Texas HCSSA
What a Texas home care policy manual has to contain.
A Texas surveyor does not read your manual against best practice. They read it against 26 TAC Chapter 558, and at your initial survey they review all agency policies that chapter requires. This page is what that means in practice, area by area, with the rule behind each one.
Rule text checked 21 October 2026.
Why the generic manual is the expensive option
The manuals that come up first when you search are sold as any-state documents at a single price. They are cheaper than writing your own and they look complete. The problem is structural, not cosmetic: a policy earns its place by matching a specific rule, with the right deadline, the right form and the right reporting route. A document written to be true in fifty states says “report promptly in accordance with applicable law.” A Texas document names the clock.
Two places that difference shows up. First, at application: your policies have to match the services you listed, and HHSC sends exactly one notice listing what is wrong, with 30 days to fix it. Second, at the initial survey, where the policy review is explicitly part of what the surveyor does, alongside your client list, your client records and your personnel files. A manual that cannot be mapped to the chapter is a manual you will end up rewriting against a deadline.
This is also the honest limit of what any document set can do. Nobody can sell you a licensing outcome or a clean survey. What you can buy is the part that is knowable in advance, written to the rule, so the work left is operating the agency rather than drafting under pressure.
What the manual has to cover
Grouped the way an agency builds it rather than the order the rules appear in. Section numbers are a starting point for your own reading, not a substitute for it — HHSC publishes a provider letter explaining how to request the current chapter free from the Secretary of State, and a rewrite of the whole chapter is pending.
Client-facing documents
| Client rights, given and explained before services begin | §558.282 |
| Advance directives | §558.283 |
| The service agreement, with the content the rule requires | §558.292 |
| Client list and services | §558.293 |
| Notice on discharge or transfer | §558.295 |
| Client records, their content and retention | §558.301 |
Care delivery and oversight
| Supervision and the service plan | §558.404 |
| Staffing requirements for your category | §558.245 |
| Scope limits: what PAS covers, and the nursing line | §558.2(87)–(88) |
| RN delegation, where you use it | 22 TAC Ch. 225 |
Staff and personnel
| Personnel records, and what has to be in each file | §558.246 |
| Employee misconduct registry and nurse aide registry checks | §558.247 |
| Administrator and alternate administrator qualifications | §558.244 |
| Administrator training: 8 hours before designation, 24 in the first year | §558.259 |
Incidents, complaints and emergencies
| Abuse, neglect and exploitation reporting, with the Texas deadlines | §558.249, §558.250 |
| Complaint intake, investigation and resolution | §558.249 and Ch. 558 complaint rules |
| Emergency preparedness planning | §558.256 |
Licence lifecycle
| Requesting the initial survey on Form 2020 within six months | §558.521 |
| Reporting changes and relocation on Form 2021 | §558.213 |
| Displaying the licence at your place of business | §558.211 |
A policy is not evidence. At survey, a policy that says you review incidents monthly raises the question of where the reviews are. That is why the policies, the forms that capture the work and the logs that show it happened over time have to be built as one set. It is the most common gap we see in agencies that bought a manual and nothing else.
If you have not applied yet, start with how to start a home care agency in Texas and the application checklist. If you are already licensed with a survey coming, the free two-minute governance check names your highest-exposure gap first.
Texas-specific documents, as editable Word files
The $147 bundle is policy-led and built for people who have not applied yet. The $497 system adds the procedures, forms and logs that turn those policies into records a surveyor can read. See real pages from both before you buy.
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 setup plan and library index
- No renewal fee to keep using what you bought
Done-With-You Document Setup
- Everything in the $497 system
- A short intake form instead of calls
- Every document customized to your agency within 5 business days
- A written checklist of the documents HHSC asks for, and which you still need
- Email support for 30 days
Every document cites the Texas rule it comes from. Rule text last checked against 26 TAC Chapter 558 in September 2026. Not affiliated with or approved by Texas HHSC.
Policy manual questions
Can I use a generic multi-state home care policy manual in Texas?
You can buy one, but it will not match what a Texas surveyor reads it against. 26 TAC Chapter 558 requires specific written policies, with Texas deadlines and Texas forms, and the initial survey includes a review of all agency policies required by that chapter. A manual written to cover every state tends to cover none of them precisely enough to evidence compliance.
What does the surveyor actually look at?
At the initial survey, four things: a list of clients receiving or who have received services for each category you are licensed in, the client records for every client admitted before the survey, all agency policies required by 26 TAC Chapter 558, and all personnel records for your employees (26 TAC §558.521(d)). Electronic client records have to be accessible to surveyors during an inspection.
Do I need the policy manual before I apply or before the survey?
Before you apply, in practice. Your policies have to match the services listed on your application, and policies that do not match invite requests for more information — and you only get one deficiency notice, with 30 days to answer it (26 TAC §558.12(d)). Writing them afterwards means writing them under a deadline.
Is a policy manual the same as procedures, forms and logs?
No, and this is where most agencies come unstuck at survey. A policy says what your agency does; a procedure says how; a form captures it; a log proves it happened over time. A surveyor who reads a policy will ask to see the records it produces. Our $147 bundle is policy-led; the $497 system adds the 17 procedures, 14 forms and 9 logs that make the policies evidenceable.
Are the documents editable?
Yes. Everything comes as editable Microsoft Word files plus PDF copies, so you put your agency name, services and service area into them rather than working around a locked template. There is no renewal fee to keep using what you bought.
Will this guarantee I pass a survey?
No, and anyone promising that is selling you something they cannot deliver. Documentation is the part of a survey you control in advance. How you operate, staff and record day to day is the rest, and no document set can guarantee a regulatory outcome.
Rule text and fees checked 21 October 2026. HHSC has proposed a rewrite of 26 TAC Chapter 558 (rule project 22R045, published in the Texas Register on 18 September 2026). It had not been adopted when this page was last checked. Confirm current rules and fees with HHSC before you rely on them.
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.