review or corrective action follow-up

Based on commonly reported deficiency patterns for private-pay care providers. No specific inspection outcome is guaranteed.

Texas products

Procedures, forms and logs you adapt to your agency, plus Texas licensing guides that cite 26 TAC Chapter 558.

Audit Readiness Toolkit

$47
One-time. Delivered by email in minutes.
  • 40-question audit readiness self-assessment
  • Incident log template
  • Supervisor review workflow
  • 12-month governance calendar
Get the toolkit — $47

Texas Licensing Starter Bundle

$147
One-time. Texas HCSSA specific.
  • 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
Get the bundle — $147

Done-With-You Setup

$1,497
One-time. No calls. Limited to a few agencies each month.
  • 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
Start done-with-you

Texas questions

What is an HCSSA licence?

Home and Community Support Services Agency licensure is how Texas licenses home care. It is governed by Title 26 of the Texas Administrative Code, Chapter 558, and covers categories including Personal Assistance Services, Licensed Home Health, and Hospice.

Do private-pay agencies need it?

Generally yes. Payment source does not exempt an agency from licensure. Confirm your specific service mix with Texas Health and Human Services before operating.

How long does licensing 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)

Free Texas survey-prep checklist

One printable page covering the records to check before an HHSC survey.

Texas care operators only. Unsubscribe any time. Your address is never sold or shared.

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.